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

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.

PAIN MANAGEMENT AND OPTIMISM LEVELS AMONG OFFICE WORKERS WITH CERVICAL SPINE COMPLAINTS

Coping with pain plays a very important role in human life and it may differ depending on the personality characteristics of patients such as their level of optimism. The aim of this study was therefore to determine whether the coping strategies for to cervical spine pain amongof office workers were determined by gender, the locus of pain control orand an optimistic attributional style. 30 office workers (Females = 15, Males = 15) took part in the experiment. The age of the participants was for females (M and for =43; SD=5.,9) and for males (M=44.,9; SD=4.,9. The subjects were asked to fill out 4 questionnaires: (CSQ), (BPCQ), (ASQ), a 10-grade visual analogue scale (VAS) and an original questionnaire. The study revealed that most of the office workers declare the ability to copeing with pain. Women were significantly more focused on emotions as a pain coping strategy than were the males participants. It was also shown that the internal locus of pain control significantly correlates with coping focused on problem solving. Participants characterized by anwith optimistic attributableional style used task oriented strategies more often than did the pessimists. There were no significant differences in the level of perceived pain between optimists and pessimists. It was foundind that there are statistically significant differences in coping with pain coping according to gender. Women were significantly more focused on emotions as a pain coping strategy than were the males participants. A high level of optimism may have a significant impact on the reduction of emotion - oriented strategies such as catastrophising by switching on more beneficial strategies to cope with pain by the individual. There are no significant differences in the level of perceived pain between pessimists and optimists.

Effect of Prayer on Intensity of Migraine Headache

Background and Aim. Migraine is a common form of headache that affects patients quality of life negatively. In addition to pharmacologic treatment, there are a variety of nonpharmacologic treatments for migraine headache. In present study, we examined the effect of prayer on intensity of migraine pain. Methods. In a prospective, randomized, controlled trial from October 2013 to June 2014, this study has been conducted in Kerman, Iran. We randomly assigned 92 patients in 2 groups to receive either 40 mg of propranolol twice a day for 2 month (group “A”) or 40 mg of propranolol twice a day for 2 months with prayer (group “B”). At the beginning of study and 3 months after intervention, patients’ pain was measured using the visual analogue scale. Results. At the beginning of study and before intervention, the mean score of pain in patients in groups A and B were 5.7 ± 1.6 and 6.5 ± 1.9, respectively. According to results of independent t test, mean score of pain intensity at the beginning of study were similar between patients in 2 groups ( P > .05). Three month after intervention, mean score of pain intensity decreased in patients in both groups. At this time, the mean scores of pain intensity were 5.4 ± 1.1 and 4.2 ± 2.3 in patients in groups A and B, respectively. This difference between groups was statistically significant ( P < .001). Conclusions. The present study revealed that prayer can be used as a nonpharmacologic pain coping strategy in addition to pharmacologic intervention for this group of patients.