1
|
Amelot A, Jacquot A, Terrier LM, Aggad M, Planty-Bonjour A, Fouquet B, Cook AR, Zemmoura I, Velut S, Destrieux C, François P, Borius PY, Mathon B. Chronic low back pain during COVID-19 lockdown: is there a paradox effect? EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 31:167-175. [PMID: 34729679 PMCID: PMC8562766 DOI: 10.1007/s00586-021-07049-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 10/27/2021] [Indexed: 11/28/2022]
Abstract
Purpose The coronavirus 2019 (COVID-19) pandemic led to a compulsory lockdown of 3 months with strict restrictions. The impact of the COVID-19 pandemic has shown broad repercussions on patients with chronic pain; especially for conditions that present a significant emotional participation such as chronic low back pain (cLBP). Methods We performed a prospective study on 50 patients. Pre- and 1-month post-lockdown questionnaires such as: the Impact of Event Scale (IES), the Oswestry Disability Index (ODI), the Roland–Morris questionnaire (RMQ) and the visual analogue scale (VAS) for back and leg pain intensity were collected. Results The mean time of the evolution of cLBP was 33.04 months (range 5–120 months). Eighteen (36%) patients improved their cLBP (i-cLBP), whereas for 14 (28%) it was worse (w-cLBP). Cox multivariate proportional hazard model identified that MODIC 1 disc disease [OR 19.93, IC95% (2.81–102.13), p = 0.015] and at-home workouts [OR 18.854, IC95% (1.151–204.9), p = 0.040] were good prognosis factors of the improvement of cLBP while subclinical/mild Covid-19 anxiety (IES score < 26) was a poor prognosis factor in improving cLBP [OR 0.21, IC95% (0.001–0.384), p = 0.009]. Furthermore, pre-lockdown benzodiazepine medication [OR 2.554, IC95% (1.20–9.9), p = 0.002] was a prognosis factor of worse cLBP. In contrast, patients with severe Covid-19 anxiety (IES score > 26) significantly improved their cLBP [OR 0.58, IC95% (0.025–0.834), p = 0.01]. Conclusion Lockdown affected the somatic component of cLBP by decreasing activities and physical measures, whereas the SARS-CoV-2 pandemic spectrum paradoxically improved the psychic and emotional component of cLBP.
Collapse
Affiliation(s)
- Aymeric Amelot
- Department of Neurosurgery, CHU Tours, 2 Boulevard de Tonnelle, 37000, Tours, France.
| | - Anais Jacquot
- Physical Medicine and Rehabilitation Department, CHU de Tours, Tours, France
| | - Louis-Marie Terrier
- Department of Neurosurgery, CHU Tours, 2 Boulevard de Tonnelle, 37000, Tours, France
| | - Mourad Aggad
- Department of Neurosurgery, CHU Tours, 2 Boulevard de Tonnelle, 37000, Tours, France
| | - Alexia Planty-Bonjour
- Department of Neurosurgery, CHU Tours, 2 Boulevard de Tonnelle, 37000, Tours, France
| | - Bernard Fouquet
- Physical Medicine and Rehabilitation Department, CHU de Tours, Tours, France
| | - Ann-Rose Cook
- Department of Neurosurgery, CHU Tours, 2 Boulevard de Tonnelle, 37000, Tours, France
| | - Ilyess Zemmoura
- Department of Neurosurgery, CHU Tours, 2 Boulevard de Tonnelle, 37000, Tours, France
| | - Stephane Velut
- Department of Neurosurgery, CHU Tours, 2 Boulevard de Tonnelle, 37000, Tours, France
| | - Christophe Destrieux
- Department of Neurosurgery, CHU Tours, 2 Boulevard de Tonnelle, 37000, Tours, France
| | - Patrick François
- Department of Neurosurgery, CHU Tours, 2 Boulevard de Tonnelle, 37000, Tours, France
| | | | - Bertrand Mathon
- Department of Neurosurgery, La Pitié-Salpêtrière, Paris, France
| |
Collapse
|
2
|
Borsa S, Pluderi M, Carrabba G, Ampollini A, Pirovano M, Lombardi F, Tomei M, Locatelli M. Letter to the Editor: Impact of COVID-19 Outbreak on Acute Low Back Pain. World Neurosurg 2020; 139:749. [PMID: 32479910 PMCID: PMC7256499 DOI: 10.1016/j.wneu.2020.05.218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 05/24/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Stefano Borsa
- Department of Neurosurgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Mauro Pluderi
- Department of Neurosurgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giorgio Carrabba
- Department of Neurosurgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonella Ampollini
- Department of Neurosurgery, ASST Santi Paolo e Carlo, San Carlo Hospital, Milan, Italy
| | - Marta Pirovano
- Department of Neurosurgery, ASST Santi Paolo e Carlo, San Carlo Hospital, Milan, Italy
| | - Francesco Lombardi
- Department of Neurosurgery, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Massimo Tomei
- Department of Neurosurgery, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy
| | - Marco Locatelli
- Department of Neurosurgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| |
Collapse
|
