scholarly journals Sleep disorders and their correction in patients with chronic back pain

2021 ◽  
pp. 201-207
Author(s):  
O. S. Kochergina ◽  
E. F. Rakhmatullina ◽  
B. E. Gubeev
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Back Pain ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
Poor Quality ◽  
Chronic Pain Syndrome

Back pain and insomnia (insomnia) significantly impair the quality of life of patients. Pain contributes to the development of sleep disorders and vice versa, poor quality sleep increases pain. Sleep disorders are widespread in the population, and in chronic pain syndrome, almost 70% of patients suffer from insomnia. The National Sleep Association singles out pain as one of the leading causes of sleep disorders. The article discusses a typical clinical case of the combination and interaction of chronic pain syndrome and insomnia. A patient with acute back pain developed a sleep disorder for which therapy was not carried out. The prescribed standard therapy for back pain, which included a non-steroidal anti-inflammatory drug, muscle relaxant, made it possible to relieve pain in a short time. However, the patient’s insomnia not only persisted, but also progressed, which led to the appearance of symptoms of asthenia in the form of fatigue, irritability, decreased performance, and ultimately significantly reduced the quality of life. In order to normalize sleep, the patient was prescribed a histamine H1 receptor blocker from the ethanolamine group, namely the drug Doxylamine. Follow-up observation for 1 year showed no exacerbation of back pain and sleep disturbances. In the treatment of patients with chronic back pain, it is necessary to pay attention to the presence of sleep disturbances and provide appropriate therapy. Today, three groups of hypnotics are used in clinical practice: melatonin receptor agonists (insufficient effectiveness in acute sleep disorders), benzodiazepines (addictive and addictive), and antihistamines. The modern drug Doxylamin belongs to the group of antihistamine hypnotics, has a good efficacy and safety profile and is included in the domestic recommendations for the treatment of insomnia.

Duloxetine Added to Tramadol in Chronic Pain Syndrome

2016 ◽  
Vol 33 (S1) ◽  
pp. S500-S501
Author(s):  
M. Domijan ◽  
Z. Lončar ◽  
S. Udovičić
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Sleep Disturbances ◽  
Short Form ◽  
Pain Syndrome ◽  
Mcgill Pain Questionnaire ◽  
Chronic Pain Syndrome ◽  
Reduction Of Pain ◽  
Competing Interest

IntroductionAbout 15–20% of the population suffering from the chronic pain. Over time, chronic pain can result in different emotional problems, social isolation, sleep disturbances, which reduce the quality of life. Chronic pain syndrome (CPS) indicates persistent pain, subjective symptoms in excess of objective findings, associated dysfunctional pain behavious and self-limitation in activities of daily living. Duloxetine is a potent antidepressant approved by the Food and Drug Administration for the chronic musculoskeletal disorder, diabetic neuropathic pain, fibromyalgia, generallized anxiety disorder and major depressive disorder.ObjectiveTo determine the effect of duloxetine on the reduction of pain and psychosocial suffering.AimsThe goal of the treatment should be to effectively reduce pain while improving function and reducing psychosocial suffering.MethodsThirty-six adult, nondepressed patients, already on tramadol therapy were included. Patients with VAS (visual analogue scale) ≥ 4were treated with duloxetine for 13 weeks. We measured pain intensity with the McGill Pain Questionnaire-Short Form (MPQ-SF) and compared VAS before starting the treatment with duloxetine and weekly for 13 weeks.ResultsPain response was defined as a 30%decrease in the MPQ-SF. A total of 62.5% of the sample met these criteria for response. Among them, 13.8% of patients were discontinued because of adverse effects. Duloxetine significantly improved functioning and the quality of life in patients with CPS.ConclusionsBecause of it is analgesic properties, duloxetine in the lower antidepressant doses (60 mg taken ones daily) combined with tramadol (another analgesic agent) can be useful in CPS for patients who do not respond satisfactory to monotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Characteristics of sleep disorders in patients with chronic back pain

2019 ◽  
Vol 10 (2) ◽  
pp. 46-52
Author(s):  
Daniil K. Vinogradov ◽  
O. B. Doronina
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Sleep Disorders ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
Neurological Status ◽  
Chronic Pain Syndrome ◽  
And Control ◽  
Vegetative Status ◽  
Comprehensive Study

Background. Insomnia is considered a risk factor for the frequency of pain, however, no reliable studies with a comprehensive analysis of the objective polysomnography data have been conducted so far. Objective. Using the method of polysomnography, to assess the changes in the structure of sleep in the chronic pain syndrome, by the example of chronic back pain. Methods. The study was carried out in two groups (basic and control,) in which the patients were examined according to the following algorithm: an objective examination, assessment of the neurological status, filling in neurological scales and questionnaires, a single comprehensive study of the night sleep (polysomnography). Results. According to the data of the polysomnographic study, presomnic disorders were detected in 25% of patients, intrasomnic disorders in 48%, and postsomnic disorders in 17%. Conclusion. These sleep patterns, measured by polysomnography, demonstrate a link between sleep disorders, changes in the psycho-vegetative status, and chronic pain syndrome.

