An Examination of Pain Catastrophizing and Endogenous Pain Modulatory Processes in Adults with Chronic Low Back Pain

Owens, Michael A.; Bulls, Hailey W.; Trost, Zina; Terry, Sarah; Gossett, Ethan W.; Wesson-Sides, K.; Goodin, Burel R.

doi:10.1093/pm/pnv074

Cited by 52 publications

(51 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Ten consecutive stimuli were applied starting at a baseline temperature of 40°C and increasing within 8°C/s to 48°C, and returning to baseline at the same rate. The interstimulus interval was set at 2.5 seconds, adapted from a protocol by Owens et al …”

Section: Methodsmentioning

confidence: 99%

Lack of Exercise‐Induced Hypoalgesia to Repetitive Back Movement in People with Chronic Low Back Pain

et al. 2019

View full text Add to dashboard Cite

& AbstractPurpose: To investigate whether people with chronic low back pain (LBP) show dysfunctional exercise-induced hypoalgesia (EIH) in response to repeated contractions of their back muscles during a lifting task. Methods: In this cross-sectional observational study conducted on asymptomatic participants (n = 18) and participants with chronic LBP (n = 21), quantitative sensory testing (QST) was applied extensively over the lumbar region and a remote area before and after a repeated task that involved lifting a 5-kg box for~7 minutes. QST included pressure pain thresholds (PPTs), thermal detection, pain thresholds, and measures of temporal summation. Topographical maps of the percentage change in PPT detected at 16 locations over the lumbar region were generated to explore regional differences and compared between groups. Results: Mean (standard deviation) PPTs measured from 16 sites over the lower back changed significantly in asymptomatic participants (+29.78 kPa [41.4]) following task completion, indicative of EIH, whereas no significant change was observed for the low back pain (LBP) group (À14.87 kPa [61.2]). No changes were detected at the remote site for either group. No changes were revealed for the thermal tests. Temporal summation data revealed decreasing pain sensitivity as the test progressed, but the test response did not change after the exercise for either group. Conclusion(s): Unlike asymptomatic individuals, participants with LBP lacked EIH over the lumbar erector spinae muscles following repeated lifting. Although these results should be considered in relation to the study limitations, particularly the absence of a control group, the findings support impaired EIH in patients with LBP. &

show abstract

Section: Methodsmentioning

confidence: 99%

Lack of Exercise‐Induced Hypoalgesia to Repetitive Back Movement in People with Chronic Low Back Pain

et al. 2019

View full text Add to dashboard Cite

show abstract

“…One of the first studies on impaired descending pain modulation in chronic LBP was published in 1992 (Peters et al, 1992), and later other studies have followed with the same result (Owens et al, 2016). Evidence has been provided that endogenous modulation is also impaired in acute LBP (Mlekusch et al, 2016) raising the question for how long the LBP should be present in order to have an impact on CPM.…”

Section: Descending Pain Controlmentioning

confidence: 96%

Assessment and manifestation of central sensitisation across different chronic pain conditions

Arendt-Nielsen

Morlion

Perrot

et al. 2017

European Journal of Pain

492

494

View full text Add to dashboard Cite

Different neuroplastic processes can occur along the nociceptive pathways and may be important in the transition from acute to chronic pain and for diagnosis and development of optimal management strategies. The neuroplastic processes may result in gain (sensitisation) or loss (desensitisation) of function in relation to the incoming nociceptive signals. Such processes play important roles in chronic pain, and although the clinical manifestations differ across condition processes, they share some common mechanistic features. The fundamental understanding and quantitative assessment of particularly some of the central sensitisation mechanisms can be translated from preclinical studies into the clinic. The clinical perspectives are implementation of such novel information into diagnostics, mechanistic phenotyping, prevention, personalised treatment, and drug development. The aims of this paper are to introduce and discuss (1) some common fundamental central pain mechanisms, (2) how they may translate into the clinical signs and symptoms across different chronic pain conditions, (3) how to evaluate gain and loss of function using quantitative pain assessment tools, and (4) the implications for optimising prevention and management of pain. The chronic pain conditions selected for the paper are neuropathic pain in general, musculoskeletal pain (chronic low back pain and osteoarthritic pain in particular), and visceral pain (irritable bowel syndrome in particular). The translational mechanisms addressed are local and widespread sensitisation, central summation, and descending pain modulation. Significance Central sensitisation is an important manifestation involved in many different chronic pain conditions. Central sensitisation can be different to assess and evaluate as the manifestations vary from pain condition to pain condition. Understanding central sensitisation may promote better profiling and diagnosis of pain patients and development of new regimes for mechanism based therapy. Some of the mechanisms underlying central sensitisation can be translated from animals to humans providing new options in development of therapies and profiling drugs under development.

