Psychosocial factors associated with disability in patients with non-specific chronic low back pain: A cross-sectional study / Factores psicosociales asociados a la discapacidad en pacientes con lumbalgia crónica inespecífica: un estudio transversal

Introduction and objectives: Chronic low back pain is the main cause of disability worldwide, generating high costs for society. To evaluate the prevalence of disability in patients with non-specific chronic low back pain and associated factors, including the impacts of low back pain and psychosocial factors linked to kinesiophobia, catastrophism, anxiety, and depression. Patients: A cross-sectional study was carried out with 108 adult individuals who had non-specific chronic low back pain. The patients answered previously validated questionnaires, namely the Brief Pain Inventory, the Roland-Morris Disability Questionnaire, the Pain Catastrophizing Scale, the Tampa Kinesiophobia Scale, and the Hospital Anxiety and Depression Scale. Results: The prevalence of disability observed was 65.7%, with the mean disability score being 15.7±5.3 points in the Roland-Morris Disability Questionnaire. Although pain intensity and other domains of the Brief Pain Inventory, like anxiety, depression, and severe kinesiophobia were significant in the bivariate analyses, they were not associated with disability in the multivariate analysis. Only catastrophic thoughts (prevalence ratio [PR]=1.19; 95% confidence interval [CI]: 1.07–1.32), and the ‘walking’ domain (PR=1.08; 95% CI: 1.03–1.14) remained statistically associated with disability. Conclusion: Pain catastrophization and impact on gait were associated with disability in individuals with non-specific chronic low back pain. Motor control thoughts and behaviors during functional activities were considered to be relevant aspects for the better assessment and treatment of these patients.(AU)

Introducción y objetivos: La lumbalgia crónica es la principal causa de discapacidad a nivel mundial, generando altos costos para la sociedad. Evaluar la prevalencia de discapacidad en pacientes con dolor lumbar crónico inespecífico y factores asociados, incluidos los impactos del dolor lumbar y factores psicosociales relacionados con la kinesiofobia, el catastrofismo, la ansiedad y la depresión. Pacientes: Se realizó un estudio transversal con 108 individuos adultos que presentaban lumbalgia crónica inespecífica. Los pacientes respondieron cuestionarios previamente validados, a saber, el Inventario Breve de Dolor, el Cuestionario de Discapacidad de Roland-Morris, la Escala de Catastrofización del Dolor, la Escala de Kinesiofobia de Tampa y la Escala de Ansiedad y Depresión Hospitalaria. Resultados: La prevalencia de discapacidad observada fue del 65,7%, siendo la puntuación media de discapacidad de 15,7±5,3 puntos en el Cuestionario de discapacidad de Roland-Morris. Aunque la intensidad del dolor y otros dominios del Inventario Breve de Dolor, como la ansiedad, la depresión y la kinesiofobia grave, fueron significativos en los análisis bivariados, no se asociaron con la discapacidad en el análisis multivariado. Sólo los pensamientos catastróficos (razón de prevalencia [PR]=1,19; intervalo de confianza [IC] del 95%: 1,07-1,32) y el dominio “caminar” (RP=1,08; IC del 95%: 1,03-1,14) permanecieron estadísticamente asociados con la discapacidad. Conclusión: La catastrofización del dolor y el impacto en la marcha se asociaron con discapacidad en personas con dolor lumbar crónico inespecífico. Los pensamientos y conductas de control motor durante las actividades funcionales se consideraron aspectos relevantes para una mejor valoración y tratamiento de estos pacientes.(AU)

A pyrazolyl-thiazole derivative causes antinociception in mice

The present study investigates the antinociceptive effect of the pyrazolyl-thiazole derivative 2-(5-trichloromethyl-5-hydroxy-3-phenyl-4,5-dihydro-1 H-pyrazol-1-yl)-4-(4-bromophenyl)-5-methylthiazole (B50) in mice. Male albino Swiss mice (30-40 g) were used in the acetic acid-induced abdominal writhes and tail-immersion tests. B50 caused dose-dependent antinociception (8, 23 and 80 µmol/kg, sc) in the acetic acid writhing assay (number of writhes: vehicle: 27.69 ± 6.15; B50 (8 µmol/kg): 16.92 ± 3.84; B50 (23 µmol/kg): 13.85 ± 3.84; B50 (80 µmol/kg): 9.54 ± 3.08; data are reported as means ± SEM for 9 animals per group). On the other hand, B50 did not cause antinociception in the tail immersion assay. Naloxone (2.75 µmol/kg, sc) prevented B50-induced antinociception (number of writhes: vehicle-saline: 31.11 ± 3.15; vehicle-naloxone: 27.41 ± 3.70; B50 (80 µmol/kg)-saline: 8.70 ± 3.33; B50 (80 µmol/kg)-naloxone: 31.84 ± 4.26; morphine-saline: 2.04 ± 3.52; morphine-naloxone: 21.11 ± 4.26; 8-9 animals per group). The removal of the methyl group of the thiazole ring of B50 or substitution of the bromo substituent with the methyl at position 4 of the phenyl group, which is attached to the thiazole ring of B50, resulted in loss of activity, suggesting that these substituents are important for antinociceptive activity. B50 had no effect on spontaneous locomotion or rotarod performance, indicating that the antinociceptive effect of B50 is not related to nonspecific motor effects. The antinociceptive profile of B50 seems to be closer to nonsteroidal anti-inflammatory drugs than to classic opioid agents, since it had no analgesic effect in a thermally motivated test.