Psychological Assessment of Control and Coping with Neuropathic Pain in the Lumbar Spine

Abstract

Background: Pain in the lumbar spine is an increasingly common problem, not only neurological or orthopaedic, but also psychological. In epidemiological studies on the prevalence of neuropathic pain, conducted in countries such as the United Kingdom, the United States France, and Brazil, it has been shown that the prevalence of chronic pain with neuropathic properties is estimated at 7-10%. Chronic neuropathic pain is more common in women (8% versus 5.7% in men) and in patients > 50 years of age (8.9% versus 5.6% in women < 49 years old). It most frequently concerns the lumbar region and lower limbs. However, in Germany, it has been revealed that 40% of all patients experience at least some features of neuropathic pain such as burning, numbness and/or tingling, especially those with chronic pain in the lumbar spine and radiculopathy. Chronic pain not only hinders a patient's daily life activities, but over time, it has negative impact on the patient's psyche: it reduces his/her well-being, causing anxiety, fear, helplessness, regret and even hostility. It should be emphasized that each of these reactions is an individual feature. Objectives: The aim of the study is to assess pain control as well as the strategies of coping with neuropathic pain in the lumbar spine. Material and methods: The study comprised 50 people with neuropathic pain in the lumbar region, including 41 women and 19 men. The average age of the respondents was 56 years, the average duration of the symptoms was 8 years. The following questionnaires were used to assess neuropathic pain: Lanss Pain Scale and DN4, and the Visual Analogue Scale (VAS) to assess pain intensity. For Pain Control Assessment - the Beliefs Questionnaire for Pain Control (BPCQ) and Pain Coping Strategy Questionnaire (CSQ). Results: Among the 3 measured factors of pain control, internal control dominates in young people, external control in middle-aged individuals, and the attitude towards random events in the elderly. There was significant statistical dependence between pain coping strategy and type of pain control. Conclusions: With the duration of pain and the age of the patient, random events play an increasingly important role in pain control. Hence, tests on pain control and coping should be carried out among patients as this would determine the most favourable treatment method.