Chronic pain transition: a concept analysis

Abstract

Chronic pain is common, costly, and potentially disabling. According to the Medical Expenditure Panel Survey in 2008, approximately 100 million adults were affected by chronic pain, with national costs estimated between $560 and $635 billion annually. Published point-prevalence estimates of adult onset chronic pain from population-based surveys vary widely, with worldwide estimates ranging from 2% to over 55% and, within the United States, from 14.6% to 64%. Among patients who seek out a health care professional after initial injury, pain, and function typically improve substantially in the first month; however, those who do not improve account for the bulk of individual and economic burden (Slater et al., 2009). This improvement or lack thereof has been linked to prognostic variables deemed responsible for the transition to chronic pain. The purpose of this analysis is to examine the concept of chronic pain transition in the context of adult onset non-cancer chronic pain. Defining the concept of chronic pain transition is essential to the future of pain research, as chronic pain transition has not been researched in the context provided here. Using Rodgers' inductive method of concept analysis, the concept of chronic pain transition was studied. A random sample of nursing, medical, psychology, and allied health literature published between 1982 and 2012 was analyzed to identify a consensual definition of chronic pain transition. The attributes, antecedents, consequences, related concepts, and surrogate terms of chronic pain transition are described, and the implications of the findings for practice and future research are discussed.