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To study the prevalence and semiotic characteristics of neuropathic pain in the common low back pain to the Black African subject. This was a prospective cross-sectional survey carried on from April 1 2009 to August 31 2009 in consultations of rheumatology, neurology, and neurosurgery at the University Hospital Yalgado Ouédraogo in Ouagadougou (Bur...
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Movement restriction has been proposed as an important modulator of changes in sensory and perceptual function and motor imagery performance that are observed in musculoskeletal pain syndromes. There are no empirical data to support this view.
The primary objective of this experiment was to determine the effects of movement restriction on local and...
Citations
... OR=1.8), therefore with a significantly positive MRI diagnosis. Most of the studies, especially those [30][31][32]. ...
... Most of the studies, in particular those of Ouédraogo DD.et al, Douala BM. Et al, Attal N. et al [23,33,34], conrm that the presence of lumboradiculalgia and decit neurological disorders were factors associated with the existence of a clinically positive MRI diagnosis. Origin: Our study shows that there were more patients from Kinshasa than from Brazzaville. ...
I. Objective: to highlight the clinico-MRI prole of lumbar disc herniation on sciatic lumboradiculgia in bi- river hospital settings (cases of Kinshasa and Brazzaville). This was aII. Materials and methods: retrospective, documentary and multicenter study of 302 patients who performed lumbar MRI examinations in 18 months in hospitals in Kinshasa and Brazzaville. The mean age of patients was 53.4 years. The most represented age groupIII. Results: was 50 to 59 years old. The female sex was predominant (55.4%) with a ratio of 0.79. The majority of patients (68.2%) came from Kinshasa. Lumboradiculalgia was the most predominant indication with (49.3%), followed by low back pain (48%). The majority of MRI examinations (91.4%) were performed without injection of contrast product. T1 and T2 weightings were performed in 100% of patients. Diseased disc degeneration was found at (41.7%) and lumbar disc herniation at (27.2%). The MRI examination was normal in (47%) of the patients. Based on potentially clinically positive relevance, only 48.7% of our MRI diagnoses were clinically positive. Age (p=0.000), lumboradiculalgia (p=0.000) and specialist physician prescription (0.039) had a statistically signicant relationship with clinically positive diagnosis. HDL is a pathological reality in the hospitals ofIV. Conclusion: Kinshasa and Brazzaville. The MRI prole found mainly corroborates the observations of the literature. Lumbar disc herniation and degenerative disc disease remain the most frequently encountered pathologies on magnetic resonance imaging in hospitals in Kinshasa and Brazzaville. They are at the origin of the lumbar spinal syndrome and affect the young population. The posterolateral disc herniation remains the most frequently encountered subtype with predominance of damage to the oors: L4-L5 and L5-S1.
... OR=1.8), therefore with a significantly positive MRI diagnosis. Most of the studies, especially those [30][31][32]. ...
Objective: Consist of making an inventory of the indications for lumbar spinal MRI in the diagnostic management of lumbar spinal pathologies in hospitals in Kinshasa and Brazzaville. About 302 patients. Materials and Methods: This was a retrospective, documentary and multicenter study on 302 patients who underwent lumbar spine MRI examinations in 18 months in hospitals in Kinshasa and Brazzaville. Results: The mean age of patients was 53.4 years. The most represented age group was 50 to 59 years old. The female sex was predominant (55.4%) with a ratio of 0.79. The majority of patients (68.2%) came from Kinshasa. Lumboradiculgia was the most represented indication (49.3%) followed by low back pain (48%). The majority of MRI examinations (91.4%) were performed without injection of contrast product. T1 and T2 weightings were performed in 100% of patients. Degenerative disc disease was found at (41.7%) and lumbar disc herniation at (27.2%). The MRI examination was normal in (47%) of the patients. Based on potentially clinically positive relevance, only 48.7% of our MRI diagnose were clinically positive. Age (p=0.000), lumboradiculgia (p=0.000) and specialist physician prescription (0.039) had a statistically significant relationship with clinically positive diagnosis. Conclusion: The use of lumbar spinal MRI examination was inappropriate in our study; this opinion mostly corroborates the observations of the literature. A codification of lumbar MRI indications in the radiological exploration of lumbar spinal disorders would avoid abusive and expensive prescriptions for a study population with low economic income.
