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Lomber Omurga Patolojilerine Bağlı Kronik Ağrısı Olan Hastalarda Girişimsel Ağrı Tedavisi ile Depresyon ve Anksiyete Düzeyleri Arası İlişki

Year 2025, Volume: 9 Issue: 2, 203 - 209, 08.08.2025
https://doi.org/10.46332/aemj.1382754

Abstract

Amaç: Bu çalışmada, lomber omurga patolojilerine bağlı kronik bel ve bacak ağrısı olan hastalarda girişimsel ağrı tedavisinin depresyon ve anksiyete düzeyleri üzerindeki etkileri ile tedavi öncesi psikolojik durumun tedavi başarısına olan etkisi araştırılmıştır.

Araçlar ve Yöntem: Bu prospektif gözlemsel çalışmaya yaşları 18-80 arasında değişen, lomber omurga patolojisine bağlı kronik ağrı nedeniyle girişimsel ağrı tedavisi planlanan 88 hasta dahil edildi. Hastalara enjeksiyondan önce ve enjeksiyondan 6 hafta sonra Beck Depresyon ve Anksiyete Envanteri, sayısal derecelendirme ölçeği (NRS) uygulandı. Hastalar iki gruba ayrıldı: Enjeksiyon sonrası enjeksiyon öncesine göre NRS skorlarında %50 veya daha fazla düşüş olanlar (başarılı grup) ve %50'den az azalma olanlar (başarısız grup).

Bulgular: Hastaların enjeksiyon sonrası ortalama NRS skorları (3.28±2.27 (0-10) vs. 7.33±1.25 (5-10), P<0.001), depresyon skorları (9.14±7.06 (0-32) vs. 12.07)±9.58 (0-48), P<0.001) ve anksiyete puanları (8.98±8.13(0-41) vs.10.87±8.34 (0-33),P=0.018) enjeksiyon öncesine göre anlamlı derecede düşüktü. NRS puanlarında enjeksiyon öncesi ve sonrası değişiklikler ile depresyon ve anksiyete puanlarındaki değişiklikler arasında istatistiksel olarak anlamlı bir ilişki olduğu ortaya çıktı. Başarılı grupta enjeksiyon sonrası depresyon ve anksiyete puanlarındaki azalma anlamlı olarak daha yüksekti.

Sonuç: Lomber omurga patolojilerine bağlı kronik ağrısı olan hastalarda girişimsel ağrı tedavisi ile ağrının giderilmesi, hastalardaki depresyon ve anksiyete belirtilerini de azaltmıştır. Tedavi öncesi depresyon ve anksiyete düzeyleri ağrı tedavisinin başarısını etkilememiştir.

