title: Effect of Tramadol/Acetaminophen on Motivation in Patients with Chronic Low Back Pain.
abstract: Background. The contribution of apathy, frequently recognized in individuals with neurodegenerative diseases, to chronic low back pain (LBP) remains unclear. Objectives. To investigate levels of apathy and clinical outcomes in patients with chronic LBP treated with tramadol-acetaminophen. Methods. A retrospective case-control study involving 73 patients with chronic LBP (23 male, 50 female; mean age 71 years) treated with tramadol-acetaminophen (n = 36) and celecoxib (n = 37) was performed. All patients were assessed using the self-reported questionnaires. A mediation model was constructed using a bootstrapping method to evaluate the mediating effects of pain relief after treatment. Results. A total of 35 (55.6%) patients met the criteria for apathy. A four-week treatment regimen in the tramadol group conferred significant improvements in the Apathy scale and numerical rating scale but not in the Rolland-Morris Disability Questionnaire, Pain Disability Assessment Scale, or Pain Catastrophizing Scale. The depression component of the Hospital Anxiety and Depression Scale was lower in the tramadol group than in the celecoxib group. The mediation analysis found that the impact of tramadol-acetaminophen on the change in apathy was not mediated by the pain relief. Conclusions. Tramadol-acetaminophen was effective at reducing chronic LBP and conferred a prophylactic motivational effect in patients with chronic LBP.
authors.affiliation: Department of Orthopaedic Surgery, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan; Department of Orthopaedic Surgery, Kurashiki Municipal Hospital, 2-39 Kojima-ekimae, Kurashiki 711-0921, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tetsunaga
authors.affiliation: Department of Orthopaedic Surgery, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Tetsunaga
authors.affiliation: Department of Orthopaedic Surgery, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Human Morphology, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Nishida
authors.affiliation: Department of Orthopaedic Surgery, Kurashiki Municipal Hospital, 2-39 Kojima-ekimae, Kurashiki 711-0921, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Takei
authors.affiliation: Department of Orthopaedic Surgery, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ozaki
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D057565:Apathy / Q000187:drug effects; D016022:Case-Control Studies; D058443:Catastrophization / Q000188:drug therapy; D000068579:Celecoxib / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009042:Motivation / Q000187:drug effects*; D010147:Pain Measurement; D012189:Retrospective Studies; D014147:Tramadol / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D052246:Cyclooxygenase 2 Inhibitors; D000082:Acetaminophen; D014147:Tramadol; D000068579:Celecoxib