Life-Style Medicine for Chronic Musculoskeletal Pain in Older People

Life-Style Medicine for Chronic Musculoskeletal Pain in Older People: A Pragmatic, Randomized Controlled Clinical Trial

The goal of this clinical trial is to determine the clinical effectiveness of lifestyle medicine in reducing chronic musculoskeletal pain in older adults, as measured by pain intensity, pain interference, self-management efficacy, stress level, sleep quality, healthier diet, better quality of life, and cost-effectiveness, compared to a waitlist control group.

Participants will be randomly assigned to either the intervention or the waitlist group. The intervention group will meet the health coach face-to-face for four sessions to negotiate and set personalized health goals. The waitlist control group will continue to receive usual care without any additional intervention for 24 weeks. Both groups will complete three assessments: at the start of the study, one month after the intervention, and three months after the intervention. The waitlist control group will be offered the same intervention after completing the study.

Inclusion Criteria:

• chronic musculoskeletal pain, defined as pain that lasted for more than 3 months persistently or intermittently, including regional pain (joints, limbs, back, and/or neck)
• a degenerative joint condition, such as osteoarthritis, and/or musculoskeletal complaints that fall under the classification of the International Classification of Disease-11 as "chronic primary musculoskeletal pain" or "chronic secondary musculoskeletal pain"
• Pain intensity score ≥ 4 on a numerical rating scale of 10
• stable baseline physical activity
• ability to understand written and verbal Chinese

Exclusion Criteria:

• patient with cancer-related pain
• inflammatory rheumatic disease
• a recent history of stroke or major surgery in the past 6 months
• terminal illness
• serious mental illness
• severe or uncontrolled heart disease
• comorbid conditions that might impede active participation in the study