Yıl: 2014 Cilt: 60 Sayı: 1 Sayfa Aralığı: 32 - 36 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain

Öz:
Amaç: Bu çalışmanın amacı, kronik bel ağrısı olan hastalar ve sağlıklı bireyler arasında basınç ağrı eşiği değerleri açısından farkı belirlemek, aynı zamanda kronik bel ağrısı olan hastalarda farklı anatomik bölgelerde basınç ağrı eşiği test edilerek yaygın ağrıyı incelemektir.Gereç ve Yöntemler: Kronik bel ağrılı 70 hasta ve 62 sağlıklı kontrol çalışmaya dahil edildi. Basınç ağrı eşiği, her iki grupta, Amerikan Romatizma Cemiyeti tarafından belirlenen 18 fibromiyalji hassas noktası, 12 siyatik valleks noktası ve 4 lomber paravertebral nokta olmak üzere toplam 34 noktada değerlendirildi. Basınç ağrı eşiği ölçümleri, yüzey alanı 1 cm2 olan elektronik basınç algometre cihazı ile yapıldı. Bulgular: Kronik bel ağrılı hastalarda tüm noktalarda ortalama basınç ağrı eşiği, sağlıklı kontrollere göre anlamlı düzeyde düşük bulundu (p=0,001). Sonuç: Bu çalışma, kronik bel ağrılı hastalarda sağlıklı kontrollere göre tüm vücutta basınç ağrı eşiğinin düşük olduğunu gösterdi. Bu sonuç, kronik bel ağrısı olan hastaların değerlendirilmesinde yaygın ağrının göz önünde bulundurulması gerektiğini düşündürür niteliktedir.
Anahtar Kelime:

Konular: Rehabilitasyon

Kronik Bel Ağrısında Basınç Ağrı Eşiği ve Yaygın Ağrının Değerlendirilmesi

Öz:
Objective: The purpose of this study was to determine differences in pain pressure threshold (PPT) values between patients with chronic low back pain (CLPB) and healthy people and to also evaluate widespread pain sensitivity by testing PPT in different sites of patients with CLBP.Material and Methods: Seventy subjects with CLBP and 62 healthy controls were included in the study. PPT values were evaluated for a total of 34 points, including 18 tender points defined for fibromyalgia syndrome by the American College of Rheumatology, 12 points for testing of sciatic valleix, and 4 lumbar paravertebral points, in both groups. An electronic pressure algometer was used to measure PPT with a stimulation surface area of 1 cm2. Results: A significantly lower mean PPT was determined for all test sites in the patients with CLBP compared with healthy controls (p=0.001).Conclusion: The study showed that patients with CLBP have significantly lower PPT values at every individual site compared with healthy controls. This result suggests that widespread pain should be taken into account in the evaluation of patients with CLBP.
Anahtar Kelime:

