Association between pain sensitivity in the hand and outcomes after surgery in patients with lumbar disc herniation or spinal stenosis

Abstract

Purpose To investigate the association between pain sensitivity in the hand pre-surgery, and patient-reported outcomes (PROs) in function, pain and health pre-and postsurgery in patients with disc herniation or spinal stenosis. Methods This is a prospective cohort study with 82 patients. Associations between pressure-, cold-and heat pain threshold (PPT, CPT, HPT) in the hand pre-surgery and Oswestry, VAS pain, EQ-5D, HADS, and Self-Efficacy Scale, pre-and three months post-surgery; were investigated with linear regression.Results Patients with disc herniation more sensitive to pressure pain pre-surgery showed lower function and selfefficacy, and higher anxiety and depression pre-surgery, and lower function, and self-efficacy, and higher pain postsurgery. Results for cold pain were similar. In patients with spinal stenosis few associations with PROs were found and none for HPT and PROs. Conclusions Altered pain response in pressure-and cold pain in the hand, as a sign of widespread pain pre-surgery had associations with higher pain, lower function and selfefficacy post-surgery in patients with disc herniation.

Health-related quality of life deviations from population norms in patients with lumbar radiculopathy: associations with pain, pain cognitions, and endogenous nociceptive modulation

“…Nervus Medianus) was included in the analyses. [56,30] First, the electrical pain threshold was determined. Stimuli were given as a constant current rectangular pulse train consisting of 5 pulses at 250 Hz, each lasting 0.5 ms. For determining the threshold, stimulation started at 0 mA and was gradually increased by steps of 0.5 mA until the patients experienced the stimulus as unpleasant.…”

“…Furthermore, there has been a growing interest in endogenous nociceptive modulation in chronic pain research. [28][29][30][31][32] Endogenous pain modulatory processes encompass various actions that the central nervous system can use to reduce (e.g. inhibition) or augment (e.g.…”

The association between pain type, cognition and complaint after mild traumatic brain injury in prospectively studied premorbidly healthy adults admitted to hospital.

“…Subjective complaint of poor outcome is also well documented in the broader pain literature, with individuals reporting a range of difficulties associated with sensory pain including poorer physical functioning, self-efficacy, cognition and mood (Lindbäck et al, 2017; Mazza et al, 2018). Similarly, it has been shown that affective distress in chronic pain patients is associated with poorer quality of life and cognitive complaint (Muñoz & Esteve, 2005; Rada et al, 2016).…”