References

  • 1. Merskey H. The taxonomy of pain. Med Clin North Am. 2007;91(1):13-20.
  • 2. Kumar K, Elavarasi P. Definition of pain and classification of pain disorders. J. Adv. Clin. Res. İnsights. 2016;3(3):87-90.
  • 3. Ahmed S, Haque SN, Hamirani M, Haque SM, Sohail S, Munir F. Frequency of anxiety and depression in patients with pain visiting pain clinic. Pak. J. Surg. 2013;29(1):36-40.
  • 4. Treede RD, Rief W, Barke A, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003-1007.
  • 5. Lattie EG, Antoni MH, Millon T, Kamp J, Walker MR. MBMD coping styles and psychiatric indicators and response to a multidisciplinary pain treatment program. J Clin Psychol Med Settings. 2013;20(4):515-525.
  • 6. Lerman SF, Rudich Z, Brill S, Shalev H, Shahar G. Longitudinal associations between depression, anxiety, pain, and pain-related disability in chronic pain patients. Psychosom Med. 2015;77(3):333-341.
  • 7. Holmes A, Christelis N, Arnold C. Depression and chronic pain. Med J Aust. 2013;199(6):17-20.
  • 8. Surah A, Baranidharan G, Morley S. Chronic pain and depression. Contin Educ Anaesth Crit Care Pain. 2014;14(2):85-89.
  • 9. Kroenke K, Wu J, Bair MJ, Krebs EE, Damush TM, Tu W. Reciprocal relationship between pain and depression: a 12-month longitudinal analysis in primary care. J Pain. 2011;12(9):964-973.
  • 10. Carroll LJ, Cassidy JD, Cote P. Depression as a risk factor for onset of an episode of troublesome neck and low back pain. Pain. 2004;107(1-2):134-139.
  • 11. Currie SR, Wang J. Chronic back pain and major depression in the general Canadian population. Pain. 2004;107(1-2):54-60.
  • 12. Hilderink PH, Burger H, Deeg DJ, Beekman AT, Oude Voshaar RC. The temporal relation between pain and depression: results from the longitudinal aging study Amsterdam. Psychosom Med. 2012;74(9):945-951.
  • 13. Jackson-Koku, G. Beck depression inventory. Occup. Med. 2016;66(2):174-175.
  • 14. Leyfer OT, Ruberg JL, Woodruff-Borden J. Examination of the utility of the beck anxiety inventory and its factors as a screener for anxiety disorders. J Anxiety Disord. 2006;20(4):444-458.
  • 15. Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011;63(11):467-472.
  • 16. Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med. 2003;163(20):2433-2445.
  • 17. Kosson D, Malec-Milewska M, Gałązkowski R, Rzońca P. Analysis of Anxiety, Depression and Aggression in Patients Attending Pain Clinics. Int J Environ Res Public Health. 2018;15(12):2898.
  • 18. Rayner L, Hotopf M, Petkova H, Matcham F, Simpson A, McCracken LM. Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs. Pain. 2016;157(7):1472-1479.
  • 19. Amow BA, Hunkeler EM, Blasey CM. Comorbid depression chronic pain, and disability in primary care. Psychosom Med. 2006;68(2):262-268.
  • 20. Jaracz J, Gattner K, Jaracz K, Górna K. Unexplained Painful Physical Symptoms in Patients with Major Depressive Disorder: Prevalence, Pathophysiology and Management. CNS Drugs. 2016;30(4):293-304.
  • 21. Vaccarino AL, Sills TL, Evans KR, Kalali AH. Multiple pain complaints in patients with major depressive disorder. Psychosom Med. 2009;71(2):159-162.
  • 22. Sariyildiz MA, Batmaz İ, Yazmalar L, Güneş M, Turan Y. The effectiveness of transforaminal epidural steroid injections on radicular pain, functionality, psychological status and sleep quality in patients with lumbar disc herniation. J Back Musculoskelet Rehabil. 2017;30(2): 265-270.
  • 23. Hadjistavropoulos HD, Hadjistavropoulos T. The relevance of health anxiety to chronic pain: research findings and recommendations for assessment and treatment. Curr Pain Headache Rep. 2003;7(2):98-104.
  • 24. Vowles KE, Zvolensky MJ, Gross RT, Sperry JA. Pain-related anxiety in the prediction of chronic low-back pain distress. J Behav Med. 2004;27(1):77-89.
  • 25. Rusu AC, Pincus T, Morley S. Depressed pain patients differ from other depressed groups: examination of cognitive content in a sentence completion task. Pain. 2012;153(9):1898-1904.
  • 26. Xu Q, Yaksh TL. A brief comparison of the pathophysiology of inflammatory versus neuropathic pain. Curr Opin Anaesthesiol. 2011;24(4):400-407.
  • 27. Porro CA. Functional imaging and pain: behavior, perception, and modulation. Neuroscientist. 2003;9(5): 354-369.
  • 28. Blackburn-Munro G, Blackburn-Munro RE. Chronic pain, chronic stress and depression: coincidence or consequence? J Neuroendocrinol. 2001;13(12):1009-1023.
  • 29. Mercier A, Auger-Aubin I, Lebeau JP, et al. Evidence of prescription of antidepressants for non-psychiatric conditions in primary care: an analysis of guidelines and systematic reviews. BMC Fam Pract. 2013;14(1): 55.
  • 30. Sinikallio S, Aalto T, Airaksinen O, et al. Depression is associated with poorer outcome of lumbar spinal stenosis surgery. Eur Spine J. 2007;16(7):905-912.
  • 31. Geoffrion R, Koenig NA, Zheng M, et al. Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes: A Prospective Cohort Study. Ann Surg Open. 2021;2(1):49.
  • 32. Kim EJ, Chotai S, Stonko DP, et al. Patient-reported outcomes after lumbar epidural steroid injection for degenerative spine disease in depressed versus non-depressed patients. Spine J. 2017;17(4):511-517.
  • 33. Lubelski D, Thompson NR, Bansal S, et al. Depression as a predictor of worse quality of life outcomes following nonoperative treatment for lumbar stenosis. J Neurosurg Spine. 2015;22(3):267-272.
  • 34. Bahar-Ozdemir Y, Sencan S, Ercalik T, Kokar S, Gunduz OH. The Effect of Pre-Treatment Depression, Anxiety and Somatization Levels on Transforaminal Epidural Steroid Injection: A Prospective Observational Study. Pain Physician. 2020;23(3):273-280.

