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Michalak M, Druszcz A, Miś M, Paprocka-Borowicz M, Rosińczuk J. Quality of Life, Disability Level, and Pain Intensity among Patients after Lumbar Disc Surgery: An Observational Three-Month Follow-Up Study. Healthcare (Basel) 2023; 11:3127. [PMID: 38132017 PMCID: PMC10742899 DOI: 10.3390/healthcare11243127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/22/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023] Open
Abstract
The prevalence of intervertebral disc degeneration in the lumbar region resulting in low back pain is high. One of the treatment options is neurosurgery. Previous studies and systematic reviews demonstrate the need to identify factors that affect the health-related quality of life of patients undergoing surgery. This study aimed to analyze the sociodemographic and clinical factors that affect the quality of life of patients undergoing lumbar disc surgery. A group of 128 patients was assessed for eligibility and qualified by radiological examinations for lumbar disc surgery by a neurosurgeon in the outpatient clinic. Finally, 110 patients were studied and evaluated 24 h and 3 months after surgery. Health-related quality of life (36-Item Short Form Survey, SF-36), disability level (Oswestry Disability Index, ODI), and pain intensity (Visual Analogue Scale, VAS) were assessed. The mean pain intensity before surgery was 7.8 ± 2.3 pts and decreased significantly 24 h after surgery, with a mean score of 3.8 ± 2.4 pts (p = 0.0000). After three months, the increase in pain intensity was at 4.8 ± 2.4 pts, but the score was still significantly better than before surgery (p = 0.0024). The mean ODI score before surgery was 29.3 ± 8.4 pts (slight disability), and three months after surgery, there was an insignificant increase to a mean value of 31.5 ± 10.4 pts (p = 0.0834). There was a statistically significant increase in quality-of-life scores at three months after surgery in the following domains: physical functioning (8.7%; p = 0.0176), bodily pain (26.2%; p = 0.0000), vitality (5.8%; p = 0.0132) and mental health (6.2%; p = 0.0163), and a decrease in role limitations due to physical problems (3.8; p = 0.0013) and general health perception (6.7%; p = 0.0112). In conclusion, the surgical procedure plays an important role in improving the quality of life of patients operated on for intervertebral disc degeneration. It was effective in reducing the pain level, especially 24 h after surgery; however, surgery did not affect the disability level.
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Affiliation(s)
- Monika Michalak
- Department of Nursing and Obstetrics, Wroclaw Medical University, 51-618 Wroclaw, Poland;
| | - Adam Druszcz
- Department of Neurosurgery, Provincial Specialist Hospital in Legnica, 59-220 Legnica, Poland;
| | - Maciej Miś
- Department of Neurosurgery, Specialist Hospital in Walbrzych, 58-309 Walbrzych, Poland;
| | | | - Joanna Rosińczuk
- Department of Nursing and Obstetrics, Wroclaw Medical University, 51-618 Wroclaw, Poland;
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Yao C, Zhang Y, Lu P, Xiao B, Sun P, Tao J, Cheng Y, Kong L, Xu D, Fang M. Exploring the bidirectional relationship between pain and mental disorders: a comprehensive Mendelian randomization study. J Headache Pain 2023; 24:82. [PMID: 37415130 DOI: 10.1186/s10194-023-01612-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND The close relationship between pain and mental health problems is well-known, and psychological intervention can provide an effective alternative to medication-based pain relief. However, previous studies on the connection between pain and psychological problems, the findings thus far have been inconclusive, limiting the potential for translating psychological interventions into clinical practice. To complement the gap, this study utilized genetic data and Mendelian randomization (MR) to examine the potential relationship between pain in different parts and common mental disorders. METHODS Based on the instrumental variables selected from the Genome-wide association study summary statistics of localized pain and mental disorders, we conducted bidirectional two-sample MR analyses to infer bidirectional causal associations between pain and mental disorders. The inverse-variance weighted MR method and MR-Egger were used as the primary statistical method according to the horizontal pleiotropy and heterogeneity level. We reported the odds ratio to infer the causal effect between pain and mental disorders. F statistic was calculated to measure the statistical efficacy of the analyses. RESULTS Insomnia is causally related to the genetic susceptibility of multisite pain including head (OR = 1.09, 95% CI: 1.06-1.12), neck/shoulder (OR = 1.12, 95% CI: 1.07-1.16), back (OR = 1.12, 95% CI: 1.07-1.18) and hip (OR = 1.08, 95% CI: 1.05-1.10). Reversely, headache (OR = 1.14, 95% CI: 1.05-1.24), neck/shoulder pain (OR = 1.95, 95% CI: 1.03-3.68), back