Prevalence of Insomnia in Patients with Chronic Back Pain

Purushothaman, Balaji; Singh, Anjani; Lingutla, Kiran; Bhatia, Chandra; Pollock, Raymond; Krishna, Manoj

doi:10.1177/230949901302100118

Cited by 23 publications

(18 citation statements)

References 13 publications

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“…This top-down modulation of pain may be facilitatory or inhibitory depending on the pattern of activity in the raphe nuclei. Alterations in the activity of this pathway of the pain matrix may robustly affect nociceptive experience [41, 93]. Implicating epigenetic mechanisms in such alterations, hind paw injections of CFA promote global histone H3 acetylation in the rat raphe nucleus 1 day after injection [86].…”

Section: Epigenetic Mechanisms In Brain Network and Their Involvemenmentioning

confidence: 99%

“…As with chronic pain, mounting data point to epigenetic adaptations in depression syndromes [91]. LAC robustly reduces depression like behavior in rats and mice, and analogous to observations in the spinal cord [47], it upregulates mGlu2 mRNA and protein levels in the PFC [93]. LAC mediated induction of mGlu2 expression was sensitive to NF- KB inhibition, and corresponded with enhanced acetylation of H3K27 bound to the mGlu2 gene ( Grm2 ) promoter [93].…”

Section: Epigenetic Mechanisms In Brain Network and Their Involvemenmentioning

confidence: 99%

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Epigenetic mechanisms of chronic pain

Descalzi

Ikegami

Ushijima

et al. 2015

Trends in Neurosciences

320

231

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Neuropathic and inflammatory pain promote a large number of persisting adaptations at the cellular and molecular level, allowing tissue or nerve damage, even if only transient, to elicit changes in cells that contribute to the development of chronic pain and associated symptoms. There is evidence that injury-induced changes in chromatin structure drive stable changes in gene expression and neural function, which may cause several symptoms, including allodynia, hyperalgesia, anxiety, and depression. Recent findings on epigenetic changes in the spinal cord and brain during chronic pain may guide fundamental advances in new treatments. In this review, we provide a brief overview of epigenetic regulation in the nervous system and then discuss the still-limited literature that directly implicates epigenetic modifications in chronic pain syndromes.

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Section: Epigenetic Mechanisms In Brain Network and Their Involvemenmentioning

confidence: 99%

Section: Epigenetic Mechanisms In Brain Network and Their Involvemenmentioning

confidence: 99%

Epigenetic mechanisms of chronic pain

Descalzi

Ikegami

Ushijima

et al. 2015

Trends in Neurosciences

320

231

View full text Add to dashboard Cite

show abstract

“…Thus, chronic pain and sleep problems need to be treated together. [28,29] There is no study in the literature on how TAESI is associated with sleep quality but the effect of TAESI should be compared with the effects of other methods of low back pain treatment. Study results in the literature are similar to the results of the present study in that they indicate that physical therapy increases the quality of sleep and reduces insomnia.…”

Section: Discussionmentioning

confidence: 99%

Effect Of Transforaminal Anterior Epidural Steroid Injection On Neuropathic Pain, Quality Of Sleep And Life

Sarı

Aydın

Güleser

et al. 2015

Agri

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Özet Amaç: Bu çalışmada bel ağrısı dolayısı ile transforaminal anterior epidural steroid injeksiyonu (TAESİ SummaryObjectives: Transforaminal anterior steroid injections are frequently used for low back pain. In the current study, It was aimed to investigate the effects of transforaminal anterior epidural steroid injection (TAESI) in patients with low back pain in regards to quality of life and sleep, and neuropathic pain. Methods: Ethics committee approval and patient consent were obtained. Patients with low back pain scheduled to receive transforaminal epidural steroid injections between October 2011 and October 2012 were included into the study. Pittsburgh Sleep Quality Index (PSQI), Short form 12 (SF 12), DN4 tests and Visual Analog Scale Score (VAS) were measured prior to procedure and three months later. All the tests were compared with baseline evaluations prior to injections. Results: One hundred and two (female/male: 52/50) patients with a mean age of 53.3±1.4 were included. Primary diagnoses were lumbar disc herniation in eighty-seven patients, spinal stenosis in seven and failed back surgery syndrome in eight patients. Statistically significant improvement was seen in the total VAS, DN4 and PSQI scores (p=0.0001) of the patients at the third month follow-up. Sleep duration (p=0.0001), habitual sleep efficiency (p=0.0001), subjective sleep quality (p=0.003), sleep latency (p=0.014), sleep disturbances (p<0.001), sleep medication use (p=0.003), and day time dysfunction (p=0.015) showed a significant decrease in sub-components. There was no significant difference in SF 12 quality of life. Conclusion: It was determined in the study that transforaminal epidural steroid injection provided a substantial improvement in patients' pain and neuropathic pain and quality of sleep, but had no effect on the quality of life.

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“…Compelling evidence, based on both self-reports and polysomnographic recordings, indicates an association between insomnia and back-pain [7], [8]. Furthermore, insomnia has been related to other types of pain, such as musculoskeletal [9], fibromyalgia [10], and arthritis [11].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies focusing on the back pain-insomnia association have suffered from critical methodological shortcomings: (i) cross-sectional studies with a limited ability to draw conclusions on causal links; (ii) small sample sizes undermining the generalizability of the findings; and (iii) inadequate adjustment for potential confounders, such as stress, depression, co-morbid chronic disease, obesity, and use of pain medication [7], [12].…”

Section: Introductionmentioning

confidence: 99%

Increased Insomnia Symptoms Predict the Onset of Back Pain among Employed Adults

Agmon

Armon

2014

PLoS ONE

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BackgroundBack pain is among the most prevalent pain disorders causing chronic disability among adults, and insomnia is a common co-morbidity. However, whether insomnia precedes back pain or vice versa remains unclear. The current study tested the temporal association between insomnia and back pain.MethodsA longitudinal design was used to investigate whether changes in insomnia over time predict the onset of back pain and vice versa. The study was conducted on a cohort of active healthy working adults (N = 2,131, 34% women) at three time points (T1, T2, and T3) over a period of 3.7 years (range = 2.2–5.12) years. Logistic regression analysis was used to test whether increased insomnia symptoms from T1 to T2 predicted the onset of new back pain. Ordinary least squares regression was used to test whether the existence of back pain at T2 predicted an increase in insomnia from T2 to T3.ResultsThe results indicated that after controlling for socioeconomic variables, self-reported health, lifestyle behaviors, and anthropometrics, a T1–T2 increase in insomnia symptoms was associated with a 1.40-fold increased risk of back pain at T3 (OR = 1.40; 95% CI = 1.10–1.71). No support was found for reverse causation; i.e., that back pain predicts subsequent increase in insomnia.ConclusionsInsomnia appears to be a risk factor in the development of back pain in healthy individuals. However, no evidence of reverse causation was found.

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Prevalence of Insomnia in Patients with Chronic Back Pain

Abstract: 47% of patients with chronic back pain had insomnia. The ODI was more reliable than the NRS for back pain to detect insomnia. Back pain should be treated early to avoid serious health problems associated with insomnia.

Cited by 23 publications

References 13 publications

Epigenetic mechanisms of chronic pain

Epigenetic mechanisms of chronic pain

Effect Of Transforaminal Anterior Epidural Steroid Injection On Neuropathic Pain, Quality Of Sleep And Life

Increased Insomnia Symptoms Predict the Onset of Back Pain among Employed Adults

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