The Relationship between Interventional Pain Treatment and Depression and Anxiety Levels in Patients with Chronic Pain Due to Lumbar Spine Pathologies

Year 2025, Volume: 9 Issue: 2, 203 - 209, 08.08.2025
https://doi.org/10.46332/aemj.1382754

Abstract

Purpose: We aimed to investigate the effect of interventional pain treatment on depression and anxiety levels in patients with chronic low back and leg pain due to lumbar spine pathologies. Secondly, we examined the effect of anxiety and depression level before treatment on pain success.

Materials and Methods: Eighty-eight patients aged 18-80 years, in whom interventional pain treatment due to chronic pain caused by lumbar spine pathology was planned were included in this prospective observational study. The Beck Depression and Anxiety Inventory, the numeric rating scale (NRS) were applied to the patients before and 6 weeks after injection. The patients were divided into two groups: those with a 50%or more decrease in the NRS scores after injection compared to the pre-injection (successful group)and those with a decrease of less than 50% (unsuccessful group).

Results: The patients’ post-injection mean NRS scores (3.28±2.27 (0-10) vs. 7.33±1.25 (5-10), P<0.001), depression scores (9.14±7.06 (0-32) vs. 12.07±9.58 (0-48), P<0.001), and anxiety scores (8.98±8.13 (0-41) vs. 10.87±8.34 (0-33), P=0.018) were significantly lower compared to those before injection. A statistically significant correlation was revealed between the pre- and post-injection changes in the NRS scores and changes in depression and anxiety scores. The decrease in depression and anxiety scores after injection in the successful group was significantly higher.

Conclusions: Relieving pain with interventional pain treatment in patients with chronic pain due to lumbar spine pathologies also reduced depression and anxiety symptoms in the patients. Depression and anxiety levels prior to treatment did not affect the success of pain treatment.

