Department of Physical Medicine and Rehabilitation, Istanbul Medeniyet University, Istanbul, Turkey.
Department of Physical Medicine and Rehabilitation, Istanbul Gaziosmanpasa Training and Research Hospital, 885. Street Mevlana District, Gaziosmanpasa, 34255, Istanbul, Turkey.
Acta Neurol Belg. 2021 Aug;121(4):873-877. doi: 10.1007/s13760-020-01285-7. Epub 2020 Feb 12.
The aim of this study was to evaluate the frequency of neuropathic pain (NP) in patients with low back pain (LBP) and the relationship of NP with demographic characteristics and pain duration. Four hundred and forty patients were evaluated with respect to NP. Demographic data were collected and Douleur Neuropathique 4 Questions (DN4) questionnaire was used to identify NP. Any difference in demographic characteristics or duration of pain was investigated between the patients with and without NP. Sociodemographic factors which are independently associated with NP were analyzed. According to DN4, 43.9% of the patients had NP. Mean age of the patients was 44.8 years (± 13.7). 343 (77.9%) of the patients had chronic LBP (more than 3 months). The patients with NP were older (p < 0.001), had higher BMI (p = 0.005) and longer LBP duration (p < 0.001) and had lower educational level (p 0.018). NP was significantly more common in unemployed patients and less common in high-activity employees (p 0.001). Logistic regression analyses identified that high-active workers' risk of having NP was 1.76 times lesser than other groups (office workers, housewives and retired patients). Nearly half of the patients with LBP were accompanied by NP. It was remarkably more common in sedentary patients and patients with low socioeconomic status. High physical activity at work was found to decrease the risk of having NP. Clinicians should emphasize on exercise training as a therapeutic intervention while LBP is being treated.
本研究旨在评估伴有腰痛(LBP)的患者中神经病理性疼痛(NP)的发生率以及 NP 与人口统计学特征和疼痛持续时间的关系。对 440 例患者进行了 NP 评估。收集了人口统计学数据,并使用 Douleur Neuropathique 4 Questions(DN4)问卷来识别 NP。比较了 NP 患者与非 NP 患者在人口统计学特征或疼痛持续时间方面的差异。分析了与 NP 独立相关的社会人口因素。根据 DN4,43.9%的患者患有 NP。患者的平均年龄为 44.8±13.7 岁。343 例(77.9%)患者患有慢性 LBP(超过 3 个月)。NP 患者年龄较大(p<0.001)、BMI 较高(p=0.005)、LBP 持续时间较长(p<0.001)、受教育程度较低(p<0.018)。NP 在失业患者中更为常见,在高活动度的员工中则不常见(p<0.001)。Logistic 回归分析表明,高活动度员工发生 NP 的风险比其他组(上班族、家庭主妇和退休患者)低 1.76 倍。近一半的腰痛患者伴有 NP。久坐患者和社会经济地位较低的患者更为常见。工作中较高的体力活动被发现可降低发生 NP 的风险。临床医生在治疗 LBP 时应强调锻炼训练作为治疗干预措施。