... The association between NeP and LBP has been demonstrated using several screening tests, and this association was found to be present in 19.3%e64.7% of patients. 13,19,21,[32][33][34][35][36][37][38][39][40] Fluctuations in NeP prevalence might be influenced by patient age and differences between screening questionnaires. These questionnaires, including the PDQ, Douleur Neuropathique 4 0 , and Self-completed Leeds Assessment of Neuropathic Symptoms and Signs pain scale questionnaires, were not developed to screen for NeP in patients with chronic LBP (CLBP). ...
OBJECTIVE
The purpose of this study was to analyze whether the type of preoperative pain affects the improvement in postoperative pain intensity in patients with a lumbar degenerative disease (LDD).
METHODS
We retrospectively reviewed 93 patients who underwent lateral lumbar interbody fusion (LLIF) without direct decompression. All patients were evaluated using Numeric Rating Scale (NRS) scores for low back pain (NRSLBP), leg pain (NRSLP), and leg numbness (NRSLN) and imaging data before and after LLIF surgery. Based on the Japanese version of the painDETECT (PDQ-J) scores, patients were classified into three groups: a neuropathic pain (NeP) group, a nociceptive pain (NocP) group, and an intermediate mixed pain (MixP) group.
RESULTS
The PDQ-J identified NeP in 20.4% of patients with LDD prior to LLIF. Preoperative NRSLBP, NRSLP, and NRSLN scores were higher in the NeP group than in the NocP group. All types of pain improved after LLIF surgery. The NRSLBP score 12 months after surgery was higher in the NeP group (3.8 ± 2.8) than in the NocP group (1.9 ± 2.2) (p = 0.008). Similar results were obtained with NRSLP (NeP group 3.1 ± 2.8, NocP group 1.5 ± 2.0, p = 0.010).
CONCLUSIONS
Although LLIF was useful for relieving all types of preoperative pain in LDD patients, the NRS scores for preoperative pain were higher in the NeP group than in the NocP group, and the postoperative NRSLBP and NRSLP score was significantly higher in the NeP group. Thus, controlling preoperative NeP may improve therapeutic efficacy.
... Des études hospitalières menées en Afrique subsaharienne rapportent les douleurs neuropathiques dans le cadre de neuropathie associée à une infection comme le Zona [4][5][6], le VIH [5][6][7] et la lèpre [8]. En milieu rhumatologique, il y a une prévalence de 28,1% au Cameroun chez des patients lombalgiques chroniques [9], 10,9% chez des patients souffrant de névralgie cervico-brachiale au Mali [10] et 49,5% au Burkina Faso chez des patients lombalgiques [11]. Ces douleurs sont associées aux radiculopathies et aux neuropathies périphériques du diabète [11,12]. ...
... En milieu rhumatologique, il y a une prévalence de 28,1% au Cameroun chez des patients lombalgiques chroniques [9], 10,9% chez des patients souffrant de névralgie cervico-brachiale au Mali [10] et 49,5% au Burkina Faso chez des patients lombalgiques [11]. Ces douleurs sont associées aux radiculopathies et aux neuropathies périphériques du diabète [11,12]. Les DN n'ont pas été étudiées en milieu rhumatologique en guinée. ...
