Pain Inhibition and Facilitation in Recurrent Low Back Pain

Aalborg University60 enrolled

Overview

This study evaluates psychophysical measures of pain inhibition and facilitation, along with cortical responses to different sensory stimuli, in patients with recurrent low back pain and matched healthy individuals.

Pain inhibitory and facilitatory mechanisms have been suggested to play a role in the development of persistent low back pain; however, there is still debate on when changes in these mechanisms occur. Similarly, evoked cortical responses can reflect neuroplastic changes in pain processing regions, which are also thought to play a role in the transition to persistent pain, but there is also debate on when these neuroplastic changes develop relative to low back pain. Therefore, this study will use patients with an intermediary clinical pain state, recurrent low back pain, and matched healthy control participants, to investigate within and between subject differences in pain inhibitory, facilitatory and neuroplastic mechanisms.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Recurrent Low Back Pain Healthy

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion: * Healthy men and women * Aged 18-60 years * No previous back pain OR \>1 previous episode of low back pain in past 12 months * No current back pain OR Pain in the region posteriorly between the inferior border of the 12th rib and the lower gluteal fold (low back pain) at time of recruitment lasting \>24 hours * Able to speak, read and understand English Exclusion: * Pregnancy * First episode of low back pain * Low back pain associated with menstruation * Chronic low back pain (continuous pain episode for \>3 months) * Currently seeking active treatment for low back pain * Red flags symptoms * Drug addiction defined as the use of cannabis, opioids or other drugs * Current or previous neurologic, musculoskeletal, mental, or other illnesses which may affect the trial * Current or previous chronic or recurrent pain condition other than low back pain * Current regular use of analgesic or other medication which may affect the trial * Lack of ability to cooperate * Recent history of acute pain particularly in the lower limbs (unless related to LBP) * Abnormally disrupted sleep in 24 hours preceding experiment

Locations (1)

CNAP, SMI, Aalborg University

Aalborg, Denmark

Outcomes

Primary Outcomes

Conditioned Pain Modulation

Pressure pain threshold (kPa) as test stimulus before compared to during a pressure conditioning stimulus on the lower leg

Time frame: Day 0 vs. Day 28

Temporal Summation of Pain

Pain rating (VAS) change over a series of 10 repeated mechanical stimuli

Time frame: Day 0 vs. Day 28

Secondary Outcomes

Pressure Pain Thresholds

Threshold of pain detection (kPa) with handheld algometry over the low back and distant sites

Time frame: Day 0 vs. Day 28

Thermal Pain Thresholds

Hot and cold pain detection thresholds (degrees)

Time frame: Day 0 vs. Day 28

Two Point Discrimination

The smallest distance (mm) for which two separate points can be distinguished over the low back

Time frame: Day 0 vs. Day 28

Proprioceptive Weighting

Center of pressure displacement during 1-minute of quiet standing

Time frame: Day 0 vs. Day 28

Sensory Evoked Potentials

EEG signals recorded in response to laser and electrical stimuli applied to the back

Time frame: Day 0 vs. Day 28

Data from ClinicalTrials.gov

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