Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2021; 9(17): 4441-4452
Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4441
Effectiveness of patient education focusing on circadian pain rhythms: A case report and review of literature
Yoichi Tanaka, Gosuke Sato, Ryota Imai, Michihiro Osumi, Hayato Shigetoh, Ren Fujii, Shu Morioka
Yoichi Tanaka, Hayato Shigetoh, Ren Fujii, Shu Morioka, Graduate School of Health Sciences, Kio University, Kitakatsuragi-gun 635-0832, Nara, Japan
Yoichi Tanaka, Department of Rehabilitation, Nara Prefecture General Rehabilitation Center, Shiki Gun Tawaramoto Cho 636-0345, Nara, Japan
Gosuke Sato, Michihiro Osumi, Shu Morioka, Neuro Rehabilitation Research Center, Kio University, Kitakatsuragi-gun 635-0832, Nara, Japan
Ryota Imai, Department of Rehabilitation, Osaka Kawasaki Rehabilitation University, Kaizuka Shi 597-0104, Osaka, Japan
Author contributions: Tanaka Y and Morioka S conceptualized the study; Tanaka Y, Shigetoh H and Fujii R reviewed the literature and contributed to manuscript drafting; Sato G, Imai R and Morioka S were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yoichi Tanaka, MSc, Research Fellow, Graduate School of Health Sciences, Kio University, 4-2-2 Umaminaka, Koryo, Kitakatsuragi-gun 635-0832, Nara, Japan. kempt_24am@yahoo.co.jp
Received: February 12, 2021
Peer-review started: February 12, 2021
First decision: March 25, 2021
Revised: April 5, 2021
Accepted: April 22, 2021
Article in press: April 22, 2021
Published online: June 16, 2021
Processing time: 103 Days and 2.5 Hours
Abstract
BACKGROUND

Neuropathic pain management should aim at improving quality of life and daily living activities of patients; therefore, emphasis should be placed on pain management including understanding the pain patterns during daily activity. Therefore, lifestyle guidance should be based on a detailed understanding of pain; however, previous studies commonly evaluated pain intensity at a single point in time. We report a case on patient education intervention based on the relationship between pain circadian rhythms and detailed physical activity during the day.

CASE SUMMARY

A man in his 60s, who suffered a brachial plexus injury in a traffic accident, presented with neuropathic pain. Early assessment of the importance of daily living activities to the patient, pain rhythmicity, and physical activity, was performed. The early assessments showed that the pain intensity was lower on days when more light-intensity physical activity (LIPA) was performed, than on days when less LIPA was performed. Consequently, patient education focused on methods to decrease the pain intensity that tended to worsen in the afternoon, and encouraged behavioral changes by suggesting the patient to take walks,” which could be used to maintain LIPA in the afternoon. On reassessment, the afternoon LIPA, which had been the focus of attention, had increased and a change was noted in the circadian rhythm of pain.

CONCLUSION

Patient education based on a composite assessment elicited positive results in relation to the pain circadian rhythm and physical activity.

Keywords: Circadian rhythms; Physical activity; Neuropathic pain; Pain management; Patient education; Case report

Core Tip: A thorough understanding of circadian pain rhythms can facilitate adjustments to patients’ lifestyle for better management of neuropathic pain. We evaluated the circadian pain rhythms and physical activity of a patient in his 60s. Based on the results of this evaluation, we provided pain neurophysiology education to the patient. We also discussed with him the relationship between his pain rhythmicity and physical activity and encouraged smooth behavioral changes for pain management by learning the importance of different types of daily life activities through dialogue.