Adresse : www.jnnpguinee.com Organe Officiel de la Société Guinéenne de Neurologie, Neurochirurgie et Psychiatrie Douleurs neuropathiques en consultation rhumatologique en Guinée. Article Original Mots clés : Douleur neuropathique, DN4, arthrose, hernie discale, Guinée Original Article RESUME Objectif : Etudier la prévalence des douleurs neuropathiques (DN) en consultation de rhumatologie. Patients et méthodes: Etude transversale de six mois au service de rhumatologie de l'hôpital national Ignace Deen de Conakry. Les patients ont été soumis au Questionnaire DN4 où la DN était définie pour un score DN4 ≥ 4 sur 10. Ont été exclus les patients atteints de pathologies non rhumatologiques pouvant induire des douleurs neuropathiques (diabète, Covid-19 guéris, hépatite virale et VIH). Résultats: Des 95 patients inclus, 31 (19 femmes) présentaient des DN (32,6%). L'âge moyen était de 48,9 ± 17,3 ans. La durée moyenne d'évolution de la DN était de 4,3±5,6 ans. Les patients consultaient principalement pour engourdissements (80,7%) et impotence fonctionnelle (67,7%). La DN était spontanée chez 94% des patients. Il s'agissait d'une douleur sévère dans 12,9 % des cas. Les items DN4 étaient essentiellement constitués d'engourdissements (n = 25; 80,7%), picotements (n = 24; 77,4%), froid douloureux (n = 23; 74,2%), brûlures (n = 20; 64,5%) et fourmillements (n = 20; 64,5%). L'arthrose (25,8%) et la hernie discale (19,3%) étaient les maladies rhumatismales prédominantes. Conclusion: Les DN sont sous-estimées en milieu rhumatologique , elles sont souvent associées à une hernie discale et l'arthrose dans notre contexte. Des études de plus grande ampleur sont nécessaires pour confirmer ces résultats. ABSTRACT Objective: To study the prevalence of neuropathic pain (NP) in rheumatology consultation. Patients and methods: Six-month cross-sectional study in the rheumatology department of the Ignace Deen National Hospital in Conakry. Patients were submitted to the DN4 Questionnaire where the NP was defined for a DN4 score ≥ 4 out of 10. Patients with non-rheumatological pathologies that may induce neuropathic pain (diabetes, recovered Covid-19, viral hepatitis and HIV) were excluded. Results: Of the 95 patients included, 31 (19 women) presented NP (32.6%). The mean age was 48.9 ± 17.3 years. The mean duration of development of Organe officiel de la Société Guinéenne de Neurologie, Neurochirurgie et Psychiatrie Revue Trimestrielle, Volume 01, N°22, 2022 65 INTRODUCTION La douleur neuropathique (DN) est définie comme la conséquence directe d'une lésion ou d'une maladie du système somatosensoriel [1]. Elle se manifeste par des douleurs spontanées qui peuvent être continues (brûlure ou froid douloureux) ou paroxystiques (décharge électrique ou coup de poignard). Ces douleurs peuvent également être provoquées sous forme d'allodynie ou d'hyperalgésie [2]. La prévalence mondiale dans la population générale varie entre 6,9 et 10% [3]. Des études hospitalières menées en Afrique subsaharienne rapportent les douleurs neuropathiques dans le cadre de neuropathie associée à une infection comme le Zona [4-6], le VIH [5-7] et la lèpre [8]. En milieu rhumatologique, il y a une prévalence de 28,1% au Cameroun chez des patients lombalgiques chroniques [9], 10,9% chez des patients souffrant de névralgie cervico-brachiale au Mali [10] et 49,5% au Burkina Faso chez des patients lombalgiques [11]. Ces douleurs sont associées aux radiculopathies et aux neuropathies périphériques du diabète [11,12]. Les DN n'ont pas été étudiées en milieu rhumatologique en guinée. L'objectif était de déterminer les caracréristiques des DN en consultation rhumatologique à l'Hôpital National Ignace Deen de Conakry (Guinée).
... [9], 59% пациентов с хронической болью в нижней части спины (ХБНЧС) испытывают трудности со сном. Результаты проведенных клинико-эпидемиологических исследований свидетельствуют, что нейропатический компонент в структуре ХБНЧС варьирует от 2,8% в китайской популяции [10], 15,8% в Великобритании [11], 35% в России [12] и до 49,5% и 54,7% -в Африке и Саудовской Аравии [13][14]. ...
