Tools for assessing burden, quality of life and caregiver function in chronic musculoskeletal pain contexts: a critical review of questionnaires

Chronic musculoskeletal (MSK) pain is a major cause of disability worldwide and affects not only patients but also their informal caregivers. Caregiving in this context is often associated with significant burden, psychological distress, and reduced quality of life. However, the assessment of caregiver outcomes in MSK pain remains heterogeneous, and it is unclear whether existing questionnaires adequately capture the multidimensional and relational nature of caregiving. This review aimed to identify and critically evaluate the questionnaires used to assess burden, quality of life, and psychosocial outcomes among caregivers of patients with chronic musculoskeletal pain. Methods: The clinical studies we reviewed in our research were identified from the using PubMed, Web of Science, Scopus, Embase, and the Cochrane Library databases. Out the initial 13778 studies, only 7 met inclusion criteria. Results: Most studies reported moderate to high caregiver burden, frequently associated with reduced quality of life, psychological distress, and functional impairment. Caregiver burden was consistently related to patient pain intensity, disability, emotional distress, and maladaptive pain-related cognitions, such as catastrophizing. Although several validated instruments were used (e.g., Zarit Burden Interview, Caregiver Burden Inventory, WHOQOL-BREF), none were specifically designed for caregivers of patients with chronic MSK pain, and key relational and psychological domains were often insufficiently addressed. Conclusions: Caregiving in chronic musculoskeletal pain contexts is associated with substantial burden and impaired well-being. Current assessment tools only partially capture the complexity of the caregiving experience. There is a need for caregiver-specific instruments tailored to chronic MSK pain to support more accurate assessment and dyad-centered interventions.