show abstract

“…Remote testing of TSP has previously been shown to be altered in acute LBP patients 61 , and has been associated with higher pain intensity, increased disability and wider pain distribution in chronic LBP patients 11,49,66 . Hence, lack of facilitated TSP in the present study might suggest exercise-induced-LBP does not produce sufficient pain intensity, duration or distribution to No specific changes in ramped-CPM effects were observed, suggesting that descending inhibitory function remained intact despite LBP presence.…”

Section: Temporal Summation During Exercise-induced-lbpmentioning

confidence: 99%

“…For instance, TSP and CPM, assessed pre-operatively in painfree patients undergoing thoracotomy, demonstrated predictive value in determining postoperative pain intensity 70,75 . TSP and CPM magnitude in people with pain conditions can also relate to the intensity of pain experienced 5,49,65 , suggesting fluctuations in TSP and CPM may be consequential to pain 2,15 . In line with this suggestion, clinical studies have demonstrated improvements in CPM and pain sensitivity following replacement of painful osteoarthritic joints 18,30 , and experimental studies have shown impaired CPM following painful saline injection 2 .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Alterations in Temporal Summation of Pain and Conditioned Pain Modulation Across an Episode of Experimental Exercise-Induced Low Back Pain

McPhee

Graven‐Nielsen

2019

The Journal of Pain

View full text Add to dashboard Cite

Persistent pain conditions, including low back pain (LBP), are often accompanied by alterations in pronociceptive and antinociceptive mechanisms, as quantified by temporal summation of pain (TSP) and conditioned pain modulation (CPM). It remains unclear whether altered pain sensitivity, CPM, and/or TSP are a consequence of pain presence or determine the degree of pain development. Pressure pain sensitivity, TSP, and CPM were assessed across an episode of exercise-induced LBP maintained for several days. Thirty healthy individuals participated in 3 experimental sessions: before (day 0), 2 days after fatiguing back muscle exercise with exercise-induced LBP present (day 2), and after pain resolution (day 7). Both handheld and cuff pressure-pain thresholds, along with TSP (10-cuff pain stimuli at .5 Hz) and CPM (cuff pain detection threshold prior versus during painful pressure conditioning) were assessed, alongside questionnaires pertaining to pain, disability, mood, sleep, menstruation, physical activity, and catastrophizing. The exercise-induced LBP model produced mild pain and disability, and reductions in pressure pain thresholds over both the lumbar and distant testing sites (p < .007). No pain-related changes were observed for TSP (p > .44) or CPM (p > .17). The baseline TSP was associated with the peak pain intensity of the exercise-induced LBP (p < .003). Perspective: Pressure-pain sensitivity was impacted by the presence of exercise-induced LBP, whereas TSP seemed to be more stable and was instead associated with the intensity of pain developed. No significant pain-related changes or associations were observed for CPM, suggesting this measure may have less usefulness in mild musculoskeletal pain conditions.

show abstract

An Examination of Pain Catastrophizing and Endogenous Pain Modulatory Processes in Adults with Chronic Low Back Pain

Cited by 52 publications

References 64 publications

Lack of Exercise‐Induced Hypoalgesia to Repetitive Back Movement in People with Chronic Low Back Pain

Lack of Exercise‐Induced Hypoalgesia to Repetitive Back Movement in People with Chronic Low Back Pain

Assessment and manifestation of central sensitisation across different chronic pain conditions

Alterations in Temporal Summation of Pain and Conditioned Pain Modulation Across an Episode of Experimental Exercise-Induced Low Back Pain

Contact Info

Product

Resources

About