Lifestyle changes are burdensome with my body broken by pain and obesity: patients' perspectives after pain rehabilitation

Elin Storm; Nina Bendelin; Kim Bergström Wessman; Maria M Johansson; Mathilda Björk; Huan-Ji Dong

doi:10.1186/s12891-023-06961-2

Lifestyle changes are burdensome with my body broken by pain and obesity: patients' perspectives after pain rehabilitation

BMC Musculoskelet Disord. 2023 Oct 25;24(1):840. doi: 10.1186/s12891-023-06961-2.

Authors

Elin Storm¹, Nina Bendelin¹, Kim Bergström Wessman¹, Maria M Johansson², Mathilda Björk¹, Huan-Ji Dong³

Affiliations

¹ Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
² Department of Activity and Health in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
³ Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. huanji.dong@liu.se.

Abstract

Background: Despite the existing evidence regarding the interrelated relationship between pain and obesity, knowledge about patients' perspectives of this relationship is scarce, especially from patients with chronic pain and obesity after completing Interdisciplinary Pain Rehabilitation Program (IPRP).

Aims: This qualitative study expands the understanding of patients' perspectives on how chronic pain and obesity influence each other and how the two conditions affect the ability to make lifestyle changes.

Method: A purposive sample of patients with Body Mass Index (BMI) ≥ 30 kg/m² and who had completed an IPRP were recruited for individual semi-structured interviews. The transcribed interviews were analysed using latent content analysis and a pattern of theme and categories was constructed based on the participants' perspectives.

Results: Sixteen patients (aged 28-63 years, 11 female, BMI 30-43 kg/m²) shared their experiences of chronic pain, obesity and lifestyle changes after IPRP. The analysis revealed one overall theme (lifestyle changes are burdensome with a body broken by both pain and obesity) and four categories (pain disturbing days and nights worsens weight control, pain-related stress makes lifestyle changes harder, a painful and obese body intertwined with negative emotions and the overlooked impact of obesity on chronic pain). Most participants perceived that their pain negatively impacted their obesity, but they were uncertain whether their obesity negatively impacted their pain. Nevertheless, the participants desired and struggled to make lifestyle changes.

Conclusion: After IPRP, patients with chronic pain and obesity perceived difficulties with self-management and struggles with lifestyle changes. They experienced a combined burden of the two conditions. Their perspective on the unilateral relationship between pain and obesity differed from the existing evidence. Future tailored IPRPs should integrate nutritional interventions and address the knowledge gaps as well.

Keywords: Chronic pain; Interdisciplinary Pain Rehabilitation Program (IPRP); Lifestyle; Obesity; Rehabilitation.

MeSH terms

Body Mass Index
Chronic Pain*
Female
Humans
Life Style
Obesity / complications
Pain Management
Qualitative Research