Comparison of the autonomic nervous system dysfunction between different chronic spine disorders: neck pain versus low back pain

Abstract

OBJECTIVE: This study aims to compare heart rate variability (HRV) between patients with chronic neck pain and patients with chronic low back pain and to correlate the chronic pain variables with heart rate variability indices. METHODS: This is a cross-sectional study. We divided the sample into two groups: neck pain (n=30) and low back pain (n=30). We used the Numeric Pain Rating Scale, Neck Disability Index, Roland-Morris Disability Questionnaire, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia, and Pain Self-Efficacy Questionnaire. For heart rate variability analysis, we used the following indices: mean RR, standard deviation of all RR intervals, mean heart rate, root mean square differences of successive RR intervals, triangular index, triangular interpolation of the interval histogram, low-frequency band in arbitrary units and in absolute values, high-frequency band in arbitrary units and in absolute values, standard deviation of the instantaneous beat-to-beat variability (standard deviation 1), long-term standard deviation of continuous RR intervals (standard deviation 2), and Stress Index. We used Student's t-test for comparisons and Spearman's coefficient for correlations. RESULTS: We observe insignificant values in the differences between the groups. Disability and self-efficacy were correlated with heart rate variability only in patients with chronic neck pain, whereas catastrophizing and kinesiophobia showed greater correlations with heart rate variability in patients with chronic low back pain. CONCLUSIONS: Autonomic dysfunction of individuals with chronic neck pain, when compared to patients with chronic low back pain, does present insignificant differences.

To what degree patient‐reported symptoms of central sensitization, kinesiophobia, disability, sleep, and life quality associated with 24‐h heart rate variability and actigraphy measurements?

“…They all used very short HRV measurement protocols (10 min or less) and found little associations with central sensitization, catastrophizing, fear of movement, and disability. [21][22][23] A previous meta-analysis of HRV studies comparing chronic pain subjects with pain-free controls showed evident differences in HRV measures. 8 The results of this meta-analysis were heavily influenced by studies that included subjects with fibromyalgia, which was not the case in our study.…”

“…Only three previous studies have directly assessed the association of PROMs to HRV in CMP subjects. They all used very short HRV measurement protocols (10 min or less) and found little associations with central sensitization, catastrophizing, fear of movement, and disability 21–23 …”

“…Research evidence of associations between CMP‐related PROMs and function changes of the ANS are limited to three studies with 10 or fewer minutes of heart rate variability (HRV) measures. Results found weak‐to‐moderate correlations between HRV parameters and perceived level of disability, catastrophizing, kinesiophobia, and symptoms of central sensitization 21–23 …”

“…Results found weak-to-moderate correlations between HRV parameters and perceived level of disability, catastrophizing, kinesiophobia, and symptoms of central sensitization. [21][22][23] Heart rate variability refers to the temporal variation of beat-to-beat intervals between heartbeats. 24 A growing body of literature suggests that organized variability in the heart rate pattern is a reasonable index of physical and emotional health.…”