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ORIJINAL ARAŞTIRMA

Kronik Bel Ağrısı Olan Hastalarda Nöropatik Ağrı Sıklığı ve İlişkili Faktörlerin Değerlendirilmesi
Evaluation of Neuropathic Pain Frequency and Related Factors in Patients with Chronic Low Back Pain
Received Date : 18 Feb 2022
Accepted Date : 27 Jun 2022
Available Online : 05 Jul 2022
Doi: 10.31609/jpmrs.2022-89033 - Makale Dili: EN
J PMR Sci. 2022;25(3):332-8
ÖZET
Amaç: Bu çalışmanın amacı, “PainDETECT ağrı anketi” kullanarak kronik bel ağrılı hastalarda nöropatik ağrı prevalansını ve nöropatik ağrı ile fiziksel özürlülük, anksiyete ve depresyon arasındaki ilişkiyi değerlendirmektir. Gereç ve Yöntemler: Haziran 2018-Aralık 2019 tarihleri arasında kronik bel ağrılı 141 hasta (35 erkek, 106 kadın; ortalama yaş: 49,4±12,0 yıl; dağılım 20-65 yıl) çalışmaya dâhil edildi. “PainDETECT ağrı anketine” dayanarak, katılımcılar 2 gruba ayrıldı: nöropatik grup ve nöropatik olmayan grup. Hastaların sosyodemografik özellikleri ve klinik verileri kaydedildi. Ağrı, görsel analog skala [visual analogue scale (VAS)] ile özürlülük, Oswestry Özürlülük İndeksi [Oswestry Disability Index (ODI)] ile depresyon, Zung Depresyon Ölçeği [Zung Self-Rating Depression Scale (SDS)] ile anksiyete, Beck Anksiyete Envanteri [Beck Anxiety Inventory (BAI)] ile değerlendirildi. Bulgular: Bu çalışmada kronik bel ağrılı hastaların %21,3’ünde nöropatik ağrı saptandı. Nöropatik ağrı, diyabet ve diz altına ağrı yayılımı ile ilişkiliydi (p=0,002, p=0,003). Ancak yaş, cinsiyet, beden kitle indeksi ve sigara kullanımı açısından gruplar arasında anlamlı fark yoktu (p=0,06, p=0,9, p=0,4, p=0,4). Mevcut ağrıyı, son 4 haftadaki ortalama ağrıyı ve son 4 haftadaki en şiddetli ağrıyı sorgulayan VAS skorları, nöropatik ağrı grubunda, nöropatik ağrı olmayan gruba göre anlamlı derecede yüksekti (p=0,001, p<0,001, p=0,001). ODI, SDS, BAI skorları nöropatik ağrı grubunda, nöropatik ağrı olmayan gruba göre anlamlı derecede yüksekti (p<0,001, p<0,001, p<0,001). Sonuç: Nöropatik ağrı, kronik bel ağrısına önemli katkıda bulunur ve rolü göz ardı edilmemelidir.
ABSTRACT
Objective: The aim of this study was to evaluate the prevalence of neuropathic pain in patients with chronic low back pain (LBP) using the PainDETECT questionnaire (PDQ) and to evaluate the relationship between neuropathic pain and physical disability, anxiety and depression. Material and Methods: Between June 2018 and December 2019, 141 patients with chronic LBP (35 males, 106 females; mean age: 49.4±12.0 years; range 20 to 65 years) were included in the study. Based on the PDQ, participants were classified into 2 groups: the neuropathic group and the non-neuropathic group. Socio-demographic characteristics and clinical data of the patients were recorded. Pain was evaluated with the visual analogue scale (VAS), disability with the Oswestry Disability Index (ODI), depression with the Zung Self-Rating Depression Scale (SDS) and anxiety with the Beck Anxiety Inventory (BAI). Results: In this study neuropatic pain was detected in 21.3% of the patients with chronic LBP. Neuropathic pain was associated diabetes and pain radiation below the knee (p=0.002, p=0.003). However, there was no significant difference between the groups in age, gender, body mass index and smoking (p=0.06, p=0.9, p=0.4, p=0.4). VAS scores questioning current pain, mean pain in the last 4 weeks, and most severe pain in the last 4 weeks were significantly higher in the neuropathic pain group than in the non-neuropathic pain group (p=0.001, p<0.001, p=0.001). ODI, SDS, BAI scores were significantly higher in the neuropathic pain group than in the non-neuropathic pain group (p<0.001, p<0.001, p<0.001). Conclusion: Neuropathic pain is a major contributor to chronic LBP and its role should not be ignored.
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