scholarly journals Painful Sleep: Insomnia in Patients with Chronic Pain Syndrome and its Consequences

Folia Medica ◽  
2020 ◽  
Vol 62 (4) ◽  
pp. 645-654
Author(s):  
Tiffany Ostovar-Kermani ◽  
Daniel Arnaud ◽  
Andrea Almaguer ◽  
Ismael Garcia ◽  
Stephanie Gonzalez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
General Population ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
Clinical History ◽  
Spinal Pain ◽  
Chronic Pain Syndrome ◽  
Pain Symptoms

Insomnia is a chronic condition that occurs a minimum of three times per week over a period of three or more subsequent months. There are multiple causes of insomnia, and even though it is considered a symptom, it can be associated with chronic illnesses. Chronic pain syndrome, which is defined as pain that persists for a period longer than 3 months, is one of several etiologies of insomnia. The prevalence of insomnia among chronic pain patients is greater in comparison with the general population (percentage or ratio). Chronic pain is common in patients with rheumatoid arthritis, spinal pain (such as chronic back pain) and fibromyalgia. The prevalence of in-somnia is also higher in cancer patients when compared to the general population. When the clinical history indicates a straightforward diagnosis of chronic pain syndrome, patients will complain of insomnia as part of their symptomatology. It is imperative to manage their underlying illness to alleviate their sleep disorder. Various medications may be used to relieve and even improve pain symptoms. Other than pharmacological interventions, non-pharmacological alternatives such as yoga, meditation, acupuncture, and psychotherapy can help improve the quality of life of these patients. The purpose of this article is to review the diagnosis and management of insomnia in chronic pain syndrome and its impact on the quality of life.

Experience of using Neurouridine® in various types of peripheral neuropathy

2021 ◽  
Vol 7-8 (217-218) ◽  
pp. 29-36
Author(s):  
Nazira Zharkinbekova ◽  
◽  
Aiganym Khamidulina ◽  
Zhazira Barat ◽  
Botagoz Rustemova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Peripheral Neuropathy ◽  
Pain Assessment ◽  
Pain Syndrome ◽  
Symptomatic Therapy ◽  
Chronic Pain Syndrome ◽  
Combination Drug ◽  
Face Scale

The quality of life of patients with chronic pain syndrome remains one of the most pressing issues. Pain is considered chronic if it lasts or recurs for more than 3-6 months. This contributes to disability, depression, sleep disorders, poor quality of life, and what is important in this situation, the cost of treatment. According to statistics, the average prevalence of chronic pain in the adult population is 20%. Practitioners everywhere are in search of new methods of pain relief. Purpose of research. The quality of life of patients with chronic pain syndrome has traditionally remained a topical issue. Given the permanent nature of pain and the completeness of approaches to its relief, the modern Clinician is constantly looking for new treatment methods that meet the principles of evidence-based medicine and safety. Material and methods. This paper presents the results of using Neurouridine® in 30 patients with peripheral neuropathy. 30 patients were randomized for a 3-week treatment period. Average age: 47.5±1.5 years. All patients received standard symptomatic therapy, and an oral combination drug containing b vitamins, folic acid, choline, and Uridine was added to the treatment in the 150 mg mode once a day. Patients made three visits to the outpatient neurological office: visit 1-to evaluate pre-treatment, visit 2-after 10 days of treatment, and visit 3-after 20 days of treatment. Each patient was presented with two performance evaluations at each study visit: pain assessment on the CRS NRS scale, and the fps Face scale. Results and discussion. Analysis of the results of the treatment showed improvement in the form of reduced pain, improved quality of life in 65.90%, rapid recovery of performance in 32.10%, reduced need for analgesics in 59.90% and complete disappearance of symptoms in 25.30% of patients. Pain was assessed using the HI NRG scale, the AZA Face scale, and the frequency of analgesics at the patient's first, second, and third visits. Conclusion. The use of Neurouridine® for analgesic purposes has shown a positive effect on reducing symptoms in patients with peripheral neuropathy. The results confirm that this therapy provides a clear regeneration of the nerves, relieving pain, and reducing the soreness characteristic of nerve damage. Keyword: peripheral neuropathy, Neurouridine®, pain assessment, quality of life.

scholarly journals KINESIOTAPE METHODOLOGY FOR CHRONIC PAIN SYNDROME IN THE LUMBOSACRAL REGION

