Assessment and correlation between subjective and physiological variables of chronic spinal pain

Moura, Caroline de Castro; Iunes, Denise Hollanda; Agostinho, Aline Aparecida Machado; Santos, Nara dos; Silva, Andréia Maria; Chaves, Erika de Cássia Lopes

doi:10.5935/1806-0013.20170102

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ORIGINAL ARTICLES • Rev. dor 18 (3) • Jul-Sep 2017 • https://doi.org/10.5935/1806-0013.20170102 copy

Assessment and correlation between subjective and physiological variables of chronic spinal pain

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND AND OBJECTIVES:

Chronic pain on the spine has a high prevalence. The assessment of subjective and physiological parameters over time, and how they relate is important to check changes in people’s health status who suffer from this condition. The objective of this study was to evaluate and correlate the subjective and physiological variables of chronic pain on the spine.

METHODS:

Observational, prospective study of repeated measures, carried out from September 2015 to January 2016, with 99 people registered on the waiting list of a University physiotherapy clinic of Minas Gerais. Four evaluations were performed with a 15-day interval.

RESULTS:

It was found statistically significant reductions over time in pain intensity (p<0.001), in its interference with daily activities (p<0.001), in pain threshold (p<0.001) and physical impairment (p<0.001). There were negative correlations between pain threshold and pain intensity in evaluations three (p=0.003) and four (p=0.001); a positive correlation between pain intensity and physical impairment in all evaluations (p<0.001); and a negative correlation between pain threshold and physical impairment in evaluations one (p=0.001), three (p=0.043) and four (p=0.004). There are also positive correlations between pain intensity and its interference with daily activities (p<0.001); and a negative correlation between pain threshold and these activities, especially in evaluations three and four.

CONCLUSION:

There are correlations between subjective variables and physiological characteristics of chronic pain on the spine.

Keywords:
Chronic pain; Pain measurement; Spine

Regions	AV 1	AV 2	AV 3	AV 4
Regions	f (%)	f (%)	f (%)	f (%)
Cervical	35 (35.40)	26 (26.30)	19 (19.20)^* * Assessment 1 ≠ Assessment 3;	20 (20.20)^**
Thoracic	27 (27,30)	25 (25.20)	27 (27.30)	22 (22.20)
Lower back	68 (68.70)	64 (64.60)	51 (51.50)^* * Assessment 1 ≠ Assessment 3; ^# # Assessment 2 ≠ Assessment 3.	56 (56.60)^ Assessment 1 ≠ Assessment 4;

	AV 1	AV 2	AV 3	AV 4	p value
	µ±σ CI	µ±σ CI	µ±σ CI	µ±σ CI	p value
Pain intensity	4.70±2.11 4,55-5,39	3.98±2.4^* * Assessment 1 ≠ Assessment 2; 3,48-4,48	3.15±2.6^ Assessment 1 ≠ Assessment 3; ^# # Assessment 2 ≠ Assessment 3; 2.62-3.67	4.00±3.0^* ***** Assessment 1 ≠ Assessment 4; ^& & Assessment 3 ≠ Assessment 4. 3.38-4.62	<0.001
Interference of pain in daily activities	4.82±2.69 4.28-5.35	3.07±2.75^* * Assessment 1 ≠ Assessment 2; 2.52-3.61	2.36±2.84^ Assessment 1 ≠ Assessment 3; ^# # Assessment 2 ≠ Assessment 3; 1.79-2.92	2.96±3.21^* ***** Assessment 1 ≠ Assessment 4; ^& & Assessment 3 ≠ Assessment 4. 2.32-3.60	<0.001
Pain threshold	2.87±1.46 2,58-3,16	1.96±0.84^* * Assessment 1 ≠ Assessment 2; 1,79-2,12	2.00±0.82 1,84-2,17	2.03±0.86 1,85-2,20	<0.001
Physical disability	12.24±6.14 11.01-13.46	9.97±6.64^* * Assessment 1 ≠ Assessment 2; 8.64-11.29	9.10±6.92 7.71-10.48	9.83±7.55^& & Assessment 3 ≠ Assessment 4. 8,32-11.33	<0.001

		AV 1	AV 2	AV 3	AV 4
Pain threshold / pain intensity	p value	0.018	0.019	0.003^* * p<0.05; Spearman's rank correlation.	<0.001^* * p<0.05; Spearman's rank correlation.
Pain threshold / pain intensity	R	-0.283	-0.235	-0.298	-0,408
Physical disability/pain intensity	p value	<0.001^* * p<0.05; Spearman's rank correlation.	<0.001^* * p<0.05; Spearman's rank correlation.	<0.001^* * p<0.05; Spearman's rank correlation.	<0.001^* * p<0.05; Spearman's rank correlation.
Physical disability/pain intensity	R	0.499	0.465	0.600	0.067
Physical disability/pain threshold	p value	0.001^* * p<0.05; Spearman's rank correlation.	0.143	0.043^* * p<0.05; Spearman's rank correlation.	0.004^* * p<0.05; Spearman's rank correlation.
Physical disability/pain threshold	R	-0.339	-0.148	-0.204	-0.029

