Recurrent low back pain patients demonstrate facilitated pronociceptive mechanisms when in pain, and impaired antinociceptive mechanisms with and without pain

McPhee, Megan; Graven‐Nielsen, Thomas

doi:10.1097/j.pain.0000000000001679

Cited by 29 publications

(41 citation statements)

References 64 publications

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“…Low PPT may be the result of pain and related factors. McPhee ME [49] found that as the duration of pain experienced by patients with LBP increased, their PPT decreased, and the residual pain caused by external stimulation lasted longer. The experiments in the present study showed that transverse abdominal muscle training could reduce the radiation range of waist pain and increase PPT, thus providing new evidence of the effectiveness of core muscle training in treating CLBP.…”

Section: Discussionmentioning

confidence: 99%

Effect of Transversus abdominis muscle training on pressure-pain threshold in patients with chronic low Back pain

Wang

2021

BMC Sports Sci Med Rehabil

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Background Therapeutic training is the most commonly used treatment methods for chronic low back pain (CLBP), and the use of a pressure biofeedback unit for transversus abdominis muscle (TrA) training is one of the core muscle training methods. The study aim of this research is to explore the effects of different intensities (sham training, low-intensity and high-intensity) of TrA muscle training on people with CLBP in pressure-pain threshold (PPT). Methods A total of 45 patients with CLBP were recruited, of whom 44 were included in the analysis. Fifteen, 14, and 15 were included in the sham training group, the low-intensity group, and the high-intensity group, respectively. A pressure biofeedback unit was used in performing a one-time TrA training intervention involving 30 times of 180 mmHg TrA contraction training at high intensity for 10 min and 15 times of 100 mmHg TrA contraction training at low intensity for 5 min. The sham training group completed comfort exercises and did not undergo training. The evaluation indicators were as follows: PPT, short-form McGill pain questionnaire, and body surface pain radiation. Results High-intensity training could activate more waist core muscles than low-intensity training. Significant changes on PPT (units: kgf) were observed in the following four muscles immediately after high-intensity training: iliopsoas [0.69 (0.13–1.25) 95% CI, p = 0.020]; quadratus lumborum [0.84 (0.23–1.45) 95% CI, p = 0.012]; erector spinae [0.66 (0.18–1.15) 95% CI, p = 0.011]; transversus abdominis [0.70 (0.26–1.14) 95% CI, p = 0.004], and in three muscles after low-intensity training: quadratus lumborum [0.61 (0.17–1.05) 95% CI, p = 0.009]; transversus abdominis [0.14 (from − 0.15 to 0.43) 95% CI, p = 0.022]; piriformis [0.55 (0.13–0.98) 95% CI, p = 0.014]. The change in body surface pain radiation immediately after exercise was [− 10.87 (from − 17.51 to − 4.22) 95% CI, p = 0.003] for high-intensity training and [− 5.21 (from − 9.40 to − 1.03) 95% CI, p = 0.019] for low-intensity training. Conclusions TrA training could increase the PPT of the waist core muscles and reduce the radiation range of waist pain. The benefits of high-intensity training are higher than those of low-intensity training. Trial registration ChiCTR-TRC-13003701. Registered 18 October 2013. Code of ethical approval: 2018069.

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Section: Discussionmentioning

confidence: 99%

Effect of Transversus abdominis muscle training on pressure-pain threshold in patients with chronic low Back pain

Wang

2021

BMC Sports Sci Med Rehabil

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“…This current study indicates that such a distribution can be reversed in healthy individuals. Reduced efficacy of endogenous pain inhibition, as observed in patients with chronic musculoskeletal pain (Christensen et al., 2020; Gerhardt et al., 2017; McPhee and Graven‐Nielsen, 2019b), is referenced as mechanisms contributing to widespread/multisite pain but not local pain (Gerhardt et al., 2017). However, administering ketamine, an NMDA antagonist, it is possible to reduce the area of pain referral in fibromyalgia patients (Graven‐Nielsen et al., 2000) and healthy controls (Schulte et al., 2003), revealing the central nature of mechanisms underlying pain referral.…”

Section: Discussionmentioning

confidence: 99%

Pain referral area is reduced by remote pain

Palsson

Doménech-García

Boudreau

et al. 2021

European Journal of Pain

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“…Similarly, HACS was considered as a static phenomenon with prevalence estimates based on a single assessment. Although reliability was high for HACS assessment methods when reported, recent work has suggested that psychological symptoms associated with the CSI [105], as well as PPT and TS [119], may fluctuate with pain severity. For now, it is still unclear if HACS is a state or a trait.…”

Section: Limitationsmentioning

confidence: 97%

The Definition, Assessment, and Prevalence of (Human Assumed) Central Sensitisation in Patients with Chronic Low Back Pain: A Systematic Review

Schuttert

Timmerman

Petersen

et al. 2021

JCM

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Central sensitisation is assumed to be one of the underlying mechanisms for chronic low back pain. Because central sensitisation is not directly assessable in humans, the term ‘human assumed central sensitisation’ (HACS) is suggested. The objectives were to investigate what definitions for HACS have been used, to evaluate the methods to assess HACS, to assess the validity of those methods, and to estimate the prevalence of HACS. Database search resulted in 34 included studies. Forty different definition references were used to define HACS. This review uncovered twenty quantitative methods to assess HACS, including four questionnaires and sixteen quantitative sensory testing measures. The prevalence of HACS in patients with chronic low back pain was estimated in three studies. The current systematic review highlights that multiple definitions, assessment methods, and prevalence estimates are stated in the literature regarding HACS in patients with chronic low back pain. Most of the assessment methods of HACS are not validated but have been tested for reliability and repeatability. Given the lack of a gold standard to assess HACS, an initial grading system is proposed to standardize clinical and research assessments of HACS in patients with a chronic low back.

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Recurrent low back pain patients demonstrate facilitated pronociceptive mechanisms when in pain, and impaired antinociceptive mechanisms with and without pain

Cited by 29 publications

References 64 publications

Effect of Transversus abdominis muscle training on pressure-pain threshold in patients with chronic low Back pain

Effect of Transversus abdominis muscle training on pressure-pain threshold in patients with chronic low Back pain

Pain referral area is reduced by remote pain

The Definition, Assessment, and Prevalence of (Human Assumed) Central Sensitisation in Patients with Chronic Low Back Pain: A Systematic Review

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