Changes in Pressure Pain Threshold in Patients With Chronic Nonspecific Low Back Pain

Imamura, Marta; Chen, Janini; Matsubayashi, Suely Reiko; Targino, Rosa Alves; Alfieri, Fábio Marcon; Bueno, Daniel Kamura; Hsing, Wu Tu

doi:10.1097/01.brs.0000435027.50317.d7

Cited by 98 publications

(82 citation statements)

References 34 publications

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“…PPT was found to decrease as a result of CLBP; however, it was not detected as a predisposing factor for the development of low back pain in the follow-up study by O'Neill et al 6 Furthermore, in the study conducted by Imamura et al, 5 PPT values of myotomes, sclerotomes and dermatomes between L1 and S3 segments were evaluated and lower PPT values were reported in CLBP patients. They proposed that the hyperalgesia in the painful area may be a result of several mechanisms such as central nervous system sensitization.…”

Section: Discussionmentioning

confidence: 99%

“…However, a limited number of studies emphasized on the perception of pain and pain threshold of patients with chronic low back pain (CLBP). 4,5 The association between high pain sensitivity in chronic pain conditions including low back pain was investigated, and it was reported that the pressure pain threshold (PPT) decreased due to long lasting pain. 4,6 One of the proposed mechanisms of pain sensitivity was sensitization of the central nervous system.…”

mentioning

confidence: 99%

“…4,6 One of the proposed mechanisms of pain sensitivity was sensitization of the central nervous system. 5 The serotoninergic system, and the 5-hydroxytryptamine (5-HT) as the key neurotransmitter, has an antinociceptive role in the dorsal horn of the descending tract of the spinal cord. 7 A previous research reported the association between serotonin receptor 2A (HTR2A) gene polymorphisms and the susceptibility to chronic pain conditions such as fibromyalgia and chronic widespread pain.…”

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confidence: 99%

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Assessment of Pain Sensitivity in Patients With Chronic Low Back Pain and Association With HTR2A Gene Polymorphism

et al. 2017

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Objectives: This study aims to investigate the association of two common HTR2A gene polymorphisms, rs6313 (102 T/C) and rs6311 (1438 A/G), with chronic low back pain (CLBP) and the pain threshold, disability, and sex differences. Patients and methods: A total of 121 patients (40 males, 81 females; mean age 36.8±9.9 years; range 18 to 50 years) having CLBP and 91 healthy controls (26 males, 65 females; mean age 34.1±10.2 years; range 18 to 55 years) were included. Pressure pain thresholds (PPTs) of all participants were examined with manual algometer in certain sites of their body. Results:The PPTs were all decreased in CLBP patients (p<0.05). Although PPTs were lower in healthy female individuals, there was no sex difference regarding PPTs in CLBP patients (p>0.05). rs6311 polymorphism of HTR2A gene was associated with CLBP (p<0.05). In rs6313 polymorphism, at least one copy of T carriers and in rs6311 polymorphism, at least one copy of G carriers showed higher disability. Conclusion: The PPT decreases in CLBP patients similar to other chronic pain conditions without any sex difference. Although rs6311 single nucleotide polymorphism of HTR2A gene was associated with CLBP and rs6313 polymorphism was not, rs6311 might have a protective effect on disability of these patients.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Assessment of Pain Sensitivity in Patients With Chronic Low Back Pain and Association With HTR2A Gene Polymorphism

et al. 2017

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“…However, as studies that utilize intramuscular EMG in the trunk do not routinely quantify the level of pain associated with this methodology, it is unclear whether discomfort following insertion is of sufficient intensity or duration to elicit changes in motion in the trunk during motor activities after the electrode insertions. Individuals with a history of LBP may have a more pronounced response to the insertion of intramuscular electrodes than healthy individuals due to elevated fear avoidance behaviors or lowered pain thresholds (Imamura et al, 2013;Wand et al, 2011). Therefore, it is also important to determine if the magnitude of any change in motion in response to electrode insertion is the same in healthy individuals and individuals with a history of LBP.…”

Section: Introductionmentioning

confidence: 99%

Does insertion of intramuscular electromyographic electrodes alter motor behavior during locomotion?

