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Chronic Low Back Pain: Neuropathic Component and Its Characteristics

Year 2018, Volume: 7 Issue: 3, 48 - 54, 01.09.2018
https://doi.org/10.5505/abantmedj.2018.35467

Abstract

INTRODUCTION: Although chronic low back pain CLBP is not a life-threatening disease, it is characterized with high level of disability and is recognized to have both neuropathic and nonneuropathic origins. The aim of this study was to determine the prevalence of neuropathic pain component by DN4 scale in patients with CLBP and evaluate its relation with clinical and demographic characteristics. METHODS: A total of 224 patients aged between 20-75 years with a history of CLBP were included in the study. The demographic data and lumbar region examinations were recorded. The patients filled out DN4 forms. The patients were evaluated for pain by visual analog scale VAS , for disability by Oswestry Disability Index ODI , for quality of life by SF-36 and for emotional status by Beck Depression Inventory BDI . RESULTS: According to the DN4 scale 55.8 % of the patients had neuropathic pain. Neuropathic component was found to be associated with female gender, radicular pain and sensory deficit. The patients with neuropathic pain had higher VAS, ODI and BDI scores whereas the patients with nociceptive pain had higher scores for all the parameters of the SF-36. DISCUSSION AND CONCLUSION: CLBP cases are generally associated with a neuropathic component. If one differentiates neuropathic pain from non-neuropathic pain, than can reduce the pain, improve the quality of life, and decrease the level of disability and depression.

References

  • William H. Kirkaldy-Willis (editor). Managing low back pain. 2nd ed., 1988.
  • Krismer M, van Tulder M; Low Back Pain Group of the Bone and Joint Health Strategies for Europe Project. Strategies for prevention and management of musculoskeletal conditions. Low Back Pain (non specific). Best Pract Res Clin Rheumatol 2007; 21(1): 77-91.
  • Weiner SS, Nordin M. Prevention and management of chronic low back pain. Best Pract Res Clin Rheumotol 2010; 24(2): 267-79.
  • Moskowitz MH. Pharmacotherapy of neuropathic low back pain. Curr Pain Headache Rep 2003; 7: 178-87.
  • Trede RD, Jensen TS, et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 2008; 70(18): 1630-5.
  • Audette JF, Emenike E, Meleger AL. Neuropathic low back pain. Curr Pain Headache Rep 2005; 9: 168-77.
  • Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J. 2008; 8(1): 8-20.
  • Bouhassira D, Attal N, Alchaar et all. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 2005; 114: 29–36.
  • Bouhassira D, Attal N. Diagnosis and assessment of neuropathic pain: the saga of clinical tools. Pain. 2011; 152(3 Suppl): 74-83.
  • Bouhassira D, Lantéri-Minet M, Attal N, Laurent B, Touboul C. Prevalence of chronic pain with neuropathic characteristics in the general population. Pain. 2008; 136(3): 380-7.
  • Berger A, Toelle T, Sadosky A, Dukes E, Edelsberg J, Oster G. Clinical and economic characteristics of patients with painful neuropathic disorders in Germany. Pain Pract. 2009; 9(1): 8-17.
  • Smith BH, Torrance N, Bennett MI, Lee AJ. Health and quality of life associated with chronic pain of predominantly neuropathic origin in the community. Clin J Pain. 2007; 23(2): 143-9.
  • Mehra M, Hill K, Nicholl D, Schadrack J. The burden of chronic low back pain with and without a neuropathic component: a healthcare resource use and cost analysis. J Med Econ. 2012; 15(2): 245
  • Morlion B. Conference report. The relevance of neuropathic components in chronic back pain. Curr Med Res Opin 2011;27(10):2067–8.
  • Rozenberg S, Foltz V, Fautrel B. Treatment strategy for chronic low back pain. Joint Bone Spine 2012; 79:555-559.
  • Kaki AM, El-Yaski AZ, Youseif E. Identifying neuropathic pain among patients with chronic low-back pain: use of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale. Reg Anesth Pain Med 2005; 30: 422-422.
  • El Sissi W, Arnaout A, Chaarani MW, et all. Prevalence of neuropathic pain among patients with chronic low-back pain in the Arabian Gulf Region assessed using the leeds assessment of neuropathic symptoms and signs pain scale. J Int Med Res. 2010; 38(6): 2135-45.
  • Freynhagen R, Baron R, et al. Pain-DETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin 2006; 22: 1-10.
  • Quedraogo DD, Nonquierma V, Napon C et all. Prevalence of neuropathic pain among black African patients suffering from common low back pain. Rheumatol Int. 2012;32(7):2149-53.
  • Isaac Z, Katz JN, Borenstein DG. Lumbar spine disorders. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt M, Weisman MH. Rheumatology. Philadelphia: Mosby Elsevier, 2008: 593-618.
  • Hassan AE, Saleh HA, Baroudy YM et al. Prevelance of neuropathic pain among patients suffering from chronic low back pain in Saudi Arabia. Saudi Med J. 2004; 25(12): 1986-90.
  • Freynhagen R, Baron R, Tölle T, et al. Screening of neuropathic pain components in patients with chronic back pain associated with nerve root compression: a pilot prospective observational study (MIPORT). Curr Med Res Opin 2006; 22: 529-37.
  • Freynhagen R, BaronR. The evaluation of neuropathic components in low back pain. Curr Pain Headache Rep. 2009; 13(3): 185-90.
  • Attal N, Perrot S, Fermanian J et all. The neuropathic components of chronic low back pain: a prospective multicenter study using the DN4 Questionnaire. J Pain. 2011; 12(10): 1080-7.
  • Beith ID, Kemp A, Kenyon J et all. Identifying neuropathic back and leg pain: a cross-sectional study. Pain. 2011; 152(7): 1511-6.
  • Schiltenwolf M, Akbar M, Freynhagen R et al. Pseudoradicular and radicular low back pain--a disease continuum rather than different entities? Answers from quantitative sensory testing. Pain 2008; 135: 65-74.
  • Finnerup NB, Otto M, McQuay HJ et all. Algorithm for neuropathic pain treatment: an evidence based proposal. Pain. 2005; 118(3): 289-305.
  • Serpell MG; Neuropathic pain study group. Gabapentin in neuropathic pain syndromes: a randomised, double-blind, placebo-controlled trial. Pain. 2002; 99(3): 557-66.
  • Romano CL, Romano D, Bonora C, Mineo G. Pregabalin, celecoxib, and their combination for treatment low back pain: J Orthop Traumatol. 2009; 10 (4): 185-191.
  • Unal-Cevik I, Sarioglu-Ay S, Evcik D. A comparison of the DN4 and LANSS questionnaires in the assessment of neuropathic pain: validity and reliability of the Turkish version of DN4. J Pain. 2010; 11(11): 1129-35.

