Frequency of Spinal Segmental Sensitization Syndrome and Associated Social Determinants of Health

Abstract

Objective: To determine the frequency of spinal segmental sensitization (SSS) syndrome and its association with socioeconomic and educational levels, Depression, smoking, and alcoholism.

Design: Analytic cross-sectional study conducted within the time frame of February-August 2022.

Setting: Outpatient consultation area of the Hospital Regional Universitario de Colima, a public health care institution in Mexico PARTICIPANTS: Ninety-eight patients over 18 years of age were selected that presented with chronic musculoskeletal pain of at least 3-month progression (N=98). The patients were initially selected through simple random sampling, complementing 60% of the calculated sample with consecutive cases due to the pandemic status.

Interventions: Not applicable.

Main outcome measure(s): The subjects gave their informed consent, authorizing the clinical history interview and physical examination that applied the 2019 diagnostic criteria of Nakazato and Romero, as well as the AMAI test, the Mexican National Education System, the Beck Depression Inventory, Fagerstrom Test, and Alcohol Use Disorders Identification Test instrument, to collect the data on socioeconomic and educational levels, Depression, smoking, and alcoholism, respectively. Frequencies and percentages were obtained for the statistical analysis, using the chi-square test, multiple logistic regression, and bivariate/multivariate analyses with the prevalence odds ratio.

Results: SSS had a 22.4% frequency and was significantly associated (P<.05) with moderate Depression and severe Depression, signifying that a patient with moderate depression had 5.57 times more probability of presenting with SSS (95% CI, 1.27-30.16, P<.05), whereas a patient with severe Depression had 8.68 times more probability of presenting with SSS (95% CI, 1.99-47.77, P<.05). The results of the remaining variables were not statistically significant.

Conclusions: There is a need for a biopsychosocial focus on SSS, in which the detection of and approach to moderate and severe Depression favors patient awareness of aspects associated with the phenomenon of chronic pain and the creation of coping strategies for that pain.

Keywords: Central sensitization; Chronic pain; Chronic widespread pain; Rehabilitation; Social determinants of health.