Цель обзора - анализ результатов исследований эффективности ритмической транскраниальной и трансспинальной магнитной стимуляции (рТМС и рТсМС) в лечении боли в пояснице. Хроническая боль в нижней части спины (ХБНЧС) преобладает над другими видами боли и, выходя за нозологические рамки болезней опорно-двигательного аппарата, поражает около 80-84% населения в течение жизни. Нейропластичность, лежащая в основе патогенеза ХБНЧС, управляется стимулами, которые могут быть опосредованы процессами, происходящими как «сверху вниз», от вышележащих к нижерасположенным иерархическим структурам нервной системы, так и «снизу вверх», - от периферических к центральным. Это находит отражение в повышенном интересе профессионального сообщества регенеративной медицины к применению высокотехнологических методов нейромодуляции ритмическими электромагнитными импульсами при ХБНЧС. Во второй части обзора представлен метаанализ накопленных к моменту его публикации литературных данных. Он дополняет опубликованную ранее информацию о том, что и рТМС, и рТсМС относятся к перспективным патогенетическим терапевтическим методам для пациентов с ХБНЧС, основываясь на экспериментальных и клинических эффектах положительного влияния на искаженную сенсорную передачу, изменение проприоцепции, управление движением и психологическую модуляцию. Обе методики зарекомендовали себя в кратковременном облегчении хронической дорсалгии, в то время как долгосрочные последствия рТсМС (>1 месяца) должны быть исследованы далее. Различные факторы, связанные с унификацией пока еще разнородных протоколов стимуляции, включая форму подачи импульсов, частоту, место приложения, регулярность и продолжительность лечения, могут улучшить дальнейшую надлежащую трактовку ее результатов. Очевидная по мнению авторов настоящего обзора, но до настоящего времени не описанная в литературе комбинация рТМС и рТсМС при ХБНЧС, могла бы повлиять на процессы управления болью при изучаемой патологии в большей степени, чем каждая из них по отдельности.
The aim of this review was to analyze results of studies on the effectiveness of repetitive transcranial and transspinal magnetic stimulation (rTMS and rTsMS) in the treatment of low back pain. Chronic low back pain (CLBP) is prevalent over other types of pain and, beyond the nosological scope of musculoskeletal diseases, affects about 80-84% of the population in a lifetime. Neuroplasticity underlying the pathogenesis of CLBP is driven by stimuli, and stimuli can be mediated by processes from «top to bottom», i.e. from the overlying to the underlying hierarchical structures of the nervous system, and vice versa, i.e. from peripheral to the central. This is reflected in the increased interest of the professional community of regenerative medicine in implementing high-tech methods of neuromodulation by repetitive electromagnetic pulses in CLBP. In this second part of the review, we present a meta-analysis of the literature data accumulated by the time of its publication. It completes our previously published information stating that both rTMS and rTsMS are viable pathogenetic therapeutic modalities for patients with CLBP, based on experimental and clinical positive effects on impaired sensory transmission, changes in proprioception, motor control, and psychological modulation. Both methods have proven successful in providing short-term relief for chronic dorsalgia, while the long-term effects of rTsMS (>1 month) require further investigation. Various factors associated with the unification of the still heterogeneous stimulation protocols, including pulse delivery form, frequency, application location, periodicity and treatment duration, may further improve proper result interpretation. The combination of rTMS and rTsMS in CLBP, which is evident to the authors of this review but has not been described in the literature yet, could have more impact on the pain management processes of the investigated pathology than each of them separately.
... Similarly, previous studies evaluating the NP component in chronic LBP patients reported similar results. [23,28,29] Our study results are, therefore, consistent with the literature. Nonetheless, further large-scale epidemiological studies are required to gain a better insight into the NP prevalence and true effect of sex in this patient population. ...
Objective:
This study aims to evaluate the effects of transforaminal epidural steroid injection (TFESI) on neuropathic pain (NP) in patients with chronic unilateral radiculopathy due to lumbar disc herniation (LDH).
