Central sensitization and changes in conditioned pain modulation in people with chronic nonspecific low back pain: a case-control study

Author(s)

Correa, Juliana Barbosa ^[1] ; Pena Costa, Leonardo Oliveira ^{[2, 1]} ; Bastos de Oliveira, Naiane Teixeira ^[1] ; Sluka, Kathleen A. ^[3] ; Liebano, Richard Eloin ^[1]

Affiliation

^[1] Univ Cidade Sao Paulo, Masters & Doctoral Programs Phys Therapy, BR-03071000 Sao Paulo - Brazil

^[2] George Inst Global Hlth, Musculoskeletal Div, Sydney, NSW - Australia

^[3] Univ Iowa, Coll Med, Grad Program Phys Therapy & Rehabil Sci, Iowa City, IA - USA

• Document type: Journal article
• Source: Experimental Brain Research; v. 233, n. 8, p. 2391-2399, AUG 2015.
• Web of Science Citations: 37

Abstract

Quantitative sensory testing is widely used in human research to investigate the state of the peripheral and central nervous system contributions in pain processing. It is a valuable tool to help identify central sensitization and may be important in the treatment of low back pain. The aim of this study was to evaluate changes in local and segmental hypersensitivity and endogenous pain inhibition in people with chronic nonspecific low back pain. Thirty patients with chronic low back pain and thirty healthy subjects were studied. Pressure pain thresholds (PPTs) were measured from the lumbar region and over the tibialis anterior muscle (TA). A cold pressor test was used to assess the activation of conditioned pain modulation (CPM), and PPTs in the lumbar region were recorded 30 s after immersion of participant's foot in a bucket with cold water. People with chronic low back pain have significantly lower PPT than controls at both the lumbar region {[}89.5 kPa (mean difference) 95 % CI 40.9-131.1 kPa] and TA {[}59.45 kPa (mean difference) 95 % CI 13.49-105.42 kPa]. During CPM, people with chronic low back pain have significantly lower PPT than controls in lumbar region {[}118.6 kPa (mean difference) 95 % CI 77.9-159.2 kPa]. Women had significantly lower PPTs than men in both lumbar region {[}101.7 kPa (mean difference) 95 % CI 37.9-165.7 kPa] and over the TA {[}189.7 kPa (mean difference) 95 % CI 14.2-145.2 kPa]. There was no significant difference in PPTs in men between healthy controls and those with low back pain, suggesting the significant differences are mediated primarily by difference between women. (AU)

• FAPESP's process: 12/13910-2 - Effects of carrier frequency of interferential current on modulation of pain and central hypersensitivity in patients with nonspecific chronic low back pain: randomized controlled trial
• Grantee: Richard Eloin Liebano
• Support Opportunities: Regular Research Grants