Smith

Kulig

2015

Journal of Electromyography and Kinesiology

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Intramuscular electromyography (EMG) is commonly used to quantify activity in the trunk musculature. However, it is unclear if the discomfort or fear of pain associated with insertion of intramuscular EMG electrodes results in altered motor behavior. This study examined whether intramuscular EMG affects locomotor speed and trunk motion, and examined the anticipated and actual pain associated with electrode insertion in healthy individuals and individuals with a history of low back pain (LBP). Before and after insertion of intramuscular electrodes into the lumbar and thoracic paraspinals, participants performed multiple repetitions of a walking turn at self-selected and controlled average speed. Low levels of anticipated and actual pain were reported in both groups. Self-selected locomotor speed was significantly increased following insertion of the electrodes. At the controlled speed, the amplitude of sagittal plane lumbo-pelvic motion decreased significantly post-insertion, but the extent of this change was the same in both groups. Lumbo-pelvic motion in the frontal and axial planes and thoraco-lumbar motion in all planes were not affected by the insertions. This study demonstrates that intramuscular EMG is an appropriate methodology to selectively quantify the activation patterns of the individual muscles in the paraspinal group, both in healthy individuals and individuals with a history of LBP.

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“…A large body of research exists to show that individuals with CLBP have lower pain thresholds to pressure or punctate stimuli compared to pain-free controls [14][15][16][17] which suggests that CLBP is associated with a state of enhanced pain sensitivity. In addition, recent advancements in dynamic experimental paradigms have shown that CLBP may also be associated with systemic changes in pain modulation.…”

Section: Introductionmentioning

confidence: 99%

Association between physical activity and pain processing in adults with chronic low back pain compared to pain-free controls

Orr

George

Simon

2017

BMR

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Abstract. BACKGROUND: Pain sensitivity has been negatively associated with physical activity levels. Few studies have examined associations between experimentally induced pain sensitivity and physical activity in adults with chronic low back pain and painfree controls. OBJECTIVE: The objective of this study was to examine associations between physical activity levels and how an individual processes pain using experimentally induced pain stimuli. METHODS: Seventy subjects (CLBP = 49; mean age = 46.8 ± 14.9; Pain-free = 21; mean age = 45.3 ± 18.2, n of females = 46) participated. A self-report questionnaire derived from the International Physical Activity Questionnaire (IPAQ) was used to calculate an activity level index. Pain sensitivity was assessed via quantitative sensory testing (QST) at the right lower extremity. RESULTS: Moderate (U = 688, p < 0.05) and vigorous (U = 649, p < 0.05) physical activity levels were higher in pain-free vs. individuals with CLBP. Activity level was not associated with pain sensitivity (Pain-free: R2 = 0.02, p > 0.05; CLBP: R2 = 0.01, p > 0.05). Both moderate (R2 = 0.49, p < 0.05) and vigorous (R2 = 0.68, p < 0.01) physical activity were associated with pain modulation amongst pain-free individuals. CONCLUSIONS: Findings suggest that physical activity influences pain modulation amongst pain-free individuals, however no relationship exists once CLBP is present. However, future investigation will elucidate the extent to which physical activity level either prevents CLBP or is effective in alleviating CLBP.

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Changes in Pressure Pain Threshold in Patients With Chronic Nonspecific Low Back Pain

Abstract: N/A.

Cited by 98 publications

References 34 publications

Assessment of Pain Sensitivity in Patients With Chronic Low Back Pain and Association With HTR2A Gene Polymorphism

Assessment of Pain Sensitivity in Patients With Chronic Low Back Pain and Association With HTR2A Gene Polymorphism

Does insertion of intramuscular electromyographic electrodes alter motor behavior during locomotion?

Association between physical activity and pain processing in adults with chronic low back pain compared to pain-free controls

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