Konular: Rehabilitasyon
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Giesbrecht RJ, Battie MC. A comparison of pressure pain detection thresholds in people with chronic low back pain and volunteers without pain. Phys Ther 2005;85:1085-92.
  • Boden SD, McCowin PR, Davis DO, Dina TS, Mark AS, Wiesel S. Abnormal magnetic-resonance scans of the cervical spine in asym- ptomatic subjects. A prospective investigation. J Bone Joint Surg Am 1990;72:1178-84.
  • Boos N, Lander PH. Clinical efficacy of imaging modalities in the diag- nosis of low-back pain disorders. Eur Spine J 1996;5:2-22. [CrossRef]
  • Clauw DJ, Williams D, Lauerman W, Dahlman M, Aslami A, Nac- hemson AL, et al. Pain sensitivity as a correlate of clinical status in individuals with chronic low back pain. Spine (Phila Pa 1976) 1999;24:2035-41. [CrossRef]
  • Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med 1994;331:69-73. [CrossRef]
  • Kosek E, Ekholm J, Hansson P. Pressure pain thresholds in different tissues in one body region. The influence of skin sensitivity in pres- sure algometry. Scand J Rehabil Med 1999;31:89-93. [CrossRef]
  • Pöntinen P. Reliability, validity, reproducibility of algometry in diag- nosis of active and latent tender spots and trigger points. J Muscu- loskelet Pain 1998;6:61-71. [CrossRef]
  • Croft P, Schollum J, Silman A. Population study of tender point co- unts and pain as evidence of fibromyalgia. BMJ 1994;309:696-9. [CrossRef]
  • Wolfe F, Ross K, Anderson J, Russell IJ. Aspects of fibromyalgia in the general population: sex, pain threshold, and fibromyalgia symptoms. J Rheumatol 1995;22:151-6.
  • Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995;38:19-28. [CrossRef]
  • Hirayama J, Yamagata M, Ogata S, Shimizu K, Ikeda Y, Takahashi K. Relationship between low-back pain, muscle spasm and pressure pain thresholds in patients with lumbar disc herniation. Eur Spine J 2006;15:41-7. [CrossRef]
  • Woolf CJ, Thompson SW, King AE. Prolonged primary afferent indu- ced alterations in dorsal horn neurones, an intracellular analysis in vivo and in vitro. J Physiol (Paris) 1988;83:255-66.
  • Giesecke T, Gracely RH, Grant MA, Nachemson A, Petzke F, Willi- ams DA, et al. Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis Rheum 2004;50:613-23. [CrossRef]
  • Koelbaek Johansen M, Graven-Nielsen T, Schou Olesen A, Arendt- Nielsen L. Generalised muscular hyperalgesia in chronic whiplash syndrome. Pain 1999;83:229-34. [CrossRef]
  • Nordeman L, Gunnarsson R, Mannerkorpi K. Prevalence and characte- ristics of widespread pain in female primary health care patients with chronic low back pain. Clin J Pain 2012;28:65-72. [CrossRef]
  • Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Golden- berg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990;33:160-72. [CrossRef]
  • Lapossy E, Maleitzke R, Hrycaj P, Mennet W, Muller W. The frequ- ency of transition of chronic low back pain to fibromyalgia. Scand J Rheumatol 1995;24:29-33. [CrossRef]
  • Boos N, Rieder R, Schade V, Spratt KF, Semmer N, Aebi M. 1995 Volvo Award in clinical sciences. The diagnostic accuracy of magne- tic resonance imaging, work perception, and psychosocial factors in identifying symptomatic disc herniations. Spine (Phila Pa 1976) 1995;20:2613-25. [CrossRef]
  • Burton AK, Tillotson KM. Prediction of the clinical course of low- back trouble using multivariable models. Spine (Phila Pa 1976) 1991;16:7-14. [CrossRef]
  • Bigos SJ, Battie MC, Spengler DM, Fisher LD, Fordyce WE, Hansson TH, et al. A prospective study of work perceptions and psychosocial factors affecting the report of back injury. Spine (Phila Pa 1976) 1991;16:1-6. [CrossRef]
  • Burton AK, Tillotson KM, Main CJ, Hollis S. Psychosocial predictors of outcome in acute and subchronic low back trouble. Spine (Phila Pa 1976) 1995;20:722-8. [CrossRef]
  • Greenough CG, Fraser RD. Comparison of eight psychometric ins- truments in unselected patients with back pain. Spine (Phila Pa 1976) 1991;16:1068-74. [CrossRef]
  • Cooper RG, Freemont AJ, Hoyland JA, Jenkins JP, West CG, Illing- worth KJ, et al. Herniated intervertebral disc-associated periradicu- lar fibrosis and vascular abnormalities occur without inflammatory cell infiltration. Spine (Phila Pa 1976) 1995;20:591-8. [CrossRef]
  • Chesterton LS, Sim J, Wright CC, Foster NE. Interrater reliability of algometry in measuring pressure pain thresholds in healthy hu- mans, using multiple raters. Clin J Pain 2007;23:760-6. [CrossRef]
  • Montenegro ML, Braz CA, Mateus-Vasconcelos EL, Rosa-e-Silva JC, Candido-dos-Reis FJ, Nogueira AA, et al. Pain pressure threshold algometry of the abdominal wall in healthy women. Braz J Med Biol Res 2012;45:578-82. [CrossRef]
  • van Wilgen P, van der Noord R, Zwerver J. Feasibility and reliability of pain pressure threshold measurements in patellar tendinopathy. J Sci Med Sport 2011;14:477-81. [CrossRef]
