Secondary hyperalgesia in chronic nonspecific low back pain
DOI:
https://doi.org/10.5935/0104-7795.20170008Keywords:
Hyperalgesia, Low Back Pain, Pain MeasurementAbstract
Objective: Secondary hyperalgesia may be present in chronic nonspecific low back pain. The study compared pressure pain threshold (PPT) in the lumbar and thoracic paravertebral muscles in individuals with non-specific chronic low back pain correlating them with disability, functional mobility, age and body mass index. Method: This is a cross-sectional study involving individuals of both sexes diagnosed with non-specific chronic low back pain, aged between 18 and 65 years, with pain of moderate to severe intensity and with pain time of ≥ 12 weeks. The volunteers were evaluated for pain intensity through the Visual Analogue Scale (VAS), disability by the Roland Morris questionnaire, functional mobility by the Timed Up and Go test, and pressure pain threshold (PPT) by algometry. We used the t-test and made Pearson’s correlation for data analysis that was done in the Graph Pad Instat program. Results: Fifty individuals (53.75 ± 13.65 years) participated in the study, and when comparing PPT values between the thoracic and lumbar regions, no significant difference was observed (p = 0.19). Moderate correlation was observed only between lumbar and thoracic PPT (r = 0.65). Other correlations, though some significant, were all weak. Conclusion: The data from this study allow us to conclude that individuals with chronic low back pain may present with secondary hyperalgesia, since the individuals presented similar values between the lumbar and thoracic PPTs, in addition to having a significant correlation between these two measures.
Downloads
References
Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24(6):769-81. DOI: http://dx.doi.org/10.1016/j.berh.2010.10.002
Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2020-37. DOI: http://dx.doi.org/10.1002/art.34347
Schenk P, Laeubli T, Klipstein A. Validity of pressure pain thresholds in female workers with and without recurrent low back pain. Eur Spine J. 2007; 16(2):267-75. DOI: http://dx.doi.org/10.1007/s00586-006-0124-x
van Tulder M, Koes B, Bombardier C. Low back pain. Best Pract Res Clin Rheumatol. 2002;16(5):761-75. DOI: http://dx.doi.org/10.1053/berh.2002.0267
Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2197-223. DOI: http://dx.doi.org/10.1016/S0140-6736(12)61689-4
Deyo RA, Weinstein JN. Low back pain. N Engl J Med. 2001;344(5):363-70. DOI: http://dx.doi.org/10.1056/NEJM200102013440508
Katz WA, Rothenberg R. Section 4: treating the patient in pain. J Clin Rheumatol. 2005;11(2 Suppl):S16-27. DOI: http://dx.doi.org/10.1097/01.rhu.0000158685.01291.04
Manek NJ, MacGregor AJ. Epidemiology of back disorders: prevalence, risk factors, and prognosis. Curr Opin Rheumatol. 2005;17(2):134-40.
Rached RDVA, Rosa CDP, Alfieri FM, Amaro SMC, Nogueira B, Dotta L, et al. Lombalgia inespecífica crônica: reabilitação. Acta Fisiatr. 2012;19(2):99-113.
Staud R. Evidence for shared pain mechanisms in osteoarthritis, low back pain, and fibromyalgia. Curr Rheumatol Rep. 2011;13(6):513-20. DOI: http://dx.doi.org/10.1007/s11926-011-0206-6
Smart KM, Blake C, Staines A, Doody C. Self-reported pain severity, quality of life, disability, anxiety and depression in patients classified with 'nociceptive', 'peripheral neuropathic' and 'central sensitisation' pain. The discriminant validity of mechanisms-based classifications of low back (±leg) pain. Man Ther. 2012;17(2):119-25. DOI: http://dx.doi.org/10.1016/j.math.2011.10.002
Mlekusch S, Schliessbach J, Cámara RJ, Arendt NL, Jüni P, Curatolo M. Do central hypersensitivity and altered pain modulation predict the course of chronic low back and neck pain? Clin J Pain. 2013;29(8):673-80. DOI: http://dx.doi.org/10.1097/AJP.0b013e318275773c
Meeus M, Nijs J. Central sensitization: a biopsychosocial explanation for chronic widespread pain in patients with fibromyalgia and chronic fatigue syndrome. Clin Rheumatol. 2007;26(4):465-73. DOI: http://dx.doi.org/10.1007/s10067-006-0433-9
Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain. 2009;10(9):895-926. DOI: http://dx.doi.org/10.1016/j.jpain.2009.06.012
O'neill S, Kjær P, Nielsen TG, Manniche C, Nielsen LA. Pressure pain thresholds are associated with, but does not predispose for low back pain. Eur Spine J. 2011;20(12):2120-5.
