Relation between socio-economic deprivation and chronic pain-related burden: a cross-sectional evaluation in a secondary care pain rehabilitation clinic
Kevin E Vowles, Katie Witkiewitz, Clearisse Del Rosario, Francis Agnew, Maura Mccarron, Claire Briggs, Danielle Rainey, Jason BrooksIntroduction
Deprivation is an established risk factor for the presence of chronic pain. Less is known about the relation between deprivation and the impact of chronic pain on functioning. The aim of the present study was to evaluate differences in functioning across people with chronic pain based on deprivation and evaluate if the risk of clinically significant disruption increases proportionally with greater deprivation.
Methods
These issues were examined in a cross-sectional analysis of 491 treatment-seeking individuals with chronic pain. Participants completed measures of pain interference, social functioning, depression, anxiety, physical function, sleep disturbance, cognitive functioning, fatigue intensity and pain intensity. Deprivation was quantified using the Northern Ireland Multiple Deprivation Measure, which rank orders all postcodes in the province across seven domains. Three deprivation categories were derived (low, middle and high), which were used to evaluate sample differences in pain-related functioning.
Results
Significant between-group differences were indicated across all measures with the lowest deprivation group reporting higher functioning in relation to the other two groups across most measures. The only exceptions were for depression and anxiety which increased significantly across each level of deprivation. A similar pattern was found when examining clinically significant scores, particularly for social functioning, depression and anxiety.
Conclusion
Deprivation is more than a risk factor for chronic pain. Deprivation is a risk factor for more distressing, disabling and disruptive chronic pain. These findings indicate that redirection of clinical efforts is warranted to allow interventions to more adequately address the complexities of those seeking treatment.