Patients and methods:
Between September 2018 and April 2019, a total of 61 patients who were diagnosed with unilateral/unilevel radiculopathy due to LDH and were scheduled for single-level TFESI were included in this study. The Numeric Rating Scale (NRS), modified Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), and NP-Douleur Neuropathique 4 Questionnaire (DN4) were used before the procedure and at 1 hour, 3 weeks, and 3 months after the procedure.
Results:
There was a significant decrease in the NRS and significant improvement in the ODI, BDI, and DN4 scores in all patients at all postprocedural timepoints (P < 0.05). The number of patients with NP decreased from 35 (60.3%) at baseline to 23 (41.2%) at 3 months (P = 0.001). The NRS scores were similar at 3 weeks and 3 months between the patients with and without NP (P > 0.05). The ODI scores were significantly higher at 3 months in the patients with NP than those without NP (P = 0.013). The BDI scores at baseline, 3 weeks, and 3 months were significantly higher in the patients with NP than those without NP (P < 0.001, P = 0.016, and P = 0.016, respectively).
Conclusion:
Our study results suggest that TFESI is an effective and safe method to decrease not only nociceptive but also NP component in patients with chronic radiculopathy due to LDH. Clinicians should keep in mind that NP is a risk factor that adversely affects the TFESI success and patients should be evaluated before the procedure.
... The most common clinical indicators utilised to identify NP in LBLP research include the PainDetect, 15 The Leeds Assessment of Neuropathic Symptoms and Signs 16 and Douleur Neuropathique 4 (DN4). 17 A cross-sectional study by Smart et al 1818 is the one study to identify clinical indicators predictive of the presence of peripheral NP in LBP (with or without leg pain), consisting of a cluster of two symptoms and one sign: 'pain referred in a dermatomal or cutaneous distribution', 'history of nerve injury, pathology or mechanical compromise' and 'pain/symptom provocation with mechanical/movement tests (eg, active/passive, neurodynamic) that move/load/compress neural tissue'. However, there is evidence to refute aspects of this cluster. ...
Introduction
Neuropathic low back-related leg pain (LBLP) can be a challenge to healthcare providers to diagnose and treat. Accurate diagnosis of neuropathic pain is fundamental to ensure appropriate intervention is given. However, to date there is no gold standard to diagnose neuropathic LBLP. A Delphi study will therefore be conducted to obtain an expert-derived consensus list of clinical indicators to identify a neuropathic component to LBLP.
Methods/analysis
Included participants will be considered experts within the field as measured against a predefined eligibility criterion. Through an iterative multistage process, participants will rate their agreement with a list of clinical indicators and suggest any missing clinical indicators during each round. Agreement will be measured using a 5-point Likert scale. Descriptive statistics will be used to measure agreement; median, IQR and percentage of agreement. A priori consensus criteria will be defined for each round. Data analysis at the end of round three will enable a list of clinical indicators to be derived.
Ethics and dissemination
Ethical approval was gained from the University of Birmingham (ERN_19-1142). On completion of the study, findings will be disseminated in a peer-reviewed journal and presented at relevant conferences.
... 14 Consequently, expert opinion guidelines 15 through a Delphi study and a variety of screening tools have been developed and used as reference standards in research studies. 5 Neuropathic pain in LBLP research is most commonly identified using screening tools, including: PainDetect, 9 Leeds Assessment of Neuropathic Symptoms and Signs 16 and Douleur Neuropathique 4. 10 Patient history and clinical examination data are also used but not as often. 6 Studies have been conducted to investigate the diagnostic validity of screening tools 17 18 and patient history/clinical examination data. ...
Introduction
Neuropathic low back-related leg pain (LBLP) can be a challenge to healthcare providers to diagnose and treat. Accurate diagnosis of neuropathic pain is fundamental to ensure appropriate intervention is given. However, to date there is no gold standard to diagnose neuropathic LBLP. Patient examination guidelines and screening tools have been developed and validated for the purpose of diagnosing neuropathic pain in LBLP; however, there has been no systematic review conducted to compare the diagnostic validity of these methods. Therefore, this systematic review will investigate the diagnostic utility of patient history, clinical examination and screening tool data to identify neuropathic pain in LBLP.