2021 ◽  
Vol 27 (3) ◽  
pp. 3950-3954
Author(s):  
Stamenka Mitova ◽  
◽  
Mariya Gramatikova ◽  
Margarita Avramova ◽  
Georgi Stoyanov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Syndrome ◽  
Control Group ◽  
Life Questionnaire ◽  
Chronic Pain Syndrome ◽  
Lumbosacral Region ◽  
Before And After ◽  
Experimental Group

Purpose: The study aims to evaluate the effect of kinesiotape methodology on chronic pain syndrome in the lumbosacral region. Material and Methods: 42 participants with chronic low back pain were recruited and randomly divided into two groups – control (n=19) and experimental (n=23). Foreword and lateral tilt, Borg and Modified Merld’Aubigne Scale for pain were used for assessment before and after treatment. Roland-Morris Questionnaire was done to assess the quality of life before and three months after treatment. The participants received a specialized kinesitherapy program combined with kinesio tape daily for 15 days with a duration of 40 minutes per procedure. They all received a home kinesitherapy program. Data were analyzed using GraphPad prism 3.02. Results: 42 participants, including 20 women and 22 men, were examined. The mean age (X±SD) of the control group was 45±9.08years, and for experimental was49.13±8.3 years. Median values of the Borg pain scale were as follows: 7.53±0.84 before, and 6.05±0.78 after treatment for the control group and 7.39±0.99 and 4.61±0.78 for the experimental group. Merld’AubigneScaleshows before and after treatment for control group 4.26±065 and 3.12±0.49 respectively, while in experimental was 4.26±0.68 and 2.09±0.44 after treatment. The average of forwarding tilts measured before and after treatment was13.79±3.77cm and 10±3.6cm for the control group and 13.13±3.76 and 7.52±2.25 for the experimental group. Initially, the quality of life questionnaire shows 17.26±1.66 and three months later was 12±1.45 for the control group and 17.35±1.5 before, and descend to 9.00±1.04 for the experimental group. There were statistically significant differences before and after treatment (p <0.05). Conclusions: Treatment significantly reduces pain and muscle spasms after application and improves thefunctionality of the lumbar spine. Kinesiotape not only helps the reduction of pain symptoms in musculoskeletal pathologies but is also a valuable addition to the kinesitherapy procedures.

Efficacy of Self-hypnosis on Quality of Life For Children with Chronic Pain Syndrome

2018 ◽  
Vol 66 (1) ◽  
pp. 43-55 ◽  
Author(s):  
Honorine Delivet ◽  
Sophie Dugue ◽  
Alexis Ferrari ◽  
Silvia Postone ◽  
Souhayl Dahmani
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome

scholarly journals Neuropathic pain in rheumatoid arthritis

2020 ◽  
Vol 12 (5) ◽  
pp. 60-65
Author(s):  
E. S. Filatova ◽  
A. M. Lila ◽  
V. A. Parfenov
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Chronic Pain ◽  
Nervous System ◽  
Neuropathic Pain ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Paindetect Questionnaire ◽  
Somatosensory Nervous System

Objective: to identify the signs of neuropathic pain (NP) in patients with rheumatoid arthritis (RA) on the basis of the PainDETECT questionnaire and neurological examination.Patients and methods. A total of 208 RA patients (39 men and 169 women; mean age, 47.7 years) with chronic pain syndrome were examined. The patients underwent rheumatological and neurological examinations; NP was diagnosed using the PainDETECT questionnaire; inflammation severity (DAS28 index), pain intensity (VAS), affective disorders (HADS), and quality of life (EQ-5D) were assessed.Results and discussion. 172 (82.7%) patients had moderate and high disease activity according to the DAS28. The signs of possible and highly probable NP according to the PainDETECT questionnaire were detected in 29.8 and 26.9% of patients, respectively; they were significantly more likely to be detected in patients with more severe pain syndrome, clinically significant anxiety, and worse quality of life, but were unassociated with RA activity according to the DAS28. Somatosensory nervous system injury (polyneuropathy, tunnel syndromes, and cervical myelopathy) was found in 77.6% of patients with possible NP and in 80.4% with highly probable NP. In other patients, NP might be caused by central sensitization. Conclusion. In patients with a RA exacerbation, chronic pain syndrome is caused not only by an active inflammatory process in the joint area and adjacent tissues, but also by somatosensory nervous system injury and central sensitization.

