Depression, Anxiety and Quality of Life among Chronic Low Back-leg Pain Patients with or without Neuropathic Pain

Aims: To investigate depression, anxiety and quality of life among chronic low back-leg pain patients with or without neuropathic pain.

Place and Duration of Study: Ankara Numune Education and Research Hospital Department of Physical Medicine and Rehabilitation Polyclinic, between October 2012 and June 2013.

Methodology: One hundred and one patients with chronic low back and leg pain were enrolled in the study. This study is a cross-sectional study. The severity of low back and leg pain was evaluated by visual analogue scale (VAS). The DN4 (Douleur Neuropathique en 4 Questions) and LANSS (Leeds Assessment of Neuropathic Symptoms and Signs) scales were used in order to evaluate the neuropathic pain. Existence of depression was evaluated by the Hamilton Depression Rating Scale (HAM-D) and anxiety was assessed by Hamilton Anxiety Rating Scale (HAM-A). The quality of life was questioned by Short Form-36 (SF-36).

Results: Neuropathic pain was detected in 65.3% by DN4 and 40.6% by LANSS among all patients. According to HAM-D results, 22.7% of the patients had depression and according to HAM-A results, 8.9% of the patients had anxiety. While frequency of depression was statistically significantly higher in patients with neuropathic pain according to LANSS (p<0,05), the frequency of anxiety was similar between groups. Although depression and anxiety was more common among patients with neuropathic pain according to DN4, there was no statistically significant difference between chronic low back-leg pain patients with or without neuropathic pain. The median SF-36 mental score was significantly lower in patients with NP according to LANSS (p<0.05). Although the median SF-36 scores (mental, physical) were higher in patients with NP according to DN4, there was no significant difference between groups (respectively p>0.05, p>0.05).

Conclusion: Patients with chronic low back and leg pain should also be questioned in terms of neuropathic symtoms and the conservative treatment should be arranged in this direction. Thus concomitant depression and anxiety would decrease, and the quality of life would increase.