  • Farasyn A, Meeusen R. The influence of non-specific low back pain on pressure pain thresholds and disability. Eur J Pain 2005;9:375-81. [CrossRef]
  • Granges G, Littlejohn G. Pressure pain threshold in pain-free sub- jects, in patients with chronic regional pain syndromes, and in pati- ents with fibromyalgia syndrome. Arthritis Rheum 1993;36:642-6. [CrossRef]
  • Kasch H, Stengaard-Pedersen K, Arendt-Nielsen L, Staehelin Jensen T. Pain thresholds and tenderness in neck and head following acute whiplash injury: a prospective study. Cephalalgia 2001;21:189-97. [CrossRef]
  • Leffler AS, Kosek E, Lerndal T, Nordmark B, Hansson P. Somatosen- sory perception and function of diffuse noxious inhibitory controls (DNIC) in patients suffering from rheumatoid arthritis. Eur J Pain 2002;6:161-76. [CrossRef]
  • Arendt-Nielsen L, Nie H, Laursen MB, Laursen BS, Madeleine P, Si- monsen OH, et al. Sensitization in patients with painful knee osteo- arthritis. Pain 2010;149:573-81. [CrossRef]
  • Bajaj P, Bajaj P, Graven-Nielsen T, Arendt-Nielsen L. Osteoarthritis and its association with muscle hyperalgesia: an experimental cont- rolled study. Pain 2001;93:107-14. [CrossRef]
  • Staud R. Is it all central sensitization? Role of peripheral tissue no- ciception in chronic musculoskeletal pain. Curr Rheumatol Rep 2010;12:448-54. [CrossRef]
  • Dray A. Peripheral mediators of pain In: Dray A, Dickenson AH,Besson JM, eds. Handbook of experimental Pharmacology. Ber- lin: Springer-Verlag, 1997.pp.22-41.
  • Dray A, Urban L. New pharmacological strategies for pain relief. Annu Rev Pharmacol Toxicol 1996;36:253-80. [CrossRef]
  • Dubner R, Ren K. Endogenous mechanisms of sensory modulation. Pain 1999;6:45-53. [CrossRef]
  • Carr DB, Goudas LC. Acute pain. Lancet 1999;353:2051-8. [CrossRef]
  • Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science 2000;288:1765-9. [CrossRef]
  • Woolf CJ. Evidence for a central component of post-injury pain hypersensitivity. Nature 1983;306:686-8. [CrossRef]
  • Coderre TJ, Katz J, Vaccarino AL, Melzack R. Contribution of central neuroplasticity to pathological pain: review of clinical and experi- mental evidence. Pain 1993;52:259-85. [CrossRef]
  • Woolf CJ, Thompson SW. The induction and maintenance of cent- ral sensitization is dependent on N-methyl-D-aspartic acid receptor activation; implications for the treatment of post-injury pain hyper- sensitivity states. Pain 1991;44:293-9. [CrossRef]
  • Woolf CJ, Doubell TP. The pathophysiology of chronic pain-- increased sensitivity to low threshold A beta-fibre inputs. Curr Opin Neurobiol 1994;4:525-34. [CrossRef]
  • Flor H, Braun C, Elbert T, Birbaumer N. Extensive reorganization of primary somatosensory cortex in chronic back pain patients. Neu- rosci Lett 1997;224:5-8. [CrossRef]
  • Peters ML, Schmidt AJ. Differences in pain perception and sensory discrimination between chronic low back pain patients and healthy controls. J Psychosom Res 1992;36:47-53. [CrossRef]
APA ÖZDOLAP ÇOBAN Ş, SARIKAYA S, KÖKTÜRK F (2014). Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain. , 32 - 36.
Chicago ÖZDOLAP ÇOBAN ŞENAY,SARIKAYA Selda,KÖKTÜRK Fürüzan Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain. (2014): 32 - 36.
MLA ÖZDOLAP ÇOBAN ŞENAY,SARIKAYA Selda,KÖKTÜRK Fürüzan Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain. , 2014, ss.32 - 36.
AMA ÖZDOLAP ÇOBAN Ş,SARIKAYA S,KÖKTÜRK F Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain. . 2014; 32 - 36.
Vancouver ÖZDOLAP ÇOBAN Ş,SARIKAYA S,KÖKTÜRK F Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain. . 2014; 32 - 36.
IEEE ÖZDOLAP ÇOBAN Ş,SARIKAYA S,KÖKTÜRK F "Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain." , ss.32 - 36, 2014.
ISNAD ÖZDOLAP ÇOBAN, ŞENAY vd. "Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain". (2014), 32-36.
APA ÖZDOLAP ÇOBAN Ş, SARIKAYA S, KÖKTÜRK F (2014). Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 60(1), 32 - 36.
Chicago ÖZDOLAP ÇOBAN ŞENAY,SARIKAYA Selda,KÖKTÜRK Fürüzan Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 60, no.1 (2014): 32 - 36.
MLA ÖZDOLAP ÇOBAN ŞENAY,SARIKAYA Selda,KÖKTÜRK Fürüzan Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, vol.60, no.1, 2014, ss.32 - 36.
AMA ÖZDOLAP ÇOBAN Ş,SARIKAYA S,KÖKTÜRK F Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2014; 60(1): 32 - 36.
Vancouver ÖZDOLAP ÇOBAN Ş,SARIKAYA S,KÖKTÜRK F Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2014; 60(1): 32 - 36.
IEEE ÖZDOLAP ÇOBAN Ş,SARIKAYA S,KÖKTÜRK F "Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain." Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 60, ss.32 - 36, 2014.
ISNAD ÖZDOLAP ÇOBAN, ŞENAY vd. "Evaluation of Pain Pressure Threshold and Widespread Pain in Chronic Low Back Pain". Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 60/1 (2014), 32-36.