慢性颈部疼痛患者的感觉、运动及心理社会特征：一项病例对照研究。

Sensory, Motor, and Psychosocial Characteristics of Individuals With Chronic Neck Pain: A Case-Control Study.

作者信息

Rampazo É P, da Silva V R, de Andrade A L M, Back C G N, Madeleine P M, Arendt-Nielsen L, Liebano Richard Eloin

机构信息

Physiotherapeutic Resources Laboratory, Department of Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos/SP, Brazil.

Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.

出版信息

Phys Ther. 2021 Mar 26. doi: 10.1093/ptj/pzab104.

DOI:10.1093/ptj/pzab104

PMID:33774667

Abstract

OBJECTIVE

Given the complex and unclear etiology of neck pain, it is important to understand the differences in central sensitization as well as psychosocial factors in individuals with chronic neck pain and healthy controls. The purpose of this study was to benchmark differences in central sensitization, psychosocial factors, and range of motion between people with nonspecific chronic neck pain and healthy controls and to analyze the correlation between pain intensity, neck disability, and psychosocial factors in people with chronic neck pain.

METHODS

Thirty individuals with chronic neck pain and 30 healthy controls were included in this case-control study. Outcome measures were as follows: central sensitization (pressure pain threshold, temporal summation, and conditioned pain modulation), psychosocial factors (depressive symptoms, pain catastrophizing, and quality of life), and active cervical range of motion.

RESULTS

People with neck pain had lower local pressure pain threshold, a decrease in conditioned pain modulation, more depressive symptoms, greater pain catastrophizing, lower quality of life, and reduced range of motion for neck rotation when compared with healthy controls. In people with neck pain, moderate correlations were observed between pain intensity and quality of life (ρ = -0.479), disability and pain catastrophizing (ρ = 0.379), and disability and quality of life (ρ = -0.456).

CONCLUSIONS

People with neck pain have local hyperalgesia, impaired conditioning pain modulation, depressive symptoms, pain catastrophizing, low quality of life, and reduced active range of motion during neck rotation, which should be taken into account during assessment and treatment.

IMPACT

This study shows that important outcomes, such as central sensitization and psychosocial factors, should be considered during assessment and treatment of individuals with nonspecific chronic neck pain. In addition, pain intensity and neck disability are correlated with psychosocial factors.

摘要

目的

鉴于颈部疼痛的病因复杂且不明，了解慢性颈部疼痛患者与健康对照者在中枢敏化以及心理社会因素方面的差异非常重要。本研究的目的是比较非特异性慢性颈部疼痛患者与健康对照者在中枢敏化、心理社会因素和活动范围方面的差异，并分析慢性颈部疼痛患者的疼痛强度、颈部功能障碍与心理社会因素之间的相关性。

方法

本病例对照研究纳入了30例慢性颈部疼痛患者和30名健康对照者。观察指标如下：中枢敏化（压痛阈值、时间总和和条件性疼痛调制）、心理社会因素（抑郁症状、疼痛灾难化和生活质量）以及颈椎活动范围。

结果

与健康对照者相比，颈部疼痛患者的局部压痛阈值更低，条件性疼痛调制降低，抑郁症状更多，疼痛灾难化程度更高，生活质量更低，颈部旋转活动范围减小。在颈部疼痛患者中，观察到疼痛强度与生活质量之间存在中度相关性（ρ = -0.479），功能障碍与疼痛灾难化之间存在中度相关性（ρ = 0.379），功能障碍与生活质量之间存在中度相关性（ρ = -0.456）。