ORIJINAL ARAŞTIRMA
Kronik Bel Ağrısı Olan Hastalarda Nöropatik Ağrı Sıklığı ve İlişkili Faktörlerin Değerlendirilmesi
Evaluation of Neuropathic Pain Frequency and Related Factors in Patients with Chronic Low Back Pain
Received Date : 18 Feb 2022
Accepted Date : 27 Jun 2022
Available Online : 05 Jul 2022
Derya KARACİFa, Ayşe BÖLÜKBAŞIa
aDepartment of Physical Medicine and Rehabilitation, Ankara University Faculty of Medicine, Ankara, Türkiye
Doi: 10.31609/jpmrs.2022-89033 - Makale Dili: EN
J PMR Sci. 2022;25(3):332-8
ÖZET
Amaç: Bu çalışmanın amacı, “PainDETECT ağrı anketi” kullanarak
kronik bel ağrılı hastalarda nöropatik ağrı prevalansını ve nöropatik ağrı ile
fiziksel özürlülük, anksiyete ve depresyon arasındaki ilişkiyi
değerlendirmektir. Gereç ve Yöntemler: Haziran 2018-Aralık 2019 tarihleri
arasında kronik bel ağrılı 141 hasta (35 erkek, 106 kadın; ortalama yaş:
49,4±12,0 yıl; dağılım 20-65 yıl) çalışmaya dâhil edildi. “PainDETECT ağrı
anketine” dayanarak, katılımcılar 2 gruba ayrıldı: nöropatik grup ve
nöropatik olmayan grup. Hastaların sosyodemografik özellikleri ve klinik
verileri kaydedildi. Ağrı, görsel analog skala [visual analogue scale (VAS)]
ile özürlülük, Oswestry Özürlülük İndeksi [Oswestry Disability Index
(ODI)] ile depresyon, Zung Depresyon Ölçeği [Zung Self-Rating Depression
Scale (SDS)] ile anksiyete, Beck Anksiyete Envanteri [Beck Anxiety
Inventory (BAI)] ile değerlendirildi. Bulgular: Bu çalışmada kronik bel
ağrılı hastaların %21,3’ünde nöropatik ağrı saptandı. Nöropatik ağrı, diyabet
ve diz altına ağrı yayılımı ile ilişkiliydi (p=0,002, p=0,003). Ancak yaş,
cinsiyet, beden kitle indeksi ve sigara kullanımı açısından gruplar arasında
anlamlı fark yoktu (p=0,06, p=0,9, p=0,4, p=0,4). Mevcut ağrıyı, son 4 haftadaki
ortalama ağrıyı ve son 4 haftadaki en şiddetli ağrıyı sorgulayan VAS
skorları, nöropatik ağrı grubunda, nöropatik ağrı olmayan gruba göre anlamlı
derecede yüksekti (p=0,001, p<0,001, p=0,001). ODI, SDS, BAI skorları
nöropatik ağrı grubunda, nöropatik ağrı olmayan gruba göre anlamlı derecede
yüksekti (p<0,001, p<0,001, p<0,001). Sonuç: Nöropatik ağrı, kronik
bel ağrısına önemli katkıda bulunur ve rolü göz ardı edilmemelidir.
Anahtar Kelimeler: Kronik bel ağrısı; nöropatik ağrı; painDETECT ağrı anketi
ABSTRACT
Objective: The aim of this study was to evaluate the prevalence
of neuropathic pain in patients with chronic low back pain (LBP) using
the PainDETECT questionnaire (PDQ) and to evaluate the relationship between
neuropathic pain and physical disability, anxiety and depression. Material
and Methods: Between June 2018 and December 2019, 141 patients
with chronic LBP (35 males, 106 females; mean age: 49.4±12.0 years; range
20 to 65 years) were included in the study. Based on the PDQ, participants
were classified into 2 groups: the neuropathic group and the non-neuropathic
group. Socio-demographic characteristics and clinical data of the patients
were recorded. Pain was evaluated with the visual analogue scale
(VAS), disability with the Oswestry Disability Index (ODI), depression with
the Zung Self-Rating Depression Scale (SDS) and anxiety with the Beck
Anxiety Inventory (BAI). Results: In this study neuropatic pain was detected
in 21.3% of the patients with chronic LBP. Neuropathic pain was associated
diabetes and pain radiation below the knee (p=0.002, p=0.003).
However, there was no significant difference between the groups in age,
gender, body mass index and smoking (p=0.06, p=0.9, p=0.4, p=0.4). VAS
scores questioning current pain, mean pain in the last 4 weeks, and most severe
pain in the last 4 weeks were significantly higher in the neuropathic
pain group than in the non-neuropathic pain group (p=0.001, p<0.001,
p=0.001). ODI, SDS, BAI scores were significantly higher in the neuropathic
pain group than in the non-neuropathic pain group (p<0.001, p<0.001,
p<0.001). Conclusion: Neuropathic pain is a major contributor to chronic
LBP and its role should not be ignored.
Keywords: Chronic low back pain; neuropathic pain; PainDETECT questionnaire
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