Martin Rabey1, Cheryl Poon2, Jonathan Wray3, Chutiporn Thamajaree4, Ryan East5, Helen Slater6. 1. School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. Electronic address: martin.rabey@curtin.edu.au. 2. School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. Electronic address: cheryl_poon@ymail.com. 3. School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. Electronic address: wrayano@gmail.com. 4. School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. Electronic address: som_nmm@hotmail.com. 5. School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. Electronic address: ryan@maddingtonphysio.com. 6. School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia. Electronic address: H.Slater@curtin.edu.au.
Abstract
BACKGROUND: People with chronic pain may exhibit pro-nociceptive phenotypes characterised partly by reduced conditioned pain modulation (CPM). Characterising variability in CPM in people with chronic low back pain (CLBP) may inform management. OBJECTIVES: To investigate pro/anti-nociceptive effects of a CPM protocol in age/sex-matched healthy controls (HCs) and people with CLBP. DESIGN: Case-controlled trial (64 participants/group). METHOD: The CPM protocol involved: test stimulus (TS) (noxious pressure applied by algometer to lumbar region); conditioning stimulus (CS) (noxious heat applied by thermode to dorsal hand). CPM recruitment was measured by the change in pain intensity (rated on a numeric rating scale (NRS)) of the TS in the presence and absence of the CS. RESULTS: Responses to this CPM protocol were variable for both groups with measures consistent with either inhibitory or facilitatory effects. A significantly greater proportion of facilitatory responses were seen in the CLBP cohort compared to HCs (73% versus 31%). In response to the CS, participants with CLBP demonstrated a mean increase in NRS scores (mean 1.3 points; p < 0.001), while HCs did not (mean -0.2 points; p = 0.35) and the between-group difference in change scores was significant (mean 1.4 points; p < 0.001; effect size (Hedges' g): 1.03). CONCLUSION: In HCs and participants with CLBP this CPM protocol elicited responses consistent with varying pro/anti-nociceptive effects. The higher proportion of participants with CLBP demonstrating a facilitatory response suggests a pro-nociceptive phenotype may characterise this cohort.
BACKGROUND:People with chronic pain may exhibit pro-nociceptive phenotypes characterised partly by reduced conditioned pain modulation (CPM). Characterising variability in CPM in people with chronic low back pain (CLBP) may inform management. OBJECTIVES: To investigate pro/anti-nociceptive effects of a CPM protocol in age/sex-matched healthy controls (HCs) and people with CLBP. DESIGN: Case-controlled trial (64 participants/group). METHOD: The CPM protocol involved: test stimulus (TS) (noxious pressure applied by algometer to lumbar region); conditioning stimulus (CS) (noxious heat applied by thermode to dorsal hand). CPM recruitment was measured by the change in pain intensity (rated on a numeric rating scale (NRS)) of the TS in the presence and absence of the CS. RESULTS: Responses to this CPM protocol were variable for both groups with measures consistent with either inhibitory or facilitatory effects. A significantly greater proportion of facilitatory responses were seen in the CLBP cohort compared to HCs (73% versus 31%). In response to the CS, participants with CLBP demonstrated a mean increase in NRS scores (mean 1.3 points; p < 0.001), while HCs did not (mean -0.2 points; p = 0.35) and the between-group difference in change scores was significant (mean 1.4 points; p < 0.001; effect size (Hedges' g): 1.03). CONCLUSION: In HCs and participants with CLBP this CPM protocol elicited responses consistent with varying pro/anti-nociceptive effects. The higher proportion of participants with CLBP demonstrating a facilitatory response suggests a pro-nociceptive phenotype may characterise this cohort.
Authors: Roland R Reezigt; Sjoerd C Kielstra; Michel W Coppieters; Gwendolyne G M Scholten-Peeters Journal: PeerJ Date: 2021-12-14 Impact factor: 2.984
Authors: Burel R Goodin; Demario S Overstreet; Terence M Penn; Rahm Bakshi; Tammie L Quinn; Andrew Sims; Travis Ptacek; Pamela Jackson; D Leann Long; Edwin N Aroke Journal: Clin Epigenetics Date: 2022-03-26 Impact factor: 6.551