Unique characteristics of patients who choose an intensive lifestyle medicine program to address chronic musculoskeletal pain.
Abby L Cheng, Katherine V Carbonell, Heidi Prather and 4 others
PMID 35567523WHAT IT FOUND
Self-reported function, pain interference, anxiety, and depression did not meaningfully separate lifestyle program patients from standard non-operative care; they were more racially diverse and had more obesity and diabetes.
Versus surgical patients, they reported worse anxiety but less pain interference.
Key findings
01Patients who enrolled in the intensive lifestyle medicine program were more racially diverse and had higher BMI and diabetes prevalence than standard non-operative or operative musculoskeletal patients: non-white race 34% versus 16-18%, mean BMI 37.6 kg/m2 versus 29.3-32.0 kg/m2, and diabetes 32% versus 12-16%.
02Compared with standard non-operative musculoskeletal patients, lifestyle program patients did not have meaningful age-adjusted differences in self-reported physical or psychological health, and the depression difference did not reach statistical significance.
03Compared with patients evaluated for hip or knee arthroplasty, lifestyle program patients reported worse anxiety and less pain interference after age adjustment and lived in less socially disadvantaged neighborhoods.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a single-center analysis at one academic medical center, so the findings may not apply to other health systems or patient populations. The study was cross-sectional and only compared baseline characteristics; it cannot show that an intensive lifestyle medicine program improves pain, function, or other outcomes. It cannot identify which patients will benefit from or stay engaged with the program, because follow-up outcomes were not analyzed. The lifestyle medicine program included several possible clinicians and services, so any observed patient differences cannot be attributed to one treatment element. Many secondary comparisons were made, so some differences may be chance and need confirmation. Patients with active severe psychiatric illness were excluded, and the lifestyle group was only 50 patients, limiting generalizability. Comparison groups were not matched, and referral patterns or community familiarity with the program may have influenced who enrolled. Missing questionnaire or medical-record data were excluded from analyses.
Declared interests
The supplied text does not include a conflicts-of-interest declaration. The publication types list research support from NIH extramural and non-U.S. government sources.
The easy way to misread this
Do not read this as evidence that an intensive lifestyle medicine program improves musculoskeletal pain or function. It only described characteristics of patients who chose that pathway, and the primary self-reported outcomes did not meaningfully differ from standard non-operative care.