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与慢性腰痛心理社会预测因素相关的压痛阈值与中枢敏化

Pressure Pain Thresholds and Central Sensitization in Relation to Psychosocial Predictors of Chronicity in Low Back Pain.

作者信息

Steinmetz Anke, Hacke Franziska, Delank Karl-Stefan

机构信息

Physical and Rehabilitation Medicine, Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, University Medicine Greifswald, 17475 Greifswald, Germany.

Department of Geriatrics, Martin-Luther-University Halle-Wittenberg, 06120 Halle/Saale, Germany.

出版信息

Diagnostics (Basel). 2023 Feb 19;13(4):786. doi: 10.3390/diagnostics13040786.

DOI:10.3390/diagnostics13040786
PMID:36832274
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9954899/
Abstract

(1) Background: Peripheral, as well as central, sensitization have been described in chronic low back pain (cLBP). The purpose of this study is to investigate the influence of psychosocial factors on the development of central sensitization. (2) Methods: This prospective study investigated local and peripheral pressure pain thresholds and their dependence on psychosocial risk factors in patients with cLBP receiving inpatient multimodal pain therapy. Psychosocial factors were assessed using the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ). (3) Results: A total of 90 patients were included in the study, 61 (75.4% women, 24.6% men) of whom had significant psychosocial risk factors. The control group consisted of 29 patients (62.1% women, 37.9% men). At baseline, patients with psychosocial risk factors showed significantly lower local and peripheral pressure pain thresholds, suggesting central sensitization, compared to the control group. Sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI), was also correlated with altered PPTs. After multimodal therapy, all participants reported increased local pain thresholds compared to at admission, independent of psychosocial chronification factors. (4) Conclusions: Psychosocial chronicity factors measured using the ÖMPSQ have a significant influence on pain sensitization in cLBP. A 14-day multimodal pain therapy increased local, but not peripheral, pressure pain thresholds.

摘要

(1) 背景:慢性下腰痛(cLBP)中已描述了外周和中枢敏化现象。本研究旨在探讨心理社会因素对中枢敏化发展的影响。(2) 方法:这项前瞻性研究调查了接受住院多模式疼痛治疗的cLBP患者的局部和外周压力疼痛阈值及其对心理社会风险因素的依赖性。使用厄勒布鲁肌肉骨骼疼痛筛查问卷(ÖMPSQ)评估心理社会因素。(3) 结果:共有90名患者纳入研究,其中61名(女性75.4%,男性24.6%)存在显著的心理社会风险因素。对照组由29名患者组成(女性62.1%,男性37.9%)。在基线时,与对照组相比,有心理社会风险因素的患者局部和外周压力疼痛阈值显著降低,提示存在中枢敏化。通过匹兹堡睡眠质量指数(PSQI)测量的睡眠质量也与疼痛阈值改变相关。多模式治疗后,所有参与者报告与入院时相比局部疼痛阈值升高,且与心理社会慢性化因素无关。(4) 结论:使用ÖMPSQ测量的心理社会慢性化因素对cLBP患者的疼痛敏化有显著影响。为期14天的多模式疼痛治疗提高了局部而非外周的压力疼痛阈值。