Daily activities	Assessment	Pain intensity		Pain threshold
Daily activities	Assessment	p value	R	p value	R
General activity	1	<0.001^* * p<0.05; Spearman's rank correlation.	0.497	0.009^* * p<0.05; Spearman's rank correlation.	-0.260
	2	<0.001^* * p<0.05; Spearman's rank correlation.	0.596	0.185	-0.134
	3	<0.001^* * p<0.05; Spearman's rank correlation.	0.763	0.016^* * p<0.05; Spearman's rank correlation.	-0.243
	4	<0.001^* * p<0.05; Spearman's rank correlation.	0.777	0.002^* * p<0.05; Spearman's rank correlation.	-0.304
Mood	1	<0.001^* * p<0.05; Spearman's rank correlation.	0.374	0.001^* * p<0.05; Spearman's rank correlation.	-0.257
	2	<0.001^* * p<0.05; Spearman's rank correlation.	0.434	0.115	-0.159
	3	<0.001^* * p<0.05; Spearman's rank correlation.	0.705	0.035^* * p<0.05; Spearman's rank correlation.	-0.212
	4	<0.001^* * p<0.05; Spearman's rank correlation.	0.672	<0.001^* * p<0.05; Spearman's rank correlation.	-0.400
Ability to walk	1	<0.001^* * p<0.05; Spearman's rank correlation.	0.407	0.069	-0.184
	2	<0.001^* * p<0.05; Spearman's rank correlation.	0.557	0.066	-0.185
	3	<0.001^* * p<0.05; Spearman's rank correlation.	0.705	0.007^* * p<0.05; Spearman's rank correlation.	-0.269
	4	<0.001^* * p<0.05; Spearman's rank correlation.	0.701	0.005^* * p<0.05; Spearman's rank correlation.	-0.281
Work	1	<0.001^* * p<0.05; Spearman's rank correlation.	0,653	0,127	-0.154
	2	<0.001^* * p<0.05; Spearman's rank correlation.	0,541	0.017^* * p<0.05; Spearman's rank correlation.	-0.240
	3	<0.001^* * p<0.05; Spearman's rank correlation.	0,454	0.037^* * p<0.05; Spearman's rank correlation.	-0.210
	4	<0.001^* * p<0.05; Spearman's rank correlation.	0,481	<0.001^* * p<0.05; Spearman's rank correlation.	-0.402
Relationship with other people	1	<0.001^* * p<0.05; Spearman's rank correlation.	0,324	0.075	-0.180
	2	<0.001^* * p<0.05; Spearman's rank correlation.	0,381	0.005^* * p<0.05; Spearman's rank correlation.	-0.278
	3	<0.001^* * p<0.05; Spearman's rank correlation.	0,551	0.039^* * p<0.05; Spearman's rank correlation.	-0.207
	4	<0.001^* * p<0.05; Spearman's rank correlation.	0,572	<0.001^* * p<0.05; Spearman's rank correlation.	-0.399
Sleep	1	<0.001^* * p<0.05; Spearman's rank correlation.	0,482	0.510	-0.067
	2	<0.001^* * p<0.05; Spearman's rank correlation.	0,553	0.246	-0.118
	3	<0.001^* * p<0.05; Spearman's rank correlation.	0,593	<0.001^* * p<0.05; Spearman's rank correlation.	-0.359
	4	<0.001^* * p<0.05; Spearman's rank correlation.	0,676	<0.001^* * p<0.05; Spearman's rank correlation.	-0.439
Enjoy life	1	<0.001^* * p<0.05; Spearman's rank correlation.	0,387	0.194	-0.132
	2	<0.001^* * p<0.05; Spearman's rank correlation.	0,480	0.030^* * p<0.05; Spearman's rank correlation.	-0.218
	3	<0.001^* * p<0.05; Spearman's rank correlation.	0,531	0.133	-0.152
	4	<0.001^* * p<0.05; Spearman's rank correlation.	0.497	0.002^* * p<0.05; Spearman's rank correlation.	-0.301

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[1] Correspondence to: Rua Gabriel Monteiro da Silva, 700, centro 37130-001 Alfenas, MG, Brasil. E-mail: carol_castro_m@hotmail.com