Yang Seoyon, Boudier-Revéret Mathieu, Hsiao Ming-Yen, Kwak Soyoung, Chang Min Cheol
Department of Rehabilitation Medicine, Ewha Woman's University Seoul Hospital, Ewha Woman's University School of Medicine, Seoul, Republic of Korea.
Department of Physical Medicine and Rehabilitation, Centre Hospitalier de l'Université de Montréal, Montreal, Canada.
J Pain Res. 2022 Jul 29;15:2133-2138. doi: 10.2147/JPR.S371263. eCollection 2022.
To investigate whether the response to intra-articular facet joint corticosteroid injection can determine the long-term prognosis (at least 5 years after injury) of whiplash injury-related neck pain sustained 3-12 months after injury.
Of 65 patients who visited a university hospital for persistent whiplash injury-induced axial neck pain sustained 3-12 months after injury (numeric rating scale score ≥3) and had received intra-articular facet joint corticosteroid injection, 40 completed the telephone interview. We divided the patients into "good response group" (≥50% pain reduction at 1 month after the injection) and "poor response group" (<50% pain reduction at 1 month after the injection). We asked participants regarding the presence and degree of neck pain, its impact on work, and the use of oral pain medication or injection treatment.
A follow-up at least 5 years after the injury found that the number of patients with persistent whiplash injury-related neck pain was significantly lower in the good response group than in the poor response group. The number of patients taking oral pain medications prescribed by a medical doctor or receiving injection treatments in a pain clinic or hospital for neck pain was lower in the good response group than in the poor response group. The number of patients who answered that their work was affected by neck pain was lower in the good response group than in the poor response group.
The response to intra-articular corticosteroid injection might be helpful in determining at least 5-year outcomes of chronic whiplash injury-induced pain.
探讨关节内小关节皮质类固醇注射的反应是否能确定损伤后3 - 12个月所患挥鞭样损伤相关颈部疼痛的长期预后(损伤后至少5年)。
65例因挥鞭样损伤导致的持续性轴向颈部疼痛(数字评定量表评分≥3)且损伤后3 - 12个月到大学医院就诊并接受关节内小关节皮质类固醇注射的患者中,40例完成了电话随访。我们将患者分为“良好反应组”(注射后1个月疼痛减轻≥50%)和“不良反应组”(注射后1个月疼痛减轻<50%)。我们询问参与者颈部疼痛的存在情况和程度、其对工作的影响以及口服止痛药物或注射治疗的使用情况。
损伤后至少5年的随访发现,良好反应组中持续性挥鞭样损伤相关颈部疼痛的患者数量显著低于不良反应组。良好反应组中因颈部疼痛服用医生开具的口服止痛药物或在疼痛诊所或医院接受注射治疗的患者数量低于不良反应组。回答其工作受到颈部疼痛影响的良好反应组患者数量低于不良反应组。
关节内皮质类固醇注射的反应可能有助于确定慢性挥鞭样损伤所致疼痛至少5年的预后情况。