• Luca Padua, Irene Aprile, Francesca Cecchi, Raffaele Molino Lova, Maria Felice Arezzo, Costanza Pazzaglia, and Don Carlo Gnocchi Pain-Rehab Group.
• Department of Neurosciences, UCSC University, Rome, Italy. lpadua@rm.unicatt.it
• Pain Med. 2012 Jun 1;13(6):769-76.

ObjectiveThe aim of this study was to quantify and characterize pain in patients undergoing lower limb postsurgical orthopedic rehabilitation and to investigate the impact of pain in slowing or interrupting their rehabilitation.DesignThe study was designed as a multicenter cross-sectional study.SettingThe study was set in rehabilitation departments of the Don Gnocchi Foundation.SubjectsThe study subjects were the inpatients attending rehabilitation.InterventionsThere were no interventions used in the study.Outcome MeasuresPain intensity was measured with a numeric rating scale (NRS); pain characteristics were assessed with the McGill Pain Questionnaire and the ID Pain (able to discriminate nociceptive from neuropathic pain). Quality of life (QoL) was measured with the Short Form 36 Health Status Survey. A semi-structured questionnaire on pain occurrence, impact, and management was administered by the physiotherapist in charge of the patients and by the physician.ResultsWe studied 139 patients, 82% of whom complained of at least moderate pain (NRS ≥ 3). According to ID pain, 45.6% patients complained of probable (33.8%) or highly probable (11.8%) neuropathic pain. A higher pain intensity was significantly related to the probability of having neuropathic pain (P < 0.001). Patients with more severe pain reported lower physical and mental QoL scores. In 38.6% of cases, pain interfered with the rehabilitation process, and in 18.5% it was the cause of physical therapy discontinuation.ConclusionsIn light of the high occurrence and intensity of pain in the sample, and of the significant impact on the rehabilitation program, clinicians should pay more attention to pain, especially neuropathic pain, in postsurgical patients. Tailored pain pharmacological therapy could possibly improve patient compliance during the rehabilitation process and enhance long-term outcomes.Wiley Periodicals, Inc.

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