Can four key psychosocial risk factors for chronic pain and disability (Yellow Flags) be modified by a pain management programme?: A pilot study

ObjectivesTo identify the extent to which an adapted pain management programme is successful in modifying pain beliefs, psychological distress, locus of control and self-efficacy using both qualitative and quantitative approaches.DesignProspective, observational study with questionnaires at baseline and following completion of a pain management programme.SettingOutpatient pain management programme in a district general hospital.ParticipantsFifteen participants experiencing chronic pain, referred from pain and rheumatology clinics within the hospital.Outcome measuresPain beliefs, self-efficacy, locus of control and psychological distress.ResultsWilcoxon signed ranks tests demonstrated significant improvements in pain beliefs, self-efficacy and psychological distress. However, changes in locus of control were not found to be significant. The qualitative data supported these findings.ConclusionsThe pilot study suggested that the pain management programme successfully modified three out of four of the psychosocial risk factors (Yellow Flags) in a population with established pain and disability. A larger scale project replicating this pilot study including a comparison group, and further research to assess the extent to which modifying Yellow Flags generalises to affect quality of life and disability, are underway.