Kronik Bel Ağrısı: Nöropatik Ağrı ve Özellikleri

Year 2018, Volume: 7 Issue: 3, 48 - 54, 01.09.2018
https://doi.org/10.5505/abantmedj.2018.35467

Abstract

GİRİŞ ve AMAÇ: Kronik bel ağrısı hayatı tehdit eden bir hastalık olmamakla birlikte ciddi dizabiliteye neden olabilmektedir. Kronik bel ağrısı nöropatik veya nosiseptif kaynaklı olabilmektedir. Bu çalışmanın amacı kronik bel ağrılı hastalarda DN4 skalasıyla nöropatik ağrıyı saptamak; klinik ve demografik özelliklerini belirlemektir. YÖNTEM ve GEREÇLER: Çalışmaya 20-75 yaş arası kronik bel ağrılı 224 hasta dahil edildi. Hastaların lomber bölge muayeneleri yapılıp demografik özellikleri kaydedildi. Bütün hastalar DN4 skalasını doldurdular. Ağrı için görsel analog skala VAS , dizabilite için Oswestry Dizabilite İndeksi ODİ , yaşam kalitesi için SF-36, ve duygusal durum için Beck Depresyon İndeksi BDİ kullanıldı.BULGULAR: DN4 skalasına göre hastaların %55, 8’inde nöropatik ağrı bulunmaktaydı. Nöropatik ağrı sıklığı kadın cinsiyetle, radiküler ağrıyla ve duyu kaybıyla artmaktaydı. Nöropatik ağrılı hastaların VAS, ODİ ve BDİ puanları daha yüksekken, nosiseptif ağrılı hastaların SF-36 puanları tüm parametrelerde daha yüksek bulundu.TARTIŞMA ve SONUÇ: Kronik bel ağrılı olgularda çoğunlukla nöropatik ağrı da vardır. Eğer hasta nöropatik ağrıyı iyi tanımlayabilirse ağrı daha iyi dindirilebilir, yaşam kalitesi arttırabilir, depresyon ve dizabilite düzeyi azaltılabilir.

