Kotova O.A.*, Teslova O.A.**, Kubrakov K.M.***
The peculiarities of pain sensation in patients with vertebrospinal injury sequelae
*Establishment "Gomel Regional Clinical Hospital for the Disabled Patriotic War Veterans", Republic of Belarus
**Education Establishment "Gomel State Medical University", Republic of Belarus
***Education Establishment "Vitebsk State Order of Peoples’ Friendship Medical University", Republic of Belarus
Objectives. To study the peculiarities of psychoemotional reactions in the sensation of pain in patients who have sustained spinal injury.
Material and methods. The study included 130 persons. The main group (1) consisted of 80 able-bodied patients who had sustained spinal cord injury at the age of 30 [25-37] years. The comparison group (2) was composed of 50 people without spinal injury, selected at random from the population. Age and sex structure of the control sample corresponded to that of the main group.
Pain sensations were assessed by means of visual analog scale of pain (VAS), and neuropathic pains questionnaire DN4. For anxiety and depression level diagnosis Taylor anxiety test and Montgomery-Aisberg depression scale (MADRS) were used. Statistical processing of data was performed with the help of software package «Statistica 6,1» (StatSoft, Tulsa, USA).
Results. After analyzing the clinical characteristics of patients with spinal injury we found no correlations between the sensation of pain and neuropathic character of pains and the remoteness of injury, its vertebral level and the degree of neurological disorders. Only in case of injuries, localized in the cervical part of the spine, there was a lower neuropathic pains threshold (H=6,92, p=0,031). Statistically significant differences of patients of the 1st and the 2nd groups according to VAS (Z=5,51, p<0,00001) and DN4 (Z=5,37, p<0,00001) and a strong positive association between DN4 and VAS (r=0,5663, p=0,000000002) were found. The association of both anxiety (Rs=0,22, p<0,02) and depression (Rs=0,32, p<0,0005) with pain sensations was determined. Neuropathic pains intensify the existing manifestations of depressive reactions (Rs=0,32, p<0,0004).
Conclusion. Patients who have had spinal injuries, experience constant pain syndrome and neuropathic pains, the presence of which affects their emotional state. The appearance of anxiety and depressive reactions accompanying pain is observed. In addition, neuropathic pains intensify the existing depressive symptoms.
Key words: spinal cord injury, neuropathic pain, anxiety, depression.
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