References

  • 1. Merskey H. The taxonomy of pain. Med Clin North Am. 2007;91(1):13-20.
  • 2. Kumar K, Elavarasi P. Definition of pain and classification of pain disorders. J. Adv. Clin. Res. İnsights. 2016;3(3):87-90.
  • 3. Ahmed S, Haque SN, Hamirani M, Haque SM, Sohail S, Munir F. Frequency of anxiety and depression in patients with pain visiting pain clinic. Pak. J. Surg. 2013;29(1):36-40.
  • 4. Treede RD, Rief W, Barke A, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003-1007.
  • 5. Lattie EG, Antoni MH, Millon T, Kamp J, Walker MR. MBMD coping styles and psychiatric indicators and response to a multidisciplinary pain treatment program. J Clin Psychol Med Settings. 2013;20(4):515-525.
  • 6. Lerman SF, Rudich Z, Brill S, Shalev H, Shahar G. Longitudinal associations between depression, anxiety, pain, and pain-related disability in chronic pain patients. Psychosom Med. 2015;77(3):333-341.
  • 7. Holmes A, Christelis N, Arnold C. Depression and chronic pain. Med J Aust. 2013;199(6):17-20.
  • 8. Surah A, Baranidharan G, Morley S. Chronic pain and depression. Contin Educ Anaesth Crit Care Pain. 2014;14(2):85-89.
  • 9. Kroenke K, Wu J, Bair MJ, Krebs EE, Damush TM, Tu W. Reciprocal relationship between pain and depression: a 12-month longitudinal analysis in primary care. J Pain. 2011;12(9):964-973.
  • 10. Carroll LJ, Cassidy JD, Cote P. Depression as a risk factor for onset of an episode of troublesome neck and low back pain. Pain. 2004;107(1-2):134-139.
  • 11. Currie SR, Wang J. Chronic back pain and major depression in the general Canadian population. Pain. 2004;107(1-2):54-60.
  • 12. Hilderink PH, Burger H, Deeg DJ, Beekman AT, Oude Voshaar RC. The temporal relation between pain and depression: results from the longitudinal aging study Amsterdam. Psychosom Med. 2012;74(9):945-951.
  • 13. Jackson-Koku, G. Beck depression inventory. Occup. Med. 2016;66(2):174-175.
  • 14. Leyfer OT, Ruberg JL, Woodruff-Borden J. Examination of the utility of the beck anxiety inventory and its factors as a screener for anxiety disorders. J Anxiety Disord. 2006;20(4):444-458.
  • 15. Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011;63(11):467-472.
  • 16. Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med. 2003;163(20):2433-2445.
  • 17. Kosson D, Malec-Milewska M, Gałązkowski R, Rzońca P. Analysis of Anxiety, Depression and Aggression in Patients Attending Pain Clinics. Int J Environ Res Public Health. 2018;15(12):2898.
  • 18. Rayner L, Hotopf M, Petkova H, Matcham F, Simpson A, McCracken LM. Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs. Pain. 2016;157(7):1472-1479.
  • 19. Amow BA, Hunkeler EM, Blasey CM. Comorbid depression chronic pain, and disability in primary care. Psychosom Med. 2006;68(2):262-268.
  • 20. Jaracz J, Gattner K, Jaracz K, Górna K. Unexplained Painful Physical Symptoms in Patients with Major Depressive Disorder: Prevalence, Pathophysiology and Management. CNS Drugs. 2016;30(4):293-304.
  • 21. Vaccarino AL, Sills TL, Evans KR, Kalali AH. Multiple pain complaints in patients with major depressive disorder. Psychosom Med. 2009;71(2):159-162.
  • 22. Sariyildiz MA, Batmaz İ, Yazmalar L, Güneş M, Turan Y. The effectiveness of transforaminal epidural steroid injections on radicular pain, functionality, psychological status and sleep quality in patients with lumbar disc herniation. J Back Musculoskelet Rehabil. 2017;30(2): 265-270.
  • 23. Hadjistavropoulos HD, Hadjistavropoulos T. The relevance of health anxiety to chronic pain: research findings and recommendations for assessment and treatment. Curr Pain Headache Rep. 2003;7(2):98-104.
  • 24. Vowles KE, Zvolensky MJ, Gross RT, Sperry JA. Pain-related anxiety in the prediction of chronic low-back pain distress. J Behav Med. 2004;27(1):77-89.
  • 25. Rusu AC, Pincus T, Morley S. Depressed pain patients differ from other depressed groups: examination of cognitive content in a sentence completion task. Pain. 2012;153(9):1898-1904.
  • 26. Xu Q, Yaksh TL. A brief comparison of the pathophysiology of inflammatory versus neuropathic pain. Curr Opin Anaesthesiol. 2011;24(4):400-407.
  • 27. Porro CA. Functional imaging and pain: behavior, perception, and modulation. Neuroscientist. 2003;9(5): 354-369.
  • 28. Blackburn-Munro G, Blackburn-Munro RE. Chronic pain, chronic stress and depression: coincidence or consequence? J Neuroendocrinol. 2001;13(12):1009-1023.
  • 29. Mercier A, Auger-Aubin I, Lebeau JP, et al. Evidence of prescription of antidepressants for non-psychiatric conditions in primary care: an analysis of guidelines and systematic reviews. BMC Fam Pract. 2013;14(1): 55.
  • 30. Sinikallio S, Aalto T, Airaksinen O, et al. Depression is associated with poorer outcome of lumbar spinal stenosis surgery. Eur Spine J. 2007;16(7):905-912.
  • 31. Geoffrion R, Koenig NA, Zheng M, et al. Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes: A Prospective Cohort Study. Ann Surg Open. 2021;2(1):49.
  • 32. Kim EJ, Chotai S, Stonko DP, et al. Patient-reported outcomes after lumbar epidural steroid injection for degenerative spine disease in depressed versus non-depressed patients. Spine J. 2017;17(4):511-517.
  • 33. Lubelski D, Thompson NR, Bansal S, et al. Depression as a predictor of worse quality of life outcomes following nonoperative treatment for lumbar stenosis. J Neurosurg Spine. 2015;22(3):267-272.
  • 34. Bahar-Ozdemir Y, Sencan S, Ercalik T, Kokar S, Gunduz OH. The Effect of Pre-Treatment Depression, Anxiety and Somatization Levels on Transforaminal Epidural Steroid Injection: A Prospective Observational Study. Pain Physician. 2020;23(3):273-280.
There are 34 citations in total.