pain (OR = 1.40, 95% CI: 1.22-1.60), and hip pain (OR = 2.29, 95% CI: 1.18-4.45) promote the genetic liability of insomnia. Depression is strongly associated with the predisposition of multisite pain including headache (OR = 1.28, 95% CI: 1.08-1.52), neck/shoulder pain (OR = 1.32, 95% CI: 1.16-1.50), back pain (OR = 1.35, 95% CI: 1.10-1.66) and stomach/abdominal pain (OR = 1.14, 95% CI: 1.05-1.25), while headache (OR = 1.06, 95% CI: 1.03-1.08), neck/shoulder (OR = 1.09, 95% CI: 1.01-1.17), back (OR = 1.08, 95% CI: 1.03-1.14), and stomach/abdominal pain (OR = 1.19, 95% CI: 1.11-1.26) are predisposing factors for depression. Additionally, insomnia is associated with the predisposition of facial, stomach/abdominal, and knee pain, anxiety was associated with the predisposition of neck/shoulder and back pain, while the susceptibilities of hip and facial pain are influenced by depression, but these associations were unidirectional. CONCLUSIONS Our results enhance the understanding of the complex interplay between pain and mental health and highlight the importance of a holistic approach to pain management that addresses both physical and psychological factors.
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Affiliation(s)
- Chongjie Yao
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Yuchen Zhang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Ping Lu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Bin Xiao
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Pingping Sun
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Jiming Tao
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
| | - Yanbin Cheng
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People's Republic of China
- Research Institute of Tuina, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 200437, People's Republic of China
| | - Lingjun Kong
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China
- Research Institute of Tuina, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 200437, People's Republic of China
| | - Dongsheng Xu
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China.
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China.
| | - Min Fang
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People's Republic of China.
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People's Republic of China.
- Research Institute of Tuina, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 200437, People's Republic of China.
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Budrovac D, Radoš I, Hnatešen D, Haršanji-Drenjančević I, Tot OK, Katić F, Lukić I, Škiljić S, Nešković N, Dimitrijević I. Effectiveness of Epidural Steroid Injection Depending on Discoradicular Contact: A Prospective Randomized Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3672. [PMID: 36834367 PMCID: PMC9962306 DOI: 10.3390/ijerph20043672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Lumbar radicular pain is a major public health and economic problem. It is among the most common reasons for professional disability. The most common cause of lumbar radicular pain is intervertebral disc herniation, which results from degenerative disc changes. The dominant pain mechanisms are direct pressure of the hernia on the nerve root and the local inflammatory process triggered by intervertebral disc herniation. Treatment of lumbar radicular pain includes conservative, minimally invasive, and surgical treatment. The number of minimally invasive procedures is constantly increasing, and among these methods is epidural administration of steroids and local anesthetic through a transforaminal approach (ESI TF). The aim of this research was to examine the effectiveness of ESI TF as measured by a visual analog scale (VAS) and the Oswestry Disability Index (ODI), depending on whether there is contact between the herniated intervertebral disc and the nerve root. In both groups of participants, there was a significant reduction in pain intensity, but there was no significant difference between the groups. In the group with disc herniation and nerve root contact, the only significant reduction was in pain intensity (p < 0.001). There were no significant differences in measurements in other domains of the ODI. In the group without disc herniation and nerve contact, there was a significant difference in all domains except weight lifting. In the group without contact, there was significant improvement after 1 month (p = 0.001) and 3 months (p < 0.001) according to the ODI, while there was no significant improvement in the group with contact. In addition, there were no significant differences in the distribution of participants based on the ODI and whether disc herniation and nerve contact was present. The results suggest that transforaminal epidural administration of steroids is a clinically effective method for treating lumbar radicular pain caused by intervertebral disc herniation in people with and without nerve root contact, without significant differences.
