Chronic Low Back Pain: Neuropathic Component and Its Characteristics

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.

Keywords

• chronic low back pain, neuropathic pain, nociceptive pain, DN4 scale

Kronik Bel Ağrısı: Nöropatik Ağrı ve Özellikleri

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.

Keywords

• kronik bel ağrısı, nöropatik ağrı, nosisptif ağrı, DN4 skalası

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