Central sensitization in adults with chronic neck pain: cross-cross study exploring differences by gender
Sensibilização central em adultos com dor cervical crônica: estudo transversal explorando as diferenças por sexo
Ana Paula Vasconcellos Abdon; Leonardo Lima Aleixo; Amanda de Oliveira Toledo; Maíra de Oliveira Viana Rela; Carlos Ewerton Maia Rodrigues; Ticiana Mesquita de Oliveira Fontenele
Abstract
Keywords
Resumo
JUSTIFICATIVA E OBJETIVOS: A presença de sensibilização central (SC) em pessoas com dor cervical crônica carece de esclarecimentos, bem como as possíveis disparidades entre os sexos. Portanto, objetivou-se avaliar a presença de SC na dor cervical crônica de acordo com o sexo.
MÉTODOS: Estudo transversal com a participação de 260 adultos (18-59 anos) com dor cervical crônica, realizado entre setembro de 2022 e setembro de 2023. Foram aplicados instrumentos para coletar perfil sociodemográfico, características da dor, incapacidade funcional da cervical e presença de SC. Para análises comparativas foi utilizado o SPSS 23.0.
RESULTADOS: Nas disparidades entre os sexos, não houve diferenças na intensidade da dor e incapacidade funcional cervical (p=0,134 e p=0,277, respectivamente). No entanto, a SC foi mais elevada nas mulheres (43,5 ± 14,0; p=0,003). No sexo feminino, a SC apresentou relação com a "interferência da dor" nos aspectos: caminhar (r=0,311; p=0,001), relacionamento interpessoal (r=0,309; p=0,001), apreciação da vida (r=0,321; p=0,001) e com incapacidade funcional da cervical (r=0,570; p=0,001). Já no sexo masculino, a SC teve relação com a "interferência da dor" em aspectos como atividade geral (r=0,311; p=0,008), humor (r=0,376; p=0,001), caminhar (r=0,313; p=0,007), relacionamento interpessoal (r=0,477; p=0,001), sono (r=0,321; p=0,006), apreciação da vida (r=0,427 p=0,001) e incapacidade funcional (r=0,667; p<0,001).
CONCLUSÃO: Mulheres com dor cervical crônica mostraram maior presença da SC, enquanto nos homens a SC esteve relacionada a uma variedade de aspectos que afetam negativamente a vida. Diante disso, as diferenças entre os sexos poderiam ser consideradas no gerenciamento de pacientes com dor cervical crônica.
Palavras-chave
References
1 Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi Ali-Asghar, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2023;23(1):1-13.
2 Aimi MA, Raupp EG, Schmit EFD, Vieira A, Candotti CT. Correlation between cervical morphology, pain, functionality, and rom in individuals with cervicalgia. Coluna/Columna 2019; 18(2):101-5.
3 Lentz TA, Harman JS, Marlow NM, Beneciuk JM, Fillingim RB, George SZ. Factors associated with persistently high-cost health care utilization for musculoskeletal pain. PLoS One 2019;14(11):e0225125.
4 Wu AM, Cross M, Elliott JM, Culbreth GT, Halle LM, Steinmetz JD, et al. Global, regional, and national burden of neck pain, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2024;6(3):142-55.
5 Pulik Ł, Dyrek N, Piwowarczyk A, Jaśkiewicz K, Sarzyńska S, Łęgosz P. The update on scales and questionnaires used to assess cervical spine disorders. Physical Therapy Reviews. 2021;26(2):150-8.
6 Kim R, Wiest C, Clark K, Cook C, Horn M. Identifying risk factors for first-episode neck pain: A systematic review. Musculoskelet Sci Pract. 2018;33:77-83.
7 Ashmawi HA, Freire GMG. Peripheral and central sensitization. Revista Dor. 2016;17:31-4.
8 Scerbo T, Colasurdo J, Dunn S, Unger J, Nijs J, Cook C. Measurement Properties of the Central Sensitization Inventory: A Systematic Review. Pain Practice. 2018;18(4):544-54.
9 Rampazo ÉP, da Silva VR, de Andrade ALM, Back CGN, Madeleine P, Arendt-Nielsen L, Liebano RE. Sensory, motor, and psychosocial characteristics of individuals with chronic neck pain: a case control study. Phys Ther. 2021; 101 (7): 1-10.
