Aşkın Ayhan, Özkan Ayten, Tosun Aliye, Demirdal Ümit Seçil, İsnaç Fethi
Department of Physical Medicine and Rehabilitation, Katip Celebi University, Izmir, Turkey.
Department of Physical Medicine and Rehabilitation, Katip Celebi University, Izmir, Turkey.
Kaohsiung J Med Sci. 2017 Mar;33(3):152-158. doi: 10.1016/j.kjms.2016.12.007. Epub 2017 Feb 3.
The aim of this study was to examine the neuropathic pain component of knee osteoarthritis (OA) patients and to investigate the relationship between neuropathic pain, disease stage, functional state, depression, anxiety, and quality of life. This study included 60 patients with knee OA. All demographic data and radiological results were recorded. Visual Analog Scale (VAS), Timed Up and Go Test, Chair Stand Test, Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC), PainDETECT questionnaire, DN4 questionnaire, Short form-36 questionnaire, and Hospital Anxiety Depression Scale were performed for each patient. Neuropathic pain was detected in 66.7% of patients based on the PainDETECT scale and in 46.7% of patients based on DN4 scale. VAS-resting, OA grade, WOMAC scores, and SF-scores showed a significant difference in patients that detected neuropathic pain with PainDETECT (p<0.05). Based on the DN4 scale, patients with neuropathic pain had significantly higher WOMAC scores and significantly lower SF-36 scores (p<0.05). The PainDETECT questionnaire scores showed positive correlations with Timed Up-and-go Test, VAS-resting, WOMAC scores, Hospital Anxiety Depression Scale scores, and a negative correlation with all SF-36 scores (p<0.05). DN4 questionnaire scores showed a negative correlation with SF-36 scores and positive correlation with WOMAC scores (p<0.05). To conclude, it should be kept in mind that patients with knee OA who describe intense pain may have a neuropathic component involved in the clinical condition. Quality of life and functional capacity are adversely affected in patients with knee OA who have neuropathic pain. This should be taken into account while planning the treatment of these patients.
本研究旨在检查膝骨关节炎(OA)患者的神经性疼痛成分,并探讨神经性疼痛、疾病阶段、功能状态、抑郁、焦虑和生活质量之间的关系。本研究纳入了60例膝OA患者。记录了所有人口统计学数据和放射学结果。对每位患者进行了视觉模拟量表(VAS)、计时起立行走测试、椅子站立测试、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、疼痛检测问卷、DN4问卷、简短健康调查-36问卷和医院焦虑抑郁量表评估。根据疼痛检测量表,66.7%的患者检测到神经性疼痛;根据DN4量表,46.7%的患者检测到神经性疼痛。在通过疼痛检测量表检测到神经性疼痛的患者中,静息VAS、OA分级、WOMAC评分和SF-36评分存在显著差异(p<0.05)。根据DN4量表,神经性疼痛患者的WOMAC评分显著更高,SF-36评分显著更低(p<0.05)。疼痛检测问卷评分与计时起立行走测试、静息VAS、WOMAC评分、医院焦虑抑郁量表评分呈正相关,与所有SF-36评分呈负相关(p<0.05)。DN4问卷评分与SF-36评分呈负相关,与WOMAC评分呈正相关(p<0.05)。总之,应牢记,描述疼痛剧烈的膝OA患者临床病情中可能存在神经性成分。患有神经性疼痛的膝OA患者的生活质量和功能能力受到不利影响。在规划这些患者的治疗时应考虑到这一点。