Evidence of impaired pain modulation in adolescents with idiopathic scoliosis and chronic back pain

Teles, Alisson Roberto; Ocay, Don Daniel; Shebreen, Abdulaziz Bin; Tice, Andrew; Saran, Neil; Ouellet, Jean; Ferland, Catherine

doi:10.1016/j.spinee.2018.10.009

Cited by 49 publications

(68 citation statements)

References 49 publications

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“…However, a cutoff value that defines functional CPM is unknown. Changes higher than 30% from baseline were considered optimal CPM efficiency in chronic low back pain population [98], and reference values in asymptomatic people range between 30 to 55% of change during the cold pressor test [103,104]. Then, the findings of the present study agree that a robust endogenous modulation of pain may be normally engaged to protect against the development of chronic pain [101,105], even in the presence of any biomechanical alteration.…”

Section: Interpretation Of the Results According To Literaturesupporting

confidence: 64%

“…When looking at the functioning of the descending inhibitory system of the four individuals with phenotype ASP-1, they presented CPM during the cold pressor test lower than 75.8% of change, which was the second aspect selected by the tree. Low efficiency of the endogenous descending inhibitory pathways was already described as a relevant aspect of chronic pain conditions [97][98][99][100]. Therefore, this possible state of chronic pain arising from the previous pain might have generated central impairments on pain modulation and could have contributed to the recent development of RCRSP.…”

Section: Interpretation Of the Results According To Literaturementioning

confidence: 98%

“…Preserved endogenous pain modulation was also found in two less frequent phenotypes among individuals with chronic RCRSP, those with no other pain intensity higher than seven points associated with bilateral RCRSP (phenotype CSP-3) or with unilateral RCRSP without kinesiophobia (phenotype CSP-4). Although apparently controversial, current evidence in chronic pain suggests that a robust endogenous pain inhibition is uncommon but possible [97][98][99][100]108] since low CPM efficiency is not a uniform aspect in individuals with chronic shoulder pain [21,22]. The presence of bilateral symptoms indicates that these individuals might have poor prognosis over time [7], but low levels of kinesiophobia are related to better shoulder prognosis [36], which together may contribute to the robustness of the endogenous pain modulation.…”

Section: Interpretation Of the Results According To Literaturementioning

confidence: 99%

See 2 more Smart Citations

Biopsychosocial Aspects in Individuals with Acute and Chronic Rotator Cuff Related Shoulder Pain: Classification Based on a Decision Tree Analysis

et al. 2020

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Biopsychosocial aspects seem to influence the clinical condition of rotator cuff related shoulder pain (RCRSP). However, traditional bivariate and linear analyses may not be sufficiently robust to capture the complex relationships among these aspects. This study determined which biopsychosocial aspects would better classify individuals with acute and chronic RCRSP and described how these aspects interact to create biopsychosocial phenotypes in individuals with acute and chronic RCRSP. Individuals with acute (<six months of pain, n = 15) and chronic (≥six months of pain, n = 38) RCRSP were included. Sociodemographic data, biological data related to general clinical health status, to shoulder clinical condition and to sensory function, and psychosocial data were collected. Outcomes were compared between groups and a decision tree was used to classify the individuals with acute and chronic RCRSP into different phenotypes hierarchically organized in nodes. Only conditioned pain modulation was different between the groups. However, the tree combined six biopsychosocial aspects to identify seven distinct phenotypes in individuals with RCRSP: three phenotypes of individuals with acute, and four with chronic RCRSP. While the majority of the individuals with chronic RCRSP have no other previous painful complaint besides the shoulder pain and low efficiency of endogenous pain modulation with no signs of biomechanical related pain, individuals with acute RCRSP are more likely to have preserved endogenous pain modulation and unilateral pain with signs of kinesiophobia.

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Section: Interpretation Of the Results According To Literaturesupporting

confidence: 64%

Section: Interpretation Of the Results According To Literaturementioning

confidence: 98%

Section: Interpretation Of the Results According To Literaturementioning

confidence: 99%

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Biopsychosocial Aspects in Individuals with Acute and Chronic Rotator Cuff Related Shoulder Pain: Classification Based on a Decision Tree Analysis

et al. 2020

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“…When considering our independent time point results, they indicate moderate to strong correlations between the thoracic deformity and the pain felt in the thoracic area before surgery. Recent literature [ 19 , 33 ], found similar results, associating severity and the location of the curve in the thoracic area to the pain reported in said area. In all cases, the association was made at the preoperative time point but does not seem to persist throughout the postoperative period.…”

Section: Discussionsupporting

confidence: 55%

Adolescent idiopathic scoliosis: evaluating perioperative back pain through a simultaneous morphological and biomechanical approach

