Musculoskeletal pain intensity, catastrophizing predict healthcare utilization, opioid use

Pain intensity and catastrophizing both affect healthcare utilization and costs in patients with musculoskeletal injuries, a recent study has shown.

Researchers enrolled 283 military service members (mean age, 31.85±8.65 years; 92.9 percent male) with musculoskeletal injuries. Participants were made to accomplish a region-specific disability measurement tool, the Pain Catastrophizing Scale (PCS), a numeric pain rating scale, and a body pain diagram. Healthcare cost and utilization, including condition-specific visits and total number of opioid prescriptions, were set as the primary outcome.

Pain intensity was significantly correlated with the number of healthcare visits (β, 0.273, 95 percent confidence interval [CI], 0.034–0.12), while disability was not. Scores on the PCS likewise showed a significant indirect effect on healthcare visits, suggesting that catastrophizing may see partial involvement.

Pain intensity (β, 0.380, 95 percent CI, 0.054–0.706) and disability (β, 0.481, 95 percent CI, 0.072–0.886) were both significantly directly associated with incident opioid use, while pain intensity remained the only factor associated with chronic opioid use (β, 0.366, 95 percent CI, 0.041–0.692). Its effect, however, was indirect. Catastrophizing was not involved in opioid use patterns.

On the other hand, neither pain intensity nor disability predicted total or condition-specific medical costs, while PCS scores did (β, 0.019, 95 percent CI, 0.00–0.041 and β, 0.064, 95 percent CI, 0.011–0.120), albeit only indirectly. Body diagram score showed a similar pattern of effect on accrued costs of care.