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Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
[Sleep disturbance in patients with chronic nonspecific neck pain before and after radiofrequency denervation]
M I Gaydash1, G Yu Evzikov1, M G Zonov1
1I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Objective:
To study the severity of insomnia before and after radiofrequency denervation (RFD) in chronic nonspecific neck pain (CNNP).
Material And Methods:
The study included 25 patients with CNNP (18 females and 7 males) aged 23 to 88, with a mean age of 63.7±16 years. Pain intensity was assessed using a Visual Analog Scale (VAS), and sleep quality was assessed using the Insomnia Severity Index (ISI) before and 3 months after RFD.
Results:
Chronic insomnia was diagnosed in the majority (18 of 25) of patients with CNNP, and in more than half (13 of 18), it preceded the occurrence of pain. Three months after RFD, the pain intensity according to VAS decreased from 7.1±1.1 to 3.2±2.7 points (p<0.001), the severity of insomnia decreased from 16.4±6.3 to 12.2±7.1 points (p<0.001). High ISI scores (14.6±3.4 points) 3 months after RFD were found in patients with sleep disorders preceding CNNP.
Conclusion:
Most patients with CNNP have chronic insomnia. RFD provides a significant reduction in the severity of pain and, as a result, improves sleep quality. Normalization of sleep is less likely in the presence of insomnia before the development of cervical pain; in such cases, cognitive behavioral therapy (CBT) may be effective.
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