Staud R, Cannon RC, Mauderli AP, Robinson ME, Price DD, Vierck CJ Jr. Temporal summation of pain from mechanical stimulation of muscle tissue in normal controls and subjects with fibromyalgia syndrome. Pain. 2003;102(1-2):87-95. DOI: http://dx.doi.org/10.1016/s0304-3959(02)00344-5
Imamura M, Chen J, Matsubayashi SR, Targino RA, Alfieri FM, Bueno DK, et al. Changes in pressure pain threshold in patients with chronic nonspecific low back pain. Spine. 2013;38(24):2098-107. DOI: http://dx.doi.org/10.1097/01.brs.0000435027.50317.d7
Fischer AA. Documentation of myofascial trigger points. Arch Phys Med Rehabil. 1988;69(4):286-91.
Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain. 1987;30(1):115-26. DOI: http://dx.doi.org/10.1016/0304-3959(87)90089-3
Farasyn A, Meeusen R. The influence of non-specific low back pain on pressure pain thresholds and disability. Eur J Pain. 2005;9(4):375-81. DOI: http://dx.doi.org/10.1016/j.ejpain.2004.09.005
Imamura M, Alfieri FM, Filippo TR, Battistella LR. Pressure pain thresholds in patients with chronic nonspecific low back pain. J Back Musculoskelet Rehabil. 2016;29(2):327-36. DOI: http://dx.doi.org/10.3233/BMR-150636
Sardá Júnior JJ, Asghari A, Nicholas MK, Thieme AL, Pimenta CAM. Validação do questionário de incapacidade Roland Morris para dor em geral. Rev Dor.2010;11(1):28-36
Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8. DOI: http://dx.doi.org/10.1111/j.1532-5415.1991.tb01616.x
Ylinen J, Nykänen M, Kautiainen H, Häkkinen A. Evaluation of repeatability of pressure algometry on the neck muscles for clinical use. Man Ther. 2007;12(2):192-7. DOI: http://dx.doi.org/10.1016/j.math.2006.06.010
Visscher CM, Lobbezoo F, Naeije M. Comparison of algometry and palpation in the recognition of temporomandibular disorder pain complaints. J Orofac Pain. 2004;18(3):214-9.
Oliveira JG, Salgueiro MM, Alfieri FM. Low back Pain and Lifestyle. UNOPAR Cient Ciênc Biol Saúde. 2014;16(4):341-4.
Price RC, Asenjo JF, Christou NV, Backman SB, Schweinhardt P. The role of excess subcutaneous fat in pain and sensory sensitivity in obesity. Eur J Pain. 2013;17(9):1316-26. DOI: http://dx.doi.org/10.1002/j.1532-2149.2013.00315.x
Egloff N, Klingler N, von Känel R, Cámara RJ, Curatolo M, Wegmann B, et al. Algometry with a clothes peg compared to an electronic pressure algometer: a randomized cross-sectional study in pain patients. BMC Musculoskelet Disord. 2011;12:174. DOI: http://dx.doi.org/10.1186/1471-2474-12-174
Downloads
Published
Issue
Section
License
Copyright (c) 2017 Acta Fisiátrica
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.