The presence of neuropathic pain was identified as a risk factor for low physical and mental quality of life in middle-aged and elderly patients, according to study results published in Spine.

Previous studies have reported that spinal kyphosis, osteoporosis, muscle strength, chronic pain, and low physical ability can decrease quality of life. However, few studies have examined the impact of neuropathic pain and spinal sagittal alignment on quality of life in healthy individuals. With this study, investigators sought to assess the effect of neuropathic pain, spinal alignment and range of motion, spinal degenerative changes evaluated with imaging techniques, osteoporosis, muscle strength, and physical ability on the risk for poor physical and mental quality of life in healthy adults.

In this prospective study, 1128 healthy adults aged 50 to 90 years (473 men; mean age, 64.3) were enrolled during their annual health checkup in the town of Yakumo in Hokkaido, Japan (Yakumo study). Quality of life was assessed using the Medical Outcomes Study 36-item short-form health survey (SF-36). The painDETECT questionnaire translated to Japanese was used to screen for neuropathic pain, with a cutoff score of ≥13 points.

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Of the study cohort, 113 patients (10%) had neuropathic pain. The patients with neuropathic pain also had lower lumber lordosis (P <.05), higher spinal inclination (P <.01), slower gait (P <.01), and a higher rate of osteoporosis. SF-36 values for all domains were lower in patients with neuropathic pain (P <.0001).

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Multivariate analysis indicated that neuropathic pain (odds ratio, 3.01; P <.05), large spinal inclination angle (odds ratio, 1.14; P <.05), and severe low back pain (odds ratio 1.04; P <.0005) were independent and significant risk factors for low physical quality of life. Neuropathic pain was the only identified risk factor for low mental quality of life (odds ratio, 5.32; P <.001).

Study limitations include that most of the participants worked in agriculture or fishing, unlike elderly people living in urban areas, and that no MRI data were available to assess for spinal stenosis.

“Neuropathic pain was found to be an independent risk factor for low physical and mental [quality of life], and sagittal spinal alignment and severity of [low back pain] were also risk factors for low physical [quality of life],” concluded the researchers.

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Imagama S, Ando K, Kobayashi K, et al. The relationship between neuropathic pain and spinal alignment: independent risk factors for low quality of life in middle-aged and elderly people (published online June 27, 2019). Spine (Phila Pa 1976). doi:10.1097/BRS.0000000000003073