3
|
Chahal HS, St Fort N, Bero L. Availability, prices and affordability of essential medicines in Haiti. J Glob Health 2013; 3:020405. [PMID: 24363923 PMCID: PMC3868824 DOI: 10.7189/jogh.03.020405] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Haiti is the poorest country in the Western Hemisphere and faces numerous challenges, including inadequate medication access for its residents. The objective of this study was to determine the availability, prices, and affordability of essential medicines in Haiti and compare these findings to other countries. Methods We conducted a cross–sectional nationwide survey in 2011 of availability and consumer prices of 60 essential medicines in Haiti using a standardized methodology developed by the World Health Organization and Health Action International. The survey was conducted in 163 medicine outlets in four health care sectors (public, retail, nonprofit and mixed sectors). Medicine prices were expressed as ratios relative to the International Reference Price. Affordability was calculated by comparing the costs of treatment for common conditions with the salary of the lowest paid government worker and was compared to available data from four Latin American countries. Results For generic medicines, the availability in public, retail, nonprofit and mixed sectors was 20%, 37%, 24% and 23% of medications, respectively. Most of the available medicines were priced higher than the International Reference Price. The lowest paid government worker would need 2.5 days’ wages to treat an adult respiratory infection with generic medicines from the public sector. For treatment of common conditions with originator brands (OB) purchased from a retail pharmacy, costs were between 1.4 (anaerobic bacterial infection) and 13.7 (hyperlipidemia) days’ wages, respectively. Treatment of pediatric bacterial infections with the OB of ceftriaxone from a retail pharmacy would cost 24.6 days’ wages. Prices in Bolivia, Colombia, Mexico and Nicaragua were frequently lower for comparable medications. Conclusions The availability of essential medicines was low and prices varied widely across all four sectors. Over 75% of Haitians live on less than US$ 2.00 /day; therefore, most medication regimens are largely unaffordable. Inclusion of essential medications on the national formulary and working with organizations responsible for importing medications into Haiti, particularly drug donation agencies, are important first steps to increasing medication access.
Collapse
Affiliation(s)
- Harinder Singh Chahal
- Department of Clinical Pharmacy, University of California, San Francisco, Cal., USA ; Haiti Initiative, University of California, San Francisco, Cal., USA
| | - Nazaire St Fort
- Haiti Initiative, University of California, San Francisco, Cal., USA
| | - Lisa Bero
- Clinical Pharmacy and Health Policy, University of California, San Francisco, Cal., USA
| |
Collapse
|
4
|
Cammack F, Shipton EA. The christchurch earthquake: crush injury, neuropathic pain, and posttraumatic stress disorder. Case Rep Med 2013; 2013:973234. [PMID: 23956754 PMCID: PMC3728530 DOI: 10.1155/2013/973234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 06/26/2013] [Indexed: 01/08/2023] Open
Abstract
On February 22, 2011, an earthquake of magnitude 6.3 struck Christchurch, New Zealand. The peak ground acceleration, a measure of the shaking or intensity of an earthquake, was one of the highest ever recorded worldwide. One hundred and eighty-five people lost their lives; many others were injured. Two cases both involving young women are presented; they sustained crush injuries to limbs after being trapped by falling debris and went on to develop severe neuropathic pain. This report examines the mechanisms of neuropathic pain in the setting of crush injury, the treatment modalities, and the association between chronic pain and posttraumatic stress disorder. These case reports highlight the fact that crush injury is relatively common during major earthquakes and that neuropathic pain is an important sequel of this. Post-traumatic stress disorder is common in earthquake survivors with a recognised association with chronic pain. Pain-related disability may increase as well. Issues such as chronic pain and physical disability should not be overlooked as attention focuses on disaster management and the treatment of life-threatening injuries.
Collapse
Affiliation(s)
- Frances Cammack
- Department of Anaesthesia, Christchurch Hospital, Christchurch 8001, New Zealand
| | - Edward A. Shipton
- Department of Anaesthesia, University of Otago, P.O. Box 4345, Christchurch 8001, New Zealand
| |
Collapse
|