10 Malfliet A, Kregel J, Cagnie B, Kuipers M, Dolphens M, Roussel N, Meeus M, Dannelels L, Bramer WM, Kijs J. Lack of evidence for central sensitization in idiopathic, non-traumatic neck pain: a systematic review. Pain Physician. 2015;18(3):223-35.
11 Siwach P, Verma B. Gender differences in description of chronic musculoskeletal pain. Int J Res Med Sci. 2023; 11(4): 1290-5.
12 IASP., International Association for the Study of Pain. IASP 2024 Global Year about Sex and Gender Disparities in Pain [Internet]. International Association for the Study of Pain. 2024 [citado 9 de março de 2024]. p. 1-8. Disponível em:
13 Koh K, Yamada K, Enomoto T, Kawai A, Hamaoka S, Chiba S, et al. Sex-Specific Impact of Pain Severity, Insomnia, and Psychosocial Factors on Disability due to Spinal Degenerative Disease. Pain Res Manag. 2020;2020:1-6.
14 Bittencourt JV, Bezerra MC, Pina MR, Reis FJJ, de Sá Ferreira A, Nogueira LAC. Use of the painDETECT to discriminate musculoskeletal pain phenotypes. Arch Physiother. 2022; 12(1):1-8.
15 Ferreira KA, Teixeira MJ, Mendonza TR, Cleeland CS. Validation of brief pain inventory to Brazilian patients with pain. Supportive Care in Cancer. 2011;19(4):505-11.
16 Cook C, Richardson JK, Braga L, Menezes A, Soler X, Kume P, Zaninelli M, Socolows F, Pietrobon R. Cross-cultural adaptation and validation of the Brazilian Portuguese version of the Neck Disability Index and Neck Pain and Disability Scale. Spine (Phila Pa 1976).2006;31(14):1621-7.
17 Neblett R, Hartzeil MM, Mayer TG, Cohen H, Gatchel RJ. Establishing Clinically Relevant Severity Levels for the Central Sensitization Inventory. Pain Practice. fevereiro de 2017;17(2):166-75.
18 Palacios-Ceña D, Albaladejo-Vicente R, Hernández-Barrera V, Lima-Florencio L, Fernández-de-las-Peñas C, Jimenez-Garcia R, Lópes-de-Andrés A, Miguel-Diez J, Perez-Farinos N. Female gender is associated with a higher prevalence of chronic neck pain, chronic low back pain, and migraine: results of the Spanish national health survey, 2017. Pain Medicine. 2021;22(2):382-95.
19 Palacios-Ceña D, Albaladejo-Vicente R, Hernández-Barrera V, Lima-Florencio L, Fernández-de-las-Penas C, Jimenez-Garcia R, Lópes de Andrés A, Miguel-Diez J, Perez-Farinos N. Female gender is associated with a higher prevalence of chronic neck pain, chronic low back pain, and migraine: results of the Spanish national health survey, 2017. Pain Medicine. 2021;22(2):382-95.
20 Roldán-Jiménez C, Pérez-Cruzado D, Neblett R, Gatchel R, Cuesta-Vargas A. Central Sensitization in Chronic Musculoskeletal Pain Disorders in Different Populations: A Cross-Sectional Study. Pain Medicine. 2020;21(11):2958-63.
21 Shigetoh H, Tanaka Y, Koga M, Osumi M, Morioka S. The Mediating Effect of Central Sensitization on the Relation between Pain Intensity and Psychological Factors: A Cross-Sectional Study with Mediation Analysis. Pain Res Manag. 2019;2019:1-6.
22 Andias R, Silva AG. Impact of Sex, Sleep, Symptoms of Central Sensitization, and Psychosocial Factors in Adolescents with Chronic Musculoskeletal Pain: An Exploratory Study. Pain Medicine. 2022;23(10): 1777-92.
23 Tanaka K, Murata S, Nishigami T, Mibu A, Manfuku M, Shinohara Y, Tanabe A, Ono R. The central sensitization inventory predicts pain-related disability for musculoskeletal disorders in the primary care setting. Eur J Pain. 2019;23(9):1640-8.
24 Rovner GS, Sunnerhagen KS, Björkdahl A, Gerdle B, Börsbo B, Johansson F, Gillans-ders D. Chronic pain and sex-differences; women accept and move, while men feel blue. PLoS One. 2017;12(4):e0175737.
25 Keogh E. Men, masculinity, and pain. Pain. 2015;156(12):2408-12.
Submitted date:
03/17/2024
Accepted date:
04/23/2024
Facebook
Google+
Twitter
LinkedIn
Mendeley
Email