Pain in the rheumatic diseases. Investigation of a key health status component.

The importance of pain in the health status and health behavior of patients with chronic rheumatic disease was evaluated. The Arthritis Impact Measurement Scales were used to estimate physical disability, psychological status, and pain in a large set of rheumatic disease patients. Explanatory regression models were built to explore the contribution of pain in physician and patient assessments of overall health, medication usage, and changes in health status over time. Results confirm that pain makes a highly significant contribution to explaining both physician and patient overall health assessments (P less than 0.001). Pain is also the most important of the 3 health status components in explaining medication usage (P less than 0.001). Finally, using prospective data, it is shown that current pain, rather than current physical or psychological disability, is the best predictor of subsequent pain (P less than 0.001). Current pain also is most associated with subsequent physical disability (P less than 0.05). These findings confirm the importance of pain in determining the health status and health behavior of individuals with chronic rheumatic disease, and suggest that doctors and other health professionals should continue to solicit and address the patient's complaints of pain.