References

  • William H. Kirkaldy-Willis (editor). Managing low back pain. 2nd ed., 1988.
  • Krismer M, van Tulder M; Low Back Pain Group of the Bone and Joint Health Strategies for Europe Project. Strategies for prevention and management of musculoskeletal conditions. Low Back Pain (non specific). Best Pract Res Clin Rheumatol 2007; 21(1): 77-91.
  • Weiner SS, Nordin M. Prevention and management of chronic low back pain. Best Pract Res Clin Rheumotol 2010; 24(2): 267-79.
  • Moskowitz MH. Pharmacotherapy of neuropathic low back pain. Curr Pain Headache Rep 2003; 7: 178-87.
  • Trede RD, Jensen TS, et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 2008; 70(18): 1630-5.
  • Audette JF, Emenike E, Meleger AL. Neuropathic low back pain. Curr Pain Headache Rep 2005; 9: 168-77.
  • Dagenais S, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. Spine J. 2008; 8(1): 8-20.
  • Bouhassira D, Attal N, Alchaar et all. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain 2005; 114: 29–36.
  • Bouhassira D, Attal N. Diagnosis and assessment of neuropathic pain: the saga of clinical tools. Pain. 2011; 152(3 Suppl): 74-83.
  • Bouhassira D, Lantéri-Minet M, Attal N, Laurent B, Touboul C. Prevalence of chronic pain with neuropathic characteristics in the general population. Pain. 2008; 136(3): 380-7.
  • Berger A, Toelle T, Sadosky A, Dukes E, Edelsberg J, Oster G. Clinical and economic characteristics of patients with painful neuropathic disorders in Germany. Pain Pract. 2009; 9(1): 8-17.
  • Smith BH, Torrance N, Bennett MI, Lee AJ. Health and quality of life associated with chronic pain of predominantly neuropathic origin in the community. Clin J Pain. 2007; 23(2): 143-9.
  • Mehra M, Hill K, Nicholl D, Schadrack J. The burden of chronic low back pain with and without a neuropathic component: a healthcare resource use and cost analysis. J Med Econ. 2012; 15(2): 245
  • Morlion B. Conference report. The relevance of neuropathic components in chronic back pain. Curr Med Res Opin 2011;27(10):2067–8.
  • Rozenberg S, Foltz V, Fautrel B. Treatment strategy for chronic low back pain. Joint Bone Spine 2012; 79:555-559.
  • Kaki AM, El-Yaski AZ, Youseif E. Identifying neuropathic pain among patients with chronic low-back pain: use of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale. Reg Anesth Pain Med 2005; 30: 422-422.
  • El Sissi W, Arnaout A, Chaarani MW, et all. Prevalence of neuropathic pain among patients with chronic low-back pain in the Arabian Gulf Region assessed using the leeds assessment of neuropathic symptoms and signs pain scale. J Int Med Res. 2010; 38(6): 2135-45.
  • Freynhagen R, Baron R, et al. Pain-DETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin 2006; 22: 1-10.
  • Quedraogo DD, Nonquierma V, Napon C et all. Prevalence of neuropathic pain among black African patients suffering from common low back pain. Rheumatol Int. 2012;32(7):2149-53.
  • Isaac Z, Katz JN, Borenstein DG. Lumbar spine disorders. In: Hochberg MC, Silman AJ, Smolen JS, Weinblatt M, Weisman MH. Rheumatology. Philadelphia: Mosby Elsevier, 2008: 593-618.
  • Hassan AE, Saleh HA, Baroudy YM et al. Prevelance of neuropathic pain among patients suffering from chronic low back pain in Saudi Arabia. Saudi Med J. 2004; 25(12): 1986-90.
  • Freynhagen R, Baron R, Tölle T, et al. Screening of neuropathic pain components in patients with chronic back pain associated with nerve root compression: a pilot prospective observational study (MIPORT). Curr Med Res Opin 2006; 22: 529-37.
  • Freynhagen R, BaronR. The evaluation of neuropathic components in low back pain. Curr Pain Headache Rep. 2009; 13(3): 185-90.
  • Attal N, Perrot S, Fermanian J et all. The neuropathic components of chronic low back pain: a prospective multicenter study using the DN4 Questionnaire. J Pain. 2011; 12(10): 1080-7.
  • Beith ID, Kemp A, Kenyon J et all. Identifying neuropathic back and leg pain: a cross-sectional study. Pain. 2011; 152(7): 1511-6.
  • Schiltenwolf M, Akbar M, Freynhagen R et al. Pseudoradicular and radicular low back pain--a disease continuum rather than different entities? Answers from quantitative sensory testing. Pain 2008; 135: 65-74.
  • Finnerup NB, Otto M, McQuay HJ et all. Algorithm for neuropathic pain treatment: an evidence based proposal. Pain. 2005; 118(3): 289-305.
  • Serpell MG; Neuropathic pain study group. Gabapentin in neuropathic pain syndromes: a randomised, double-blind, placebo-controlled trial. Pain. 2002; 99(3): 557-66.
  • Romano CL, Romano D, Bonora C, Mineo G. Pregabalin, celecoxib, and their combination for treatment low back pain: J Orthop Traumatol. 2009; 10 (4): 185-191.
  • Unal-Cevik I, Sarioglu-Ay S, Evcik D. A comparison of the DN4 and LANSS questionnaires in the assessment of neuropathic pain: validity and reliability of the Turkish version of DN4. J Pain. 2010; 11(11): 1129-35.
There are 30 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Esra Selimoğlu This is me

