Sensory characteristics of chronic non-specific low back pain: A subgroup investigation

It has been proposed that patients with chronic non-specific low back pain (CNSLBP) can be broadly classified based on clinical features that represent either predominantly a mechanical pain (MP) or non-mechanical pain (NMP) profile. The aim of this study was to establish if patients with CNSLBP who...

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Main Authors: O'Sullivan, Peter, Waller, Robert, Wright, Tony, Gardner, J., Johnston, R., Payne, C., Shannon, A., Ware, B., Smith, Anne
Format: Journal Article
Published: Churchill Livingstone 2014
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/45744
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author O'Sullivan, Peter
Waller, Robert
Wright, Tony
Gardner, J.
Johnston, R.
Payne, C.
Shannon, A.
Ware, B.
Smith, Anne
author_facet O'Sullivan, Peter
Waller, Robert
Wright, Tony
Gardner, J.
Johnston, R.
Payne, C.
Shannon, A.
Ware, B.
Smith, Anne
author_sort O'Sullivan, Peter
building Curtin Institutional Repository
collection Online Access
description It has been proposed that patients with chronic non-specific low back pain (CNSLBP) can be broadly classified based on clinical features that represent either predominantly a mechanical pain (MP) or non-mechanical pain (NMP) profile. The aim of this study was to establish if patients with CNSLBP who report features of NMP demonstrate differences in pain thresholds compared to those who report MP characteristics and pain-free controls. This study was a cross-sectional design investigating whether pressure pain threshold (PPT) and/or cold pain threshold (CPT) at three anatomical locations differed between patients with mechanical CNSLBP (n= 17) versus non-mechanical CNSLBP (n= 19 and healthy controls (n= 19) whilst controlling for confounders. The results of this study provide evidence of increased CPT at the wrist in the NMP profile group compared to both the MP profile and control subjects, when controlling for gender, sleep and depression (NMP versus MP group Odds Ratio (OR): 18.4, 95% confidence interval (CI): 2.5-133.1, p= 0.004). There was no evidence of lowered PPT at any site after adjustment for confounding factors. Those with an MP profile had similar pain thresholds to pain-free controls, whereas the NMP profile group demonstrated elevated CPT’s consistent with central amplification of pain. These findings may represent different pain mechanisms associated with these patient profiles and may have implications for targeted management.
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spelling curtin-20.500.11937-457442017-09-13T14:26:11Z Sensory characteristics of chronic non-specific low back pain: A subgroup investigation O'Sullivan, Peter Waller, Robert Wright, Tony Gardner, J. Johnston, R. Payne, C. Shannon, A. Ware, B. Smith, Anne classification Pain sensitivity biopsychosocial chronic non-specific low back pain It has been proposed that patients with chronic non-specific low back pain (CNSLBP) can be broadly classified based on clinical features that represent either predominantly a mechanical pain (MP) or non-mechanical pain (NMP) profile. The aim of this study was to establish if patients with CNSLBP who report features of NMP demonstrate differences in pain thresholds compared to those who report MP characteristics and pain-free controls. This study was a cross-sectional design investigating whether pressure pain threshold (PPT) and/or cold pain threshold (CPT) at three anatomical locations differed between patients with mechanical CNSLBP (n= 17) versus non-mechanical CNSLBP (n= 19 and healthy controls (n= 19) whilst controlling for confounders. The results of this study provide evidence of increased CPT at the wrist in the NMP profile group compared to both the MP profile and control subjects, when controlling for gender, sleep and depression (NMP versus MP group Odds Ratio (OR): 18.4, 95% confidence interval (CI): 2.5-133.1, p= 0.004). There was no evidence of lowered PPT at any site after adjustment for confounding factors. Those with an MP profile had similar pain thresholds to pain-free controls, whereas the NMP profile group demonstrated elevated CPT’s consistent with central amplification of pain. These findings may represent different pain mechanisms associated with these patient profiles and may have implications for targeted management. 2014 Journal Article http://hdl.handle.net/20.500.11937/45744 10.1016/j.math.2014.03.006 Churchill Livingstone restricted
spellingShingle classification
Pain sensitivity
biopsychosocial
chronic non-specific low back pain
O'Sullivan, Peter
Waller, Robert
Wright, Tony
Gardner, J.
Johnston, R.
Payne, C.
Shannon, A.
Ware, B.
Smith, Anne
Sensory characteristics of chronic non-specific low back pain: A subgroup investigation
title Sensory characteristics of chronic non-specific low back pain: A subgroup investigation
title_full Sensory characteristics of chronic non-specific low back pain: A subgroup investigation
title_fullStr Sensory characteristics of chronic non-specific low back pain: A subgroup investigation
title_full_unstemmed Sensory characteristics of chronic non-specific low back pain: A subgroup investigation
title_short Sensory characteristics of chronic non-specific low back pain: A subgroup investigation
title_sort sensory characteristics of chronic non-specific low back pain: a subgroup investigation
topic classification
Pain sensitivity
biopsychosocial
chronic non-specific low back pain
url http://hdl.handle.net/20.500.11937/45744