番茄社区

ANAHEIM, Calif. -- People who suffer from chronic low back pain (CLBP) are likely to have greater pain sensitivity, researchers reported here.

Compared to healthy controls, people with CLBP reported greater sensitivity to both mechanical pain stimuli, as well as deep muscle hyperalgesia, reported lead author Samantha Meints, PhD, of Brigham and Women's Hospital in Boston, and colleagues at the .

Additionally, people with CLBP were more likely to catastrophize feeling of pain versus healthy controls.

"This is actually part of a larger series of studies that's looking at different mechanisms of acupuncture treatment for chronic low back pain," Meints told 番茄社区 during a poster session, adding that in general, her group was not surprised by these findings. "I'm really interested in how different mechanisms such as catastrophizing or pain sensitization might predict or explain why people develop chronic low back pain or why they don't get better."

"I was interested here in looking at the differences in people who don't have low back pain compared to those who do and trying to determine what some of those important mechanisms are so that we can develop better treatments and more personalized treatments for those conditions," she noted.

The analysis included 167 people with CLBP compared to 33 pain-free controls. The participants underwent several measures for pain including a two-point discrimination test placed on the hand and back, deep muscle hyperalgesia measured with an inflated cuff placed upon the calf, and mechanical punctate pain consisting of various sized probes upon the skin to determine temporal summation.

Although both groups rated the temporal summation of the probes as high (15.97 versus 14.64), those with CLBP tended to rate the mean pain rating of the probes significantly higher (10.06 versus 3.09, P<0.05)

Catastrophizing of pain was also strongly interrelated with several of the pain measures that people with CLBP tended to rate as high.

Meints's group also ran mediation models to determine whether this increase in likelihood of catastrophizing was explaining the differences in sensitivity and to see whether these individuals may have systemic brain or neurological changes underlying this relationship.

"What we found did hold true for one particular finding and that's the amount of pressure needed to create this deep muscle pain," Meints said.

Another factor at play are race differences underlying these findings on chronic low back pain and other pain conditions, Meints highlighted, adding that her group's subsequent research has indicated African Americans have both greater pain sensitivity and greater likelihood of catastrophizing pain, although was not looked at in the current analysis.

"At this point, more research is needed, but what we're seeing is that maybe we need to tackle some of these mechanisms like catastrophizing or like this pain sensitization -- how can we change those things in order to have better outcomes for our treatments. Thinking about psychosocial treatments that do target catastrophizing in particular is likely a good option," Meints said.

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