MO705SLEEP DISTRUBANCES IN PATIENTS ON PERITONEAL DIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Dahmane Rihem ◽  
Chaker Hanen ◽  
Toumi Salma ◽  
Zini Olfa ◽  
Mseddi Fatma ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Peritoneal Dialysis ◽  
Sleep Quality ◽  
Sleep Disorders ◽  
Sleep Disturbances ◽  
Poor Quality ◽  
Quality Of Sleep ◽  
The Mean

Abstract Background and Aims Sleep disturbances are more common in patients with chronic renal failure and on dialysis than in the general population. They affect their mental health and quality of life. The objective of this study was to evaluate the sleep disorders of patients on peritoneal dialysis (PD). Method We report the results of a descriptive cross-sectional study in 27 patients on PD in order to assess the quality of sleep in these patients and its relation with mental health and quality of life. Sleep quality was performed using the Pittsburgh Sleep Quality Index (PSQI) to assess origin and extent of sleep disorders. Anxiety-depressive disorders were assessed using the HAD (Hospital anxiety and depression) scale. The quality of life (QOL) measurement was performed by the SF36 and KDQoL. Results We included 15 men and 12 women with an average age of 45.74 years (21–77). Eleven patients were on automated peritoneal dialysis (APD) and 16 patients on continuous ambulatory peritoneal dialysis (CAPD). The mean duration of dialysis was 45.77 ± 25 months. Poor quality of sleep was reported in 14 patients. The mean PSQI was 7.22 ± 4.87. The most affected components were sleep duration and usual sleep efficiency. Depression was objectified in 22.22% of patients and 26% of patients had anxiety. Impaired quality of sleep was associated with decreased quality of life. The components of the physical dimension of quality of life: limitation due to physical condition, physical pain were significantly lower in dialysis patients with good quality of sleep (p=0.014, p= 0.033 respectively) The mental dimension component of QOL of SF36: relationship to others, limitation due to mental condition was also lower in patients with sleep disturbances (p=0.039, p= 0.036 respectively). Symptoms and problems, as well as the effects and the burden of kidney disease were not associated with poor quality of sleep. Impaired sleep quality was also not significantly associated with depression or anxiety in our series. Conclusion Sleep disturbances are common in PD patients and are associated with decreased quality of life. Therefore, they must be taken into account in the therapeutic measures recommended in order to improve the quality of life of these patients and reduce morbidity and mortality.

Sleep disturbance in patients attending specialized chronic pain clinics in Denmark: a longitudinal study examining the relationship between sleep and pain outcomes

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Henrik Bjarke Vaegter ◽  
Mette Terp Høybye ◽  
Frederik Hjorth Bergen ◽  
Christine E. Parsons
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Sleep Quality ◽  
Pain Intensity ◽  
Sleep Disturbances ◽  
Pain Disability ◽  
Pain Clinics ◽  
Pain Outcomes

Abstract Objectives Sleep disturbances are highly prevalent in patients with chronic pain. However, the majority of studies to date examining sleep disturbances in patients with chronic pain have been population-based cross-sectional studies. The aims of this study were to 1) examine the frequency of sleep disturbances in patients referred to two interdisciplinary chronic pain clinics in Denmark, 2) explore associations between sleep disturbances and pain intensity, disability and quality of life at baseline and follow-up, and 3) explore whether changes in sleep quality mediated the relationships between pain outcomes at baseline and pain outcomes at follow-up. Methods We carried out a longitudinal observational study, examining patients enrolled in two chronic pain clinics assessed at baseline (n=2,531) and post-treatment follow-up (n=657). Patients reported on their sleep disturbances using the sleep quality subscale of the Karolinska Sleep Questionnaire (KSQ), their pain intensity using 0–10 numerical rating scales, their pain-related disability using the Pain Disability Index (PDI), and quality of life using the EuroQol-VAS scale. The average time between baseline and follow-up was 207 days (SD=154). Results At baseline, the majority of patients reported frequent sleep disturbances. We found a significant association at baseline between self-reported sleep disturbances and pain intensity, pain-related disability, and quality of life, where greater sleep disturbance was associated with poorer outcomes. At follow-up, patients reported significant improvements across all pain and sleep outcomes. In two mediation models, we showed that changes in sleep disturbances from baseline to follow-up were significantly associated with (i) pain intensity at follow-up, and (ii) pain disability at follow-up. However, baseline pain intensity and disability scores were not associated with changes in sleep disturbances and, we did not find evidence for significant mediation of either pain outcome by changes in sleep disturbances. Conclusions Self-reported sleep disturbances were associated with pain outcomes at baseline and follow-up, with greater sleep disturbances associated with poorer pain outcomes. Changes in sleep quality did not mediate the relationships between baseline and follow-up scores for pain intensity and disability. These findings contribute to a growing body of evidence confirming an association between sleep and chronic pain experience, particularly suggestive of a sleep to pain link. Our data following patients after interdisciplinary treatment suggests that improved sleep is a marker for a better outcome after treatment.

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