The Role of Pain in the Recovery of Instrumental and Social Functioning After Hip Fracture

Abstract

Objective: It is critical to identify modifiable factors associated with functional recovery from hip fracture. The authors examined the association between pain intensity and two functional endpoints—instrumental activities of daily living and social activity participation—after hip fracture. Method: A total of 270 cognitively intact, community-dwelling persons older than 65 who underwent surgical hip fracture repair in New Haven, Connecticut, were followed for 12 months. Results: Pain intensity was strongly negatively associated with both instrumental and social functioning ( p values < .001). Increases in pain intensity between 6 and 12 months were also associated with concurrent decreases in function ( p values < .001). These relationships were partly explained by depressive symptoms and a marker of physical ability—gait speed. Discussion: Interventions to control pain may enhance functional status after hip fracture; however, pain relief must be maintained to sustain recovery. Attention to the complex relationships among pain, depressive symptoms, and physical impairments should inform intervention development.