St-Georges

Teles

Rabau

et al. 2020

BMC Musculoskelet Disord

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Background Adolescent idiopathic scoliosis (AIS) has been associated with diminished postural stability and a greater prevalence of back pain. Currently, the literature is lacking information on the effect of spinal fusion on both postural stability and its association with back pain. Our objectives were to evaluate the postsurgical effect of spinal morphological changes on static standing balance and assess the influence of these alterations on reported pain throughout the perioperative period. Methods Twenty consecutive AIS patients schedule to undergo spinal fusion surgery were recruited and followed prospectively at the Shriners Hospitals for Children-Canada. Data was collected at the preoperative, 6 weeks and 6 months postoperative visits. Spinal morphology data was collected through 3D reconstructed simultaneous standing biplanar radiographs using the SterEOS software. Postural balance was assessed through Moticon© sensor insoles and analyzed through their software. The data was simultaneously collected as part of the Global Biomechanical and morphological Assessment. Pain was evaluated through self-reported questionnaires. Results Morphological curve parameters were significantly reduced after surgery. Balance parameters did not change significantly throughout the perioperative period with the exception of the Center of Pressure of the left foot medial/lateral transient shift ( P = 0.017) at 6 weeks. Of note, preoperative balance parameters were associated with the degree of right thoracic Cobb angles ( P = 0.029 R = 0.528). Pain scores significantly improved 6 weeks and 6 months after the surgery. Pain intensity diminished in the thoracic and lumbar spine but worsen in the neck region at the 6 weeks and 6 months postoperative time points ( P = 0.044). Greater residual Cobb angle difference between Mid thoracic and Thoracolumbar/Lumbar curves was associated with greater pain severity at 6 weeks postop ( P < 0.005). In addition, greater residual thoracic deformity was associated with significant pain severity 6 months after surgery ( P < 0.05). Conclusions Improved spinal morphology of postsurgical AIS patients has no significant impact on their static standing balance. Suggesting that other factors apart from the spinal morphology may contribute to AIS patients’ balance during stance. Although balance did not influence pain severity, spinal morphology and its correction appear to have influenced the intensity and location of back pain.

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“…The clinical utility of QST has been well documented in a variety of pain disorders, such as arthritis and neuropathic pain syndromes, and it has been used to characterize pain and predict prognosis and response to therapy, as described in several excellent reviews (Arendt‐Nielsen & Yarnitzky, ; Backonja et al , ; Cruz‐Almeida & Fillingim, ; Bouhassira & Attal, ; Edwards et al , ; Smith et al , ). While the majority of this work has been done in adults (Coronado et al , ; Edwards et al , ; Moss et al , , ; Maher et al , ), there is a growing body of literature in paediatric disorders (Blankenburg et al , , ; Kristensen et al , ; Cornelissen et al , ; Lieber et al , ; Teles et al , ). QST may also be used to elucidate underlying mechanisms in order to evaluate whether targeted treatments may be effective (Grosen et al , ) and to measure somatosensory profiles and changes in physiological responses over time (Geber et al , ).…”

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confidence: 99%

Quantitative sensory testing in children with sickle cell disease: additional insights and future possibilities

et al. 2019

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Summary Quantitative sensory testing (QST) is used in a variety of pain disorders to characterize pain and predict prognosis and response to specific therapies. In this study, we aimed to confirm results in the literature documenting altered QST thresholds in sickle cell disease (SCD) and assess the test–retest reliability of results over time. Fifty‐seven SCD and 60 control subjects aged 8–20 years underwent heat and cold detection and pain threshold testing using a Medoc TSAII. Participants were tested at baseline and 3 months; SCD subjects were additionally tested at 6 months. An important facet of our study was the development and use of a novel QST modelling approach, allowing us to model all data together across modalities. We have not demonstrated significant differences in thermal thresholds between subjects with SCD and controls. Thermal thresholds were consistent over a 3‐ to 6‐month period. Subjects on whom hydroxycarbamide (HC) was initiated shortly before or after baseline testing (new HC users) exhibited progressive decreases in thermal sensitivity from baseline to 6 months, suggesting that thermal testing may be sensitive to effective therapy to prevent vasoocclusive pain. These findings inform the use of QST as an endpoint in the evaluation of preventative pain therapies.

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Evidence of impaired pain modulation in adolescents with idiopathic scoliosis and chronic back pain

Cited by 49 publications

References 49 publications

Biopsychosocial Aspects in Individuals with Acute and Chronic Rotator Cuff Related Shoulder Pain: Classification Based on a Decision Tree Analysis

Biopsychosocial Aspects in Individuals with Acute and Chronic Rotator Cuff Related Shoulder Pain: Classification Based on a Decision Tree Analysis

Adolescent idiopathic scoliosis: evaluating perioperative back pain through a simultaneous morphological and biomechanical approach

Quantitative sensory testing in children with sickle cell disease: additional insights and future possibilities

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