Association between pain sensitivity in the hand and outcomes after surgery in patients with lumbar disc herniation or spinal stenosis.
To investigate the association between pain sensitivity in the hand pre-surgery, and patient-reported outcomes (PROs) in function, pain and health pre- and post-surgery in patients with disc herniation or spinal stenosis.



This is a prospective cohort study with 82 patients. Associations between pressure-, cold- and heat pain threshold (PPT, CPT, HPT) in the hand pre-surgery and Oswestry, VAS pain, EQ-5D, HADS, and Self-Efficacy Scale, pre- and three months post-surgery; were investigated with linear regression.



Patients with disc herniation more sensitive to pressure pain pre-surgery showed lower function and self-efficacy, and higher anxiety and depression pre-surgery, and lower function, and self-efficacy, and higher pain post-surgery. Results for cold pain were similar. In patients with spinal stenosis few associations with PROs were found and none for HPT and PROs.



Altered pain response in pressure- and cold pain in the hand, as a sign of widespread pain pre-surgery had associations with higher pain, lower function and self-efficacy post-surgery in patients with disc herniation.
Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden. yvonne.lindback@liu.se.
Yvonne
0000-0002-1498-0498
Y
Lindbäck
Department of Spinal Surgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Hans
H
Tropp
Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden.
Paul
P
Enthoven
Pain and Rehabilitation Centre and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Björn
B
Gerdle
Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden.|Faculty of Health Science and Medicine, Bond University, Gold Coast, QLD, 4229, Australia.
Allan
A
Abbott
Department of Medical and Health Sciences, Division of Physiotherapy, Faculty of Medicine and Health Sciences, Linköping University, SE-581 83, Linköping, Sweden.
Birgitta
B
Öberg
D000368:Aged; D001007:Anxiety / Q000209:etiology; D015331:Cohort Studies; D003080:Cold Temperature; D003863:Depression / Q000209:etiology; D005260:Female; D006225:Hand; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017288:Pain Threshold; D011184:Postoperative Period; D011312:Pressure; D020377:Self Efficacy; D013130:Spinal Stenosis / Q000601:surgery*; D064232:Visual Analog Scale
Disc herniation; Quantitative sensory testing; Spinal stenosis; Spinal surgery; Widespread pain