Comparison the Effects of Physical Therapy on Chronic Pain in Active or Sedentary Military Personnel.

Background: Chronic pain (CP) is a debilitating condition in which pain persists for months or years beyond the expected duration seen in normal healing processes. Because of the social and economic burden of CP in military personnel, it is important to ascertain pain-related physical, mental and psychological conditions to improve pain management.

Objective: The aim of the study was to evaluate the effectiveness of the physical therapy in active military personnel (AMP) with CP through self-reported questionnaires.

Methods: Sixty male AMP outpatients suffering from CP were included and divided into two groups according to their exercise levels in daily life (30 patients exercised regularly, while the remaining 30 had a sedentary lifestyle). All participants completed the following forms and questionnaires: Oswestry Disability Index (ODI), Visual Analogue Scale (VAS) for pain, Neck Disability Index (NDI), Neck Bournemouth Questionnaire (NBQ), International Physical Activity Questionnaire (IPAQ), Hospital Anxiety-Depression Index (HADS), 36-item Short Form Survey (SF-36), Automatic Thoughts Questionnaire (ATQ), and Pain Belief Questionnaire (PBQ). Patients were given 10 sessions of a standardized physical therapy program, including hot pack applications, TENS, ultrasound therapy and also home-based physical exercise.

Results: The median age of patients was 22 (min-max: 20-42) years. The HADS and PBQ-psychological scores were high and ATQ scores were low in both groups. After the treatment, ODI and VAS scores decreased in both groups; however, the group comprised of patients that exercised regularly at baseline also demonstrated a significant decrease in NBQ and NDI values.

Conclusion: We showed that three components of pain (physical, cognitive and emotional) are indeed effective on pain intensity and levels of disability. Our study showed that scales related with pain could improve by physical therapy in AMP, and that patients who normally exercised benefitted from physical therapy at a relatively higher degree. Chronic pain needs to be managed in the context of the patient's biological, psychological, social and also occupational characteristics; thus, individualized, patient-specific and multi-factorial treatments should be considered whenever possible.