Low back pain classifications and their associations with disability, quality-of-life, and sociodemographic factors: a comprehensive examination using the PainDETECT questionnaire

Abstract

Background: Low back pain (LBP) is a debilitating phenomenon that significantly impacts quality-of-life (QOL). The PainDETECT questionnaire (PD-Q) is a screening tool aimed at distinguishing nociceptive pain (NoP) and neuropathic pain (NeP) classifications. Associations between these classifications and patient-reported outcome measures (PROMs) and sociodemographic parameters are yet to be established.

Objective: The study aimed to determine the relationship between NeP as assessed by the PD-Q and pain, disability, QOL and sociodemographic factors.

Methods: A retrospective analysis of an ongoing prospectively collected database was conducted involving 512 patients aged >18 years who presented to a tertiary spine clinic for LBP having completed the PainDETECT questionnaire, Oswestry Disability Index (ODI), EuroQol Five-Dimensional (EQ-5D) questionnaire or answered questions regarding sociodemographic status.

Results: The NeP group had a higher mean numerical rating scale (NRS) score (7.96$\pm$1.54 vs. 5.76$\pm$2.27, p < 0.001) and lower age (55$\pm$15.6 vs. 59$\pm$17.8, p < 0.05) compared to the NoP group. When confounded for NRS, analysis of covariance demonstrated an 89.5% higher total ODI score (p < 0.001) and 50.5% lower EQ-5D utility score (p < 0.001) in the NeP compared to NoP group. Smokers and individuals with a no partner marital status were 2.373 (OR = 2.373, 95%C.I. [1.319-4.266], p < 0.01) and 2.384 times (OR = 2.384, 95%C.I. [1.390-4.092], p < 0.01) more likely to have NeP compared to NoP, respectively. Patients with NeP were also of lower income class compared to patients with NoP (Z=-2.45, p < 0.05).

Conclusion: NeP was associated with higher levels of disability and lower QOL. Smokers, individuals with a no partner marital status, and individuals with a lower income class were more likely to suffer NeP rather than NoP. These findings have illuminated a crucial notion: in patients with elevated NRS, the detrimental impact of NeP on patient wellbeing underscores the fundamental need to represent pain on a nociceptive-neuropathic continuum, permitting more accurate differentiation of pain components.

Keywords:

• Low back pain
• neuropathic pain
• PainDETECT questionnaire
• sociodemographic
• disability
• quality of life

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