Details

Primary Language English
Subjects Anaesthesiology
Journal Section Original Articles
Authors

Tülin Arıcı 0000-0002-2855-8773

Tuğçehan Sezer Akman 0000-0003-4135-8407

Early Pub Date August 1, 2025
Publication Date August 8, 2025
Submission Date October 29, 2023
Acceptance Date February 23, 2025
Published in Issue Year 2025 Volume: 9 Issue: 2

Cite

APA Arıcı, T., & Sezer Akman, T. (2025). The Relationship between Interventional Pain Treatment and Depression and Anxiety Levels in Patients with Chronic Pain Due to Lumbar Spine Pathologies. Ahi Evran Medical Journal, 9(2), 203-209. https://doi.org/10.46332/aemj.1382754
AMA Arıcı T, Sezer Akman T. The Relationship between Interventional Pain Treatment and Depression and Anxiety Levels in Patients with Chronic Pain Due to Lumbar Spine Pathologies. Ahi Evran Med J. August 2025;9(2):203-209. doi:10.46332/aemj.1382754
Chicago Arıcı, Tülin, and Tuğçehan Sezer Akman. “The Relationship Between Interventional Pain Treatment and Depression and Anxiety Levels in Patients With Chronic Pain Due to Lumbar Spine Pathologies”. Ahi Evran Medical Journal 9, no. 2 (August 2025): 203-9. https://doi.org/10.46332/aemj.1382754.
EndNote Arıcı T, Sezer Akman T (August 1, 2025) The Relationship between Interventional Pain Treatment and Depression and Anxiety Levels in Patients with Chronic Pain Due to Lumbar Spine Pathologies. Ahi Evran Medical Journal 9 2 203–209.
IEEE T. Arıcı and T. Sezer Akman, “The Relationship between Interventional Pain Treatment and Depression and Anxiety Levels in Patients with Chronic Pain Due to Lumbar Spine Pathologies”, Ahi Evran Med J, vol. 9, no. 2, pp. 203–209, 2025, doi: 10.46332/aemj.1382754.
ISNAD Arıcı, Tülin - Sezer Akman, Tuğçehan. “The Relationship Between Interventional Pain Treatment and Depression and Anxiety Levels in Patients With Chronic Pain Due to Lumbar Spine Pathologies”. Ahi Evran Medical Journal 9/2 (August2025), 203-209. https://doi.org/10.46332/aemj.1382754.
JAMA Arıcı T, Sezer Akman T. The Relationship between Interventional Pain Treatment and Depression and Anxiety Levels in Patients with Chronic Pain Due to Lumbar Spine Pathologies. Ahi Evran Med J. 2025;9:203–209.
MLA Arıcı, Tülin and Tuğçehan Sezer Akman. “The Relationship Between Interventional Pain Treatment and Depression and Anxiety Levels in Patients With Chronic Pain Due to Lumbar Spine Pathologies”. Ahi Evran Medical Journal, vol. 9, no. 2, 2025, pp. 203-9, doi:10.46332/aemj.1382754.
Vancouver Arıcı T, Sezer Akman T. The Relationship between Interventional Pain Treatment and Depression and Anxiety Levels in Patients with Chronic Pain Due to Lumbar Spine Pathologies. Ahi Evran Med J. 2025;9(2):203-9.

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