Clinical analysis of qualitative and quantitative pain characteristics in patients with acute and chronic vertebrogenic lumbosacral pain syndromes

Abstract

Diverse approaches exist for diagnosing and treating patients afflicted with acute and chronic low back pain syndromes (LBP), thereby necessitating a comprehensive evaluation of the pain syndrome and a meticulous analysis of the neuropathic component to enhance our scholarly comprehension of the distinct differences in pain progression among these individuals. A total of 125 individuals (56 females and 69 males) diagnosed with vertebral lumbar pain syndromes (LBP), aged between 20 and 68 years (42.8 ± 11.1 years), underwent comprehensive evaluation. Stratification into two distinct groups was based on the duration of the pain syndrome: an acute pain group (pain lasting up to 3 months) and a chronic pain group (pain persisting beyond 3 months). Pain assessment, administered upon hospitalization, involved utilizing of well-established tools such as the Visual Analogue Scale (VAS), DN4 Questionnaire, and McGill Pain Questionnaire. The initial pain intensity, measured by VAS upon admission, was recorded as 7.15 ± 1.17 in the acute pain group and 6.08 ± 0.96 in the chronic pain group. Analysis of responses to the DN4 questionnaire revealed that patients with acute pain syndrome obtained an average score of 2.26 ± 1.01, whereas those in the chronic pain group scored 4.53 ± 1.02. The presence of a neuropathic component was identified in 38 % of patients with acute pain and 56 % of patients with chronic pain. Correlational analyses indicated a weak positive correlation (r = 0.12, p < 0.05) between VAS scores and the assessment of neuropathic pain using the DN4 questionnaire in the acute pain group. However, the chronic pain group observed a moderate positive correlation (r = 0.41, p < 0.001). Patients experiencing chronic LBP expressed their pain sensations in a more emotionally descriptive manner. Notably, the chronic pain group exhibited a statistically significant elevation in the number of selected descriptors according to the Index of Chosen Descriptors (ICD) on the sensory scale, as well as an increased Pain Rank Index (PRI) on both sensory and affective scales, compared to the acute pain group. To summarize, individuals with chronic LBP exhibit a more prevalence of the neuropathic component. Moreover, patients in the chronic pain group demonstrated higher scores indicative of sensory and psychosocial aspects of pain. Key words: acute pain, chronic pain, neuropathic component of pain, verbal descriptors, McGill Pain Questionnaire