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Affiliation(s)
- Dino Budrovac
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Ivan Radoš
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Dijana Hnatešen
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, 31000 Osijek, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Ivana Haršanji-Drenjančević
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Ozana Katarina Tot
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Franjo Katić
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Iva Lukić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Institute for Laboratory Diagnostics, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Sonja Škiljić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Nenad Nešković
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, 31000 Osijek, Croatia
| | - Iva Dimitrijević
- Department of Anaesthesiology, Reanimatology and Intensive Care, University Hospital Centre Osijek, 31000 Osijek, Croatia
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Hnatešen D, Radoš I, Dimitrijević I, Budrovac D, Omrčen I, Pavić R, Gusar I, Čebohin M, Šolić K. Influence of the Cognitive and Emotional Status of Patients with Chronic Pain on Treatment Success (Reduction in Pain Intensity and Adherence to Pharmacotherapy): A Prospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15968. [PMID: 36498036 PMCID: PMC9735997 DOI: 10.3390/ijerph192315968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
This prospective study aimed to determine the cognitive and emotional status among patients with chronic pain and to examine the potential influence on the treatment success, measured by the reduction in pain intensity and adherence to pharmacotherapy. A total of seventy patients were followed for two months. The results of the comparison between patients who did and did not follow the physician’s instructions regarding adherence to pharmacotherapy showed a significant difference in cognitive status and a reduction in pain intensity. Patients who followed the physician’s instructions on taking analgesics had significantly higher scores on the Montreal Cognitive Assessment (MoCA) of cognitive status and a substantially higher reduction in pain intensity. Scores on the MoCA test provide statistically significant indications regarding patients’ decision to follow instructions regarding adherence to pharmacotherapy. Scores on the MoCA test, anxiety, age, and pain intensity (measured with a numeric rating scale—NRS) on admission were identified as potential predictors for the reduction in pain intensity. The linear regression model was statistically significant (χ2 = 40.0, p < 0.001), explained between 43.5% and 61.1% of variance regarding the reduction in pain intensity. The findings of this study show that cognitive status, measured with MoCA, and emotional status, measured with the Depression, Anxiety, and Stress Scale (DASS-21), significantly influence the reduction in pain intensity and adherence to pharmacotherapy. The results suggest that cognitive and emotional status may be potential predictors of treatment success. This finding points to the importance of a biopsychosocial approach in the treatment of chronic pain, where an important emphasis can be placed on the psychosocial determinants of pain.
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Affiliation(s)
- Dijana Hnatešen
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Ivan Radoš
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Iva Dimitrijević
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Dino Budrovac
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Ivan Omrčen
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Department of Pain Management, University Hospital Osijek, 31000 Osijek, Croatia
| | - Roman Pavić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Clinical Hospital of Traumatology, University Hospital Centre “Sestre Milosrdnice”, 10000 Zagreb, Croatia
| | - Ivana Gusar
- Department of Health Studies, University of Zadar, 23000 Zadar, Croatia
| | - Maja Čebohin
- Nursing Institute “Professor Radivoje Radić”, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Medical School Osijek, 31000 Osijek, Croatia
| | - Krešimir Šolić
- Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Faculty of Electrical Engineering, Computer Science and Information Technology Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
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Recent and Frequent Mental Distress Among Women with a History of Military Service, 2003–2019. J Behav Health Serv Res 2022; 50:119-127. [PMID: 36369432 DOI: 10.1007/s11414-022-09825-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/13/2022]
Abstract
Examining women veterans' self-reported mental health is critical to understanding their unique mental and physical health needs. This study describes self-reported mental distress over a 17-year period among cross-sectional nationally representative samples of women in the USA using data from the Behavioral Risk Factor Surveillance System (BRFSS) core national surveys from 2003 to 2019. Nationally representative prevalence estimates of self-reported mental distress were compared between women veterans and their (1) men veteran and (2) women civilian counterparts. In each year examined, women veterans report significantly more days of recent mental distress and significantly higher prevalence of frequent mental distress than their men veteran counterparts. In several years, women veterans also report greater levels of recent and frequent mental distress than women civilians. These findings highlight the long-standing high prevalence of self-reported poor mental health among women veterans and suggest that specific efforts to address mental health among women veterans as a unique population may be warranted.
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