Effects of pain duration on psychosocial adjustment in orthopedic patients: the importance of early diagnosis and treatment of pain.

Six hundred thirty-five orthopedic patients who were consecutively referred to an outpatient pain assessment service were grouped into one of five pain-duration categories: 0-3 mo, 4-6 mo, 7-9 mo, 9-12 mo, and more than 12 mo. Comprehensive psychosocial assessment of the patients revealed that longer pain-duration patients are older, complain of greater body surface in pain, have had more surgery, have been out of work longer, report taking more pain medication, have been married more times, are more likely to be involved in worker's compensation, and report a greater likelihood of current suicidal ideation. In addition, patients with longer pain duration showed higher pain intensity and sensitivity, less confidence in coping ability, higher dependency traits, and greater reliability of self-report. Finally, longer pain duration was associated with reports of more symptoms of psychopathologic disturbance, especially in patients with pain durations from 9 to 12 mo. Because the data presented are correlation in nature, prospective analysis of the psychosocial adjustment of orthopedic pain patients is suggested.