Different Treatments in Chronic Pain Patients.

Study Overview
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Brief Summary
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The goal of this observational study is to compare different treatment options in a chronic pain population. The main questions it aims to answer are: What is the effectiveness of the different therapy options in the pain center of Sint-Lucas on outcomes related to pain and disability? What are predictive factors for the different therapy options in the pain center of Sint-Lucas? Which factors predict improvement in pain related outcomes? Participant data will be gathered as part of their routine care. They can be advised to 4 different treatment options: Consultations with the pain specialist Interventions by the pain specialist (infiltrations, denervations) Baxter therapy Interdisciplinary treatment Researchers will compare patients with different dominant pain mechanisms to see which treatment are most effective for which dominant pain mechanisms.

Detailed Description
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The aim of the present study is to describe the natural flow of the chronic pain patients at the pain center AZ Sint-Lucas. Patients will be examined before starting the therapy, and receive standardized questionnaires at several fixed time points (before, during, and after their therapy trajectory). Information about the present dominant pain mechanism will be gathered during the examination. The questionnaires will gather demographic data, information about the present dominant pain mechanism, psychosocial factors, catastrophizing, fear and avoidance, illness perceptions, fatigue and information about therapy success. During the examination, typical signs of a dominant nociplastic pain mechanism will be gathered. By processing the data of the questionnaires and the examination, knowledge about (1) the amount of patients with a dominant nociplastic pain mechanism at intake, (2) the treatment trajectory for a specific diagnosis, and (3) the prediction of the therapy effect and prognosis will be obtained.

Official Title
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Research of the Different Treatments for Chronic Pain Patients, Their Effectiveness and Associated Predictors, Offered at the Pain Center AZ Sint-Lucas Ghent.

Conditions
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Chronic Pain, Nociplastic Pain

Intervention / Treatment
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* Other: Consultation
* Procedure: Interventions
* Drug: Baxter therapy
* Behavioral: Interdisciplinary therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adults Chronic pain patients Dutch speaking, or good understanding Exclusion Criteria: Adults unable to give consent Adults who do not understand Dutch

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Chronic pain patients<br>Chronic pain patients with a dominant nociceptive pain mechanism, a dominant neuropathic pain mechanism and a dominant nociplastic pain mechanism. They will receive different treatments: Consultations, Interventions (injections, denervations...), Baxter therapy and interdisciplinary treatment. | Other: Consultation<br>* Consultation with the pain specialist, which might entail prescription of medication of vitamins.<br>Procedure: Interventions<br>* Facet injections, nerve denervations, infiltrations, Qutenza, Spinal Cord Stimulation, Transcutaneous Electrical Nerve Stimulation<br>Drug: Baxter therapy<br>* Ketamine or Linisol baxter therapy<br>Behavioral: Interdisciplinary therapy<br>* Interdisciplinary therapy provided by the physiotherapist, psychologist and occupational therapist.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Pain disability from baseline until 18 months | Pain Disability Index, ranges from zero to 70, with a higher score indicating more pain-related disability | 0 weeks, 4 weeks, 10 weeks, 6 months, 12 months, 18 months | 
| Change in Pain intensity from baseline until 18 months | Numeric Rating Scale for pain intensity in the past week, ranges from zero to 100, with a higher score indicating a higher pain intensity | 0 weeks, 4 weeks, 10 weeks, 6 months, 12 months, 18 months | 
| Change in Pain Frequency from baseline until 18 months | Questions | 0 weeks, 4 weeks, 10 weeks, 6 months, 12 months, 18 months | 
| Change in Functionality from baseline until 18 months | Patient Specific Complaints questionnaire, using a Numeric Rating Scale, ranging from zero to 100, with a higher score indicating a higher amount of functional disability | 0 weeks, 4 weeks, 10 weeks, 6 months, 12 months, 18 months | 
| Change in Quality of Life from baseline until 18 months | EuroQol-5D questionnaire | 0 weeks, 4 weeks, 10 weeks, 6 months, 12 months, 18 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Post exertional malaise from baseline until 18 months | Questions based on the criteria for Chronic Fatigue Syndrome. | 0 weeks, 4 weeks, 10 weeks, 6 months, 12 months, 18 months | 
| Change in Quality of Life from baseline until 18 months | EuroQol - 5D, five questions about health range from one to three with a higher score indicating more difficulties. One question about perceived health ranges from zero to 100 with a higher score indicating better health. | 0 weeks, 4 weeks, 10 weeks, 6 months, 12 months, 18 months |