Effectiveness of duloxetine on severity of pain and quality of life in chronic low back pain in patients who had posterior spinal fixation

Abstract

Background: In this study, we want to search the effectiveness of Duloxetine on the severity of pain and quality of life in patients with chronic low back pain who had posterior spinal fixation. Methods: In this randomized, placebo-controlled trial done in 6 months 50 patients who had CLBP and were candidates for PSF surgery selected and divided into two groups (drug and placebo). They filled the VAS, SF-36, and Hamilton questionnaires before surgery and after 6 weeks from using 30 mg of duloxetine or placebo. Results: Significant differences were evidenced among groups for the Visual Analogue Scale (P = 0.005) and Verbal Analogue Scale (p = 0.003). Patients in the Duloxetine group have more visual and verbal pain scores than the placebo group. In the quality of life, there was a significant difference between the two groups before the intervention. Also, significant differences were evidenced among groups for the Hamilton Anxiety Rating Scale (p = 0.17). After the intervention, only the Hamilton Anxiety Rating Scale (p = 0.001) and ‘bodily pain’ and ‘general health’ subscales of quality of life (p = 0.008, 0.004, respectively) have a significant difference between the two groups. There was a significant difference between pre and post-intervention in the Hamilton Anxiety Rating Scale only in the duloxetine group. Also, in terms of quality of life, the subscales of ‘physical role’, ‘emotional role’, ‘physical pain’ and ‘total score of quality of life’ in the duloxetine and placebo groups were significantly different between pre and post-intervention. However, the subscales of ‘physical function’ and ‘general health’ were significantly different only in the duloxetine group between pre and post-intervention. Conclusion: The results suggest that the use of duloxetine in patients who had spinal surgery can help to better control back pain, on the other hand, it can cause a better psychological condition that affects the quality of life.

Providing a clearer insight into how sport-related concussion and physical pain impact mental health, cognition, and quality of life

“…When accounting for physical pain, we found the same results regarding SRC and cognitive flexibility, but also that physical pain was associated with depression, state-trait anxiety, and quality of life. Therefore, despite literature that links both SRC and physical pain with poor mental health, 3,4,14,16 cognitive impairment, 5,6 and reduced quality of life, 7,8,32,33 a more nuanced explanation would be that SRC is responsible for cognitive impairment and physical pain contributes to poor mental health and reduced quality of life. SRC and impaired cognitive flexibility have been linked before, 24,25 however, the role that physical pain has on cognitive flexibility is unclear.…”

“…Likewise, not being able to compete at a sporting level that one once could, can lead to poorer mental health and quality of life. However, even if these examples did explain reduced quality of life in athletes, it is still unclear whether this is due to SRC or physical pain, with evidence that both negatively impact quality of life, [31][32][33][34] and therefore this warrants further exploration.…”

“…This is due to evidence that physical pain can also lead to poorer mental health, 14,16 impaired cognition, 26,27 and reduced quality of life. 32,33 Although SRC and pain are often experienced simultaneously, 9,10 and athletes are among the most at-risk of sustaining both, the two contributing factors are rarely examined in conjunction in the literature. Therefore, the present study aims to address this gap in the literature, as learning which factor affects each outcome will allow better support for athletes that have sustained SRC, are experiencing physical pain, or both.…”

Postoperative acute pain management with duloxetine as compared to placebo: A systematic review with meta‐analysis of randomized clinical trials

“…The number of articles identified, screened, excluded, and included are shown schematically in the PRISMA flow diagram (Figure 1). Some studies were initially found to be eligible but later excluded either due to the dose of duloxetine administered other than 60 mg [49][50][51][52] or duloxetine is assessed for subacute and chronic pain after surgery. [53][54][55] We excluded one study by Koh et al 56 because, in this trial, duloxetine 60 mg was given for 6 weeks postoperatively only in patients centrally sensitized to pain.…”