Self-Reported Non-Pharmacological Treatments Differ between Clusters of Orofacial Pain Patients

Objectives: The aim of the study is to investigate the differences in self-reported non-pharmacological treatments between three clusters of patients suffering from orofacial pain: the adaptive, the pain sensitive and the global symptoms clusters. We hypothesize that patients belonging to the global-symptoms cluster will report a greater number of non-pharmacological treatments compared to the other clusters.
Methods: This is a cross-sectional study of patients suffering from orofacial pain who sought treatment at non-opioid prescribing chronic pain clinic between 03/01/2017 and 10/03/2019. Patients at this clinic are systematically assigned to one of the 3 clusters (adaptive, pain sensitive, global-symptoms), and they complete a series of surveys that include their experience regarding 25 non-pharmacological treatments. Data on the modality and the number of non-pharmacological treatments (such as physical-therapy, acupuncture) were collected and analyzed to describe the differences between the clusters. Parametric and non-parametric tests were used for data analysis. Statistical significance was set at 0.05 and power at 0.80. Patients gave their written consent to participate in the study. IRB number Pro00077946.
Results: A total of 310 patients were included in the study. The adaptive cluster accounted for 44% of patients, followed by the pain sensitive, 31%, and global symptom, 25%, clusters (P<0.001). Non-pharmacological treatments were reported by 248 patients (80%). The global-symptom cluster had the highest number of participants endorsing non-pharmacological treatments, followed by the pain sensitive and adaptive cluster (92%, 82% and 71% respectively; P<0.001). The median numbers of non-pharmacological treatment reported by the adaptive, pain sensitive and global-symptoms clusters were: 2(IQR-5), 2(IQR-5), and 5(IQR-5), P<0.001, respectively. Ice/heat (58%), mouth-appliance (53%), massage (43%) and physical-therapy (40%) were the most common non-pharmacological treatments reported.
Conclusions: In patients suffering from orofacial pain, non-pharmacological treatments are commonly reported, however their endorsement is different between the adaptive, pain sensitive and global-symptoms cluster. Non-pharmacological treatments are more prevalent in the global symptoms cluster.