From acute to persistent low back pain

a longitudinal investigation of somatosensory changes using quantitative sensory testing - an exploratory study

Anna Marcuzzi, Paul Wrigley, Catherine M. Dean, Petra Graham, Julia Hush

Research output: Contribution to journalArticle

10 Citations (Scopus)
15 Downloads (Pure)

Abstract

Introduction: Chronic low back pain (LBP) is commonly associated with generalised pain hypersensitivity. It is suggested that such somatosensory alterations are important determinants for the transition to persistent pain from an acute episode of LBP. Although cross-sectional research investigating somatosensory function in the acute stage is developing, no longitudinal studies designed to evaluate temporal changes have been published.Objectives: This exploratory study aimed to investigate the temporal development of somatosensory changes from the acute stage of LBP to up to 4 months from onset.Methods: Twenty-five people with acute LBP (<3 weeks’ duration) and 48 pain-free controls were prospectively assessed at baseline using quantitative sensory testing with the assessor blinded to group allocation, and again at 2 and 4 months. Psychological variables were concurrently assessed. People with acute LBP were classified based on their average pain severity over the previous week at 4 months as recovered (≤1/10 numeric rating scale) or persistent (≥2/10 numeric rating scale) LBP.Results: In the persistent LBP group, (1) there was a significant decrease in pressure pain threshold between 2 and 4 months (P < 0.013), and at 4 months, pressure pain threshold was significantly different from the recovered LBP group (P < 0.001); (2) a trend towards increased temporal summation was found at 2 months and 4 months, at which point it exceeded 2 SDs beyond the pain-free control reference value. Pain-related psychological variables were significantly higher in those with persistent LBP compared with the recovered LBP group at all time points (P < 0.05).Conclusion: Changes in mechanical pain sensitivity occurring in the subacute stage warrant further longitudinal evaluation to better understand the role of somatosensory changes in the development of persistent LBP. Pain-related cognitions at baseline distinguished persistent from the recovered LBP groups, emphasizing the importance of concurrent evaluation of psychological contributors in acute LBP.
Original languageEnglish
Article numbere641
Pages (from-to)1-10
Number of pages10
JournalPain Reports
Volume3
Issue number2
DOIs
Publication statusPublished - Mar 2018

Bibliographical note

Copyright the Author(s) 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • acute pain
  • low back pain
  • quantitative sensory testing
  • chronic pain
  • conditioned pain modulation
  • Low back pain
  • Acute pain
  • Conditioned pain modulation
  • Chronic pain
  • Quantitative sensory testing

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