Association between pain sensitivity in the hand and outcomes after surgery in patients with lumbar disc herniation or spinal stenosis

Eur Spine J. 2017 Oct;26(10):2581-2588. doi: 10.1007/s00586-017-4979-9. Epub 2017 Feb 6.

Abstract

Purpose: To investigate the association between pain sensitivity in the hand pre-surgery, and patient-reported outcomes (PROs) in function, pain and health pre- and post-surgery in patients with disc herniation or spinal stenosis.

Methods: This is a prospective cohort study with 82 patients. Associations between pressure-, cold- and heat pain threshold (PPT, CPT, HPT) in the hand pre-surgery and Oswestry, VAS pain, EQ-5D, HADS, and Self-Efficacy Scale, pre- and three months post-surgery; were investigated with linear regression.

Results: Patients with disc herniation more sensitive to pressure pain pre-surgery showed lower function and self-efficacy, and higher anxiety and depression pre-surgery, and lower function, and self-efficacy, and higher pain post-surgery. Results for cold pain were similar. In patients with spinal stenosis few associations with PROs were found and none for HPT and PROs.

Conclusions: Altered pain response in pressure- and cold pain in the hand, as a sign of widespread pain pre-surgery had associations with higher pain, lower function and self-efficacy post-surgery in patients with disc herniation.

Keywords: Disc herniation; Quantitative sensory testing; Spinal stenosis; Spinal surgery; Widespread pain.

MeSH terms

  • Aged
  • Anxiety / etiology
  • Cohort Studies
  • Cold Temperature
  • Depression / etiology
  • Female
  • Hand*
  • Humans
  • Intervertebral Disc Displacement / surgery*
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Pain Threshold*
  • Postoperative Period
  • Pressure
  • Self Efficacy
  • Spinal Stenosis / surgery*
  • Visual Analog Scale*