Rehabilitation of Chronic Pain in Post-Critical Care Patients. A Narrative Review

Abstract

Chronic pain in post-critical care patients is a multifaceted issue with profound implications for patient well-being and quality of life. This review aims to address the rehabilitation of patients who suffer from chronic pain following discharge from the intensive care unit (ICU). Despite growing awareness of the prevalence and impact of this condition, significant gaps in knowledge persist regarding the optimal rehabilitation strategies for these patients. To conduct this study, an extensive literature search was undertaken, encompassing peer-reviewed articles, clinical trials, and observational studies in Medline, Scopus, and Cinahl databases, using specific keywords. Studies were identified based on their titles, abstracts, and those that met the inclusion criteria. Sixteen studies were eligible for inclusion in this review, varying in methodology, assessment tool, assessment time, or follow-up. The findings of this review illuminate the existing gaps in knowledge by synthesizing evidence on the various rehabilitation approaches employed, their effectiveness, and the factors influencing patient outcomes. So far, healthcare professionals have targeted either pain treatment, finding an analgesic medication or the proper position/exercise, or pain management, helping the patient manage life despite the unrelieved pain. Conventional pain treatment or control has been replaced by pain rehabilitation, in which a biopsychosocial approach enables healthcare professionals to provide patients with the knowledge and skills to manage their pain and disability through personal multidimensional choices. Early rehabilitation programs, quick mobilization, and greater family participation should be encouraged. The strengths of this study lie in its thorough analysis of the available literature and the provision of valuable insights into the heterogeneous nature of chronic pain in post-critical care patients. However, limitations include the limited availability of high-quality randomized controlled trials in this domain. Overall, this review contributes to an improved understanding of rehabilitation strategies for chronic pain in post-critical care patients and underscores the need for further research to enhance patient care and outcomes.