Conditioned Pain Modulation in Localized vs Widespread Chronic Low Back Pain

Ahram Canadian University

Status: Enrolling

Conditions: Chronic Low-back Pain

Treatments: Other: Localized vs Widespread Mechanical Pain Hypersensitivity

Study type: Observational

Funder types: Other

Identifiers

NCT05972395

LBP01

Details and patient eligibility

About

This study aims to compare function of the body's endogenous pain modulation system between people with localized low back pain versus widespread body pain. Endogenous pain modulation refers to the body's natural ability to inhibit one pain stimulus by applying a second pain stimulus. This study will assess pain inhibition by measuring pressure pain thresholds at the low back before and during cold water hand immersion. The researchers hypothesize that those with widespread body pain will have worse functioning of pain inhibition compared to those with localized low back pain only. The results may provide insights into personalized chronic pain management approaches.

Full description

Chronic low back pain (CLBP) is highly prevalent worldwide. Impairments in conditioned pain modulation (CPM) have been documented in CLBP populations. CPM refers to endogenous pain inhibition, where one noxious stimulus inhibits pain from a second noxious stimulus. This relies on descending inhibitory pathways. However, it is unknown whether CPM alterations differ between individuals with localized versus widespread mechanical pain hypersensitivity. The aim of this cross-sectional quantitative sensory testing study is to compare CPM function between localized and widespread CLBP subgroups. A sample of 75 adults with CLBP of at least 3 months duration will be recruited from a chronic pain clinic. Based on pressure pain threshold mapping at the low back and distal sites, participants will be classified as having localized or widespread mechanical hyperalgesia.

Enrollment: 75 estimated patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Ages 18-60 years
• Chronic LBP >3 months
• Average LBP intensity ≥4/10

Exclusion criteria

• Known LBP pathologies
• Previous lumbar surgery
• Neuropathic LBP
• Comorbid generalized pain conditions

Trial design

75 participants in 2 patient groups

Localized CLBP

Description:

Chronic low back pain \>3 months with localized pressure pain hyperalgesia

Treatment:

Other: Localized vs Widespread Mechanical Pain Hypersensitivity

Widespread CLBP

Description:

Chronic low back pain \>3 months with widespread pressure pain hyperalgesia

Treatment:

Other: Localized vs Widespread Mechanical Pain Hypersensitivity