Methods and analysis
This protocol is informed and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Protocols. CINAHL, EMBASE, MEDLINE, Web of Science, Cochrane Library, AMED, Pedro, PubMed, key journals and grey literature will be searched rigorously to find diagnostic accuracy studies investigating patient examination data to identify neuropathic pain in LBLP patients. Two independent reviewers will conduct the search, extract the data and assess risk of bias for included studies using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. The overall quality of included studies will be evaluated using Grading of Recommendations, Assessment, Development and Evaluation guidelines. A meta-analysis will be conducted if deemed appropriate. Otherwise, a narrative synthesis will be conducted.
Ethics and dissemination
No research ethics is required for this systematic review since patient data will not be collected. This review will help to inform healthcare professionals and researchers on the most effective means in which to diagnose neuropathic pain in LBLP. Results of this review will be submitted for publication in a peer-review journal and conference presentations.
PROSPERO registration number
CRD42019140861
... All the studies had been published between 2004 and 2015. Most (n = 10; 50%) originated from Europe (2,7,9,(24)(25)(26)(27)(28)(29)(30), followed by Asia (n = 5; 25%) (10,17,(31)(32)(33), and Africa (n = 4; 20%) (8,(34)(35)(36). The study sample recruitment site was not reported in one study (37). ...
... Out of these studies, 17 (85%) were cross sectional, 2 were cohort, and one was a case control study. Eleven (55%) studies were multi-center (2,10,(24)(25)(26)(27)(29)(30)(31)34,35) whereas the remaining were single-center studies (7)(8)(9)17,28,32,33,36,37). Twelve (60%) studies were carried out primarily to assess the prevalence of NeP in patients with LBP, while the remaining focused either on the effects of NeP on a range of patientreported outcomes or on the validation of a range of NeP-related questionnaires. ...
... Eighteen (90%) studies included patients with LBP as the main clinical concern, while 2 studies included patients with multiple pain conditions. The LBP etiology was reported in 8 (40%) studies (10,17,24,31,32,(34)(35)(36). ...
Background: Low back pain (LBP) is a complex syndrome which includes a nociceptive (NcP) component, a neuropathic (NeP) component, or a mixture of components (mixed pain). The NeP component (NePC) in LBP is defined as the presence of NeP with or without an NcP. Objective: This meta-analysis aimed at assessing the pooled prevalence of NePC in patients with LBP and at identifying the factors causing significant heterogeneity in reported prevalence. Study Design: Meta-analysis. Methods: A systematic literature search was carried out, with inclusion of all epidemiological studies describing the NeP prevalence levels in LBP patients while using standard diagnostic methods. The "pooled prevalence rate (PPR)" of NePC, either on its own or in combination with NcP, was calculated. A pre-specified subgroup analysis was carried out, considering LBP duration, presence of leg pain, diagnostic method(s), and questionnaire(s) used. Results: The meta-analysis included 20 studies relating to a total of 14,269 LBP patients, of whom 7,969 patients (55.8%) were identified as presenting with NePC. The pooled PR (95% CI) of NePC in patients with LBP was 0.47 (0.40-0.54), while the pooled PR of NcP was 0.56 (0.48-0.63). Higher NePC pooled PR values were identified in LBP with leg pain as compared to uncomplicated LBP (respectively: 0.60; 0.47-0.73 vs 0.27; 0.23-0.31; Pinteraction < 0.01). Limitations: The quality of the included studies was assessed using ad-hoc criteria. Due to the limited number of available studies, one may need to be cautious in reaching conclusions about the impact of disease duration on NePC prevalence values. We pooled studies which used a range of different diagnostic methods, with putatively different sensitivity/specificity diagnosing levels. Conclusion: Overall, high NePC prevalence levels were here identified in LBP patients. As the pain is a subjective phenomenon and there is no gold standard for the diagnosis of NePC, there is the possibility that the pooled effect estimate may alter depending upon the diagnostic method used.
