Tabatabaei Shafiei Pedram, Åkerstedt Josefin, Awad Amar, Sjöberg Rickard L, Wänman Johan
Department of Clinical Science, Umeå University, Umeå, Sweden.
Department of Diagnostics and Interventions, Umeå, Sweden.
Pain Pract. 2025 Mar;25(3):e70017. doi: 10.1111/papr.70017.
Pain, comprising sensory and emotional elements, is influenced by pain catastrophizing, which magnifies pain and promotes helplessness and rumination. This study explores the relationship between pain catastrophizing and outcomes following selective nerve root blockade (SNRB) in patients with lumbar radicular pain (LRP).
A prospective cohort study of 103 LRP patients, confirmed by MRI, was conducted. All participants underwent SNRB at Umeå University Hospital. Outcomes were measured using PROMIS-29 and the Pain Catastrophizing Scale (PCS) at baseline and several intervals up to 84 days post-intervention. Patients were categorized into responder (≥30% pain reduction) and non-responder groups and stratified into three groups based on baseline PCS scores. Changes in outcomes from baseline to 14 days post-SNRB were analyzed in relation to PCS groups. PCS changes over time were evaluated between responders and non-responders. Statistical analyses assessed PCS and outcome changes.
Baseline pain catastrophizing was not a significant predictor of pain response to SNRB. However, responders demonstrated significant reductions in pain catastrophizing following the intervention, suggesting that SNRB may influence cognitive coping mechanisms related to pain.
SNRB reduces pain catastrophizing in LRP patients, although baseline catastrophizing does not predict pain outcomes. Addressing catastrophizing remains important but may serve better as an outcome measure rather than a predictor of treatment response.
疼痛由感觉和情感成分组成，受疼痛灾难化思维的影响，这种思维会放大疼痛并加剧无助感和反复思考。本研究探讨了腰椎神经根性疼痛（LRP）患者中疼痛灾难化思维与选择性神经根阻滞（SNRB）后疗效之间的关系。
对103例经MRI确诊的LRP患者进行了一项前瞻性队列研究。所有参与者均在乌梅奥大学医院接受了SNRB。在基线以及干预后长达84天的几个时间点，使用PROMIS-29和疼痛灾难化量表（PCS）对疗效进行测量。将患者分为反应者（疼痛减轻≥30%）和无反应者组，并根据基线PCS评分分为三组。分析了SNRB后14天内与PCS分组相关的疗效变化。评估了反应者和无反应者之间PCS随时间的变化。统计分析评估了PCS和疗效变化。
基线时的疼痛灾难化思维不是SNRB疼痛反应的显著预测因素。然而，反应者在干预后疼痛灾难化思维显著降低，这表明SNRB可能会影响与疼痛相关的认知应对机制。
SNRB可降低LRP患者的疼痛灾难化思维，尽管基线时的灾难化思维并不能预测疼痛疗效。应对灾难化思维仍然很重要，但它可能更适合作为一种疗效指标，而不是治疗反应的预测指标。
