Asian Spine J.  2015 Apr;9(2):254-262. 10.4184/asj.2015.9.2.254.

Neuropathic Pain in Elderly Patients with Chronic Low Back Painand Effects of Pregabalin: A Preliminary Study

• Sakai Y
• Ito K
• Hida T
• Ito S
• Harada A

• KMID: 2270169
• DOI: http://doi.org/10.4184/asj.2015.9.2.254

Abstract

STUDY DESIGN: Preliminary study. PURPOSE: To assess the association of neuropathic pain with chronic low back pain (LBP) and the effect of pregabalin on neuropathic pain in the elderly. OVERVIEW OF LITERATURE: Of those with chronic LBP, 37% were predominantly presenting with neuropathic pain in young adults. Pregabalin is effective for pain in patients with diabetic neuropathy and peripheral neuralgia. No study has reported on the effects of pregabalin for chronic LBP in elderly patients yet.
METHODS
Pregabalin was administered to 32 patients (age, > or =65 years) with chronic LBP for 4 weeks. Pain and activities of daily living were assessed using the Neuropathic Pain Screening Questionnaire (NePSQ), the pain DETECT questionnaire, visual analog scale, the Japanese Orthopedic Association score, the short form of the McGill Pain Questionnaire and the Roland Morris Disability Questionnaire. Modic change and spinal canal stenosis were investigated using magnetic resonance imaging.
RESULTS
Altogether, 43.3% of patients had neuropathic pain according to the NePSQ and 15.6% patients had pain according to the pain DETECT. The efficacy rate of pregabalin was 73.3%. A significant effect was observed in patients with neuropathic pain after 4 weeks of administration.
CONCLUSIONS
Neuropathic pain was slightly less frequently associated with chronic LBP in the elderly. Pregabalin was effective in reducing pain in patients with chronic LBP accompanied with neuropathic pain. Lumbar spinal stenosis and lower limb symptoms were observed in patients with neuropathic pain. We recommend the use of pregabalin for patients after evaluating a screening score, clinical symptoms and magnetic resonance imaging studies.

Keyword

Low back pain; Elderly person; Pregabalin; Treatment outcome

MeSH Terms

Activities of Daily Living
Aged*
Asian Continental Ancestry Group
Constriction, Pathologic
Diabetic Neuropathies
Humans
Low Back Pain
Lower Extremity
Magnetic Resonance Imaging
Mass Screening
Neuralgia*
Orthopedics
Pain Measurement
Spinal Canal
Spinal Stenosis
Treatment Outcome
Visual Analog Scale
Young Adult
Pregabalin
Surveys and Questionnaires