Multidimensional pain profiles in four cases of chronic non-specific axial low back pain: An examination of the limitations of contemporary classification systems

Classifying patients with chronic low back pain (CLBP) may facilitate targeted treatment, and optimise outcomes. Most classification systems (CS) do not consider multiple, interacting dimensions (for example, psychological or movement dimensions) involved in the lived experience of people with CLBP....

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Main Authors: Rabey, Martin, Beales, Darren, Slater, Helen, O'Sullivan, Peter
Format: Journal Article
Published: Churchill Livingstone 2015
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/44265
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author Rabey, Martin
Beales, Darren
Slater, Helen
O'Sullivan, Peter
author_facet Rabey, Martin
Beales, Darren
Slater, Helen
O'Sullivan, Peter
author_sort Rabey, Martin
building Curtin Institutional Repository
collection Online Access
description Classifying patients with chronic low back pain (CLBP) may facilitate targeted treatment, and optimise outcomes. Most classification systems (CS) do not consider multiple, interacting dimensions (for example, psychological or movement dimensions) involved in the lived experience of people with CLBP. A framework incorporating these multiple dimensions, and acknowledging individual variability, could provide a pathway to better assess and treat people with CLBP. Here we explored this proposition, presenting four cases (P1e4), profiling their clinical presentations within a multidimensional framework.P1's profile was characterised by localised lumbar sensitisation consistent with dominant peripheral nociception. P2 presented a ‘mixed’ profile characterised by localised lumbar hypersensitivity, combined with factors suggestive of centrally-mediated facilitation of nociception. P3's profile suggested widespread hypersensitivity possibly reflective of dominant centrally-mediated pain mechanisms. P4's profile was characterised by dominant psychosocial factors and comorbidities. These cases are discussed in relation to contemporary CLBP CS, highlighting the complexity of these disorders and limitations of CS for people with CLBP and their treating health professionals. This paper reinforces the need for a consensus CS for people with CLBP that is flexible, has clinical utility and considers all relevant dimensions.
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spelling curtin-20.500.11937-442652017-09-13T16:01:42Z Multidimensional pain profiles in four cases of chronic non-specific axial low back pain: An examination of the limitations of contemporary classification systems Rabey, Martin Beales, Darren Slater, Helen O'Sullivan, Peter classification biopsychosocial back pain Classifying patients with chronic low back pain (CLBP) may facilitate targeted treatment, and optimise outcomes. Most classification systems (CS) do not consider multiple, interacting dimensions (for example, psychological or movement dimensions) involved in the lived experience of people with CLBP. A framework incorporating these multiple dimensions, and acknowledging individual variability, could provide a pathway to better assess and treat people with CLBP. Here we explored this proposition, presenting four cases (P1e4), profiling their clinical presentations within a multidimensional framework.P1's profile was characterised by localised lumbar sensitisation consistent with dominant peripheral nociception. P2 presented a ‘mixed’ profile characterised by localised lumbar hypersensitivity, combined with factors suggestive of centrally-mediated facilitation of nociception. P3's profile suggested widespread hypersensitivity possibly reflective of dominant centrally-mediated pain mechanisms. P4's profile was characterised by dominant psychosocial factors and comorbidities. These cases are discussed in relation to contemporary CLBP CS, highlighting the complexity of these disorders and limitations of CS for people with CLBP and their treating health professionals. This paper reinforces the need for a consensus CS for people with CLBP that is flexible, has clinical utility and considers all relevant dimensions. 2015 Journal Article http://hdl.handle.net/20.500.11937/44265 10.1016/j.math.2014.07.015 Churchill Livingstone restricted
spellingShingle classification
biopsychosocial
back pain
Rabey, Martin
Beales, Darren
Slater, Helen
O'Sullivan, Peter
Multidimensional pain profiles in four cases of chronic non-specific axial low back pain: An examination of the limitations of contemporary classification systems
title Multidimensional pain profiles in four cases of chronic non-specific axial low back pain: An examination of the limitations of contemporary classification systems
title_full Multidimensional pain profiles in four cases of chronic non-specific axial low back pain: An examination of the limitations of contemporary classification systems
title_fullStr Multidimensional pain profiles in four cases of chronic non-specific axial low back pain: An examination of the limitations of contemporary classification systems
title_full_unstemmed Multidimensional pain profiles in four cases of chronic non-specific axial low back pain: An examination of the limitations of contemporary classification systems
title_short Multidimensional pain profiles in four cases of chronic non-specific axial low back pain: An examination of the limitations of contemporary classification systems
title_sort multidimensional pain profiles in four cases of chronic non-specific axial low back pain: an examination of the limitations of contemporary classification systems
topic classification
biopsychosocial
back pain
url http://hdl.handle.net/20.500.11937/44265