Sadiye Murat This is me

Selin Turan Turgut This is me

Afitap İçağasıoğlu This is me

Serap Yunsuroğlu Gürek This is me

Yasemin Yumusakhuylu This is me

Publication Date September 1, 2018
Published in Issue Year 2018 Volume: 7 Issue: 3

Cite

APA Selimoğlu, E., Murat, S., Turgut, S. T., İçağasıoğlu, A., et al. (2018). Kronik Bel Ağrısı: Nöropatik Ağrı ve Özellikleri. Abant Medical Journal, 7(3), 48-54. https://doi.org/10.5505/abantmedj.2018.35467
AMA Selimoğlu E, Murat S, Turgut ST, İçağasıoğlu A, Gürek SY, Yumusakhuylu Y. Kronik Bel Ağrısı: Nöropatik Ağrı ve Özellikleri. Abant Med J. September 2018;7(3):48-54. doi:10.5505/abantmedj.2018.35467
Chicago Selimoğlu, Esra, Sadiye Murat, Selin Turan Turgut, Afitap İçağasıoğlu, Serap Yunsuroğlu Gürek, and Yasemin Yumusakhuylu. “Kronik Bel Ağrısı: Nöropatik Ağrı Ve Özellikleri”. Abant Medical Journal 7, no. 3 (September 2018): 48-54. https://doi.org/10.5505/abantmedj.2018.35467.
EndNote Selimoğlu E, Murat S, Turgut ST, İçağasıoğlu A, Gürek SY, Yumusakhuylu Y (September 1, 2018) Kronik Bel Ağrısı: Nöropatik Ağrı ve Özellikleri. Abant Medical Journal 7 3 48–54.
IEEE E. Selimoğlu, S. Murat, S. T. Turgut, A. İçağasıoğlu, S. Y. Gürek, and Y. Yumusakhuylu, “Kronik Bel Ağrısı: Nöropatik Ağrı ve Özellikleri”, Abant Med J, vol. 7, no. 3, pp. 48–54, 2018, doi: 10.5505/abantmedj.2018.35467.
ISNAD Selimoğlu, Esra et al. “Kronik Bel Ağrısı: Nöropatik Ağrı Ve Özellikleri”. Abant Medical Journal 7/3 (September 2018), 48-54. https://doi.org/10.5505/abantmedj.2018.35467.
JAMA Selimoğlu E, Murat S, Turgut ST, İçağasıoğlu A, Gürek SY, Yumusakhuylu Y. Kronik Bel Ağrısı: Nöropatik Ağrı ve Özellikleri. Abant Med J. 2018;7:48–54.
MLA Selimoğlu, Esra et al. “Kronik Bel Ağrısı: Nöropatik Ağrı Ve Özellikleri”. Abant Medical Journal, vol. 7, no. 3, 2018, pp. 48-54, doi:10.5505/abantmedj.2018.35467.
Vancouver Selimoğlu E, Murat S, Turgut ST, İçağasıoğlu A, Gürek SY, Yumusakhuylu Y. Kronik Bel Ağrısı: Nöropatik Ağrı ve Özellikleri. Abant Med J. 2018;7(3):48-54.