Keywords
lumbosacral radicular pain
pain catastrophizing scale.
Abstract
Objetive: The aim of this study was to investigate the relationship existent between pain catastrophism and pain intensity and pain interference, in patients with lumbosacral radicular pain. The effect on catastrophism of epidural steroid injections was also asessed. Material an methods: A prospective study was conducted on 52 patients with unilateral lumbosacral radicular pain. In 39 of them, the Brief Pain Inventory and the Catastrophism Scale was applied before and one month afer a epidural steroid injection. Responderes to treatment ere defined with a decrease of 2 points or more in pain intensity. For catastrophism, a score of 30 was considered severe. A value of p < 0.05 was taken as statistical significance. Results: Catastrophism was significantly higher in women. Moderate and statistically significant positive linear correlations between pain intensity, pain interference and catastrophism were found. In treated patients, a significant decrease in pain intensity, pain interference and catastrophism were observed. Sixteen patients were considered treatment responders. In them, pain intensity and catastrophism had a clinical and statistically significant reduction. Score of Intensity was reduced from 7.8 ± 0.8 to 3.9 ± 3.1 (50 % of change percentage, p = 0.0001), functional interference of pain evaluated by Score of Interference from 8.2 ± 1.6 to 5.0 ± 3.8 (40 % of change percentage, p = 0.0027) and Total Catastrophism from 37 ± 13 to 17.5 ± 16 (57 % of change percentage, p < 0.0001). No difference were found in Total Catastrophism evaluated before the proceduresl between responders and no responders to epidural steroid injections. Conclusions: Epidural steroid injections was effective in reducing pain in 41 % of controlled patients. The decrease in pain was accompanied by a reduction in Total Catastrophism, which showed to be a dynamic construct, capable of being modified by interventional pain treatments. Previous catastrophism was found to not be related to response to treatment.References
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