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

Hnatešen, Dijana; Radoš, Ivan; Dimitrijević, Iva; Budrovac, Dino; Omrčen, Ivan; Pavić, Roman; Gusar, Ivana; Čebohin, Maja; Šolić, Krešimir

doi:10.3390/ijerph192315968

Cited by 2 publications

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“…Lumbar radicular pain is usually self-limiting; within a few weeks, the pain decreases with or without treatment [ 10 ]. The first line of treatment is a conservative approach [ 11 ], which could be partially compromised if pharmacotherapy is avoided due to the patient’s impaired cognitive or emotional status, which have been identified as potential predictors of treatment success [ 12 ]. If conservative treatment has not achieved the desired outcome, epidural administration of local anesthetic and steroids is considered [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Epidural Steroid Injection Depending on Discoradicular Contact: A Prospective Randomized Trial

Budrovac

Radoš

Hnatešen

et al. 2023

IJERPH

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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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Section: Introductionmentioning

confidence: 99%