Department of Anesthesiology, Pain Management Center, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts..
Department of Anesthesiology, Pain Management Center, Brigham and Women's Hospital, Harvard Medical School, Chestnut Hill, Massachusetts.
J Pain. 2018 Dec;19(12):1461-1470. doi: 10.1016/j.jpain.2018.07.001. Epub 2018 Jul 17.
Growing evidence suggests that chronic low back pain (CLBP) is associated with pain sensitization, and that there are sex and race disparities in CLBP. Given the sex and race differences in pain sensitization, this has been hypothesized as a mechanism contributing to the sex and race disparities in CLBP. This study examined sex and race differences in pain sensitization among patients with CLBP, as well as the role of catastrophizing as a potential mediator of those differences. The study found that compared with men, women required less pressure to produce deep muscle pain and rated mechanical punctate pain as more painful. Compared with non-Hispanic white patients, black patients demonstrated greater pain sensitivity for measures of deep muscle hyperalgesia and mechanical punctate pain. Furthermore, catastrophizing partially mediated the race differences in deep muscle pain such that black participants endorsed greater pain catastrophizing, which partially accounted for their increased sensitivity to, and temporal summation of, deep muscle pain. Taken together, these results support the need to further examine the role of catastrophizing and pain sensitization in the context of sex and race disparities in the experience of CLBP. PERSPECTIVE: This study identifies sex and race differences in pain sensitization among patients with CLBP. Further, it recognizes the role of catastrophizing as a contributor to such race differences. More research is needed to further dissect these complex relationships.
越来越多的证据表明，慢性下背痛（CLBP）与疼痛敏感有关，并且在 CLBP 中存在性别和种族差异。鉴于疼痛敏感存在性别和种族差异，这被假设为导致 CLBP 中性别和种族差异的一种机制。本研究检查了 CLBP 患者中疼痛敏感的性别和种族差异，以及作为这些差异潜在中介的灾难化作用。研究发现，与男性相比，女性需要的压力较小就能产生深部肌肉疼痛，并将机械点状疼痛评定为更痛。与非西班牙裔白种人患者相比，黑种人患者在深部肌肉痛觉过敏和机械点状疼痛的测量中表现出更大的疼痛敏感性。此外，灾难化部分介导了种族之间深部肌肉疼痛的差异，即黑人参与者对疼痛灾难化的认同程度更高，这部分解释了他们对深部肌肉疼痛的敏感性增加和时间总和。综上所述，这些结果支持进一步研究灾难化和疼痛敏感在 CLBP 体验的性别和种族差异中的作用的必要性。观点：本研究确定了 CLBP 患者中疼痛敏感的性别和种族差异。此外，它还认识到灾难化是导致这种种族差异的一个因素。需要进一步的研究来进一步剖析这些复杂的关系。
