The Association Between Conditioned Pain Modulation and Pain Catastrophizing in Chronic Low Back Pain

Aalborg University

Status: Completed

Conditions: Chronic Low Back Pain; Pain, Somatic; Catastrophizing Pain

Treatments: Diagnostic Test: Pain catastrophizing scale; Procedure: Cold Pressor Test; Diagnostic Test: PPT measurement

Study type: Interventional

Funder types: Other

Identifiers

NCT03644810

S-20170021

Details and patient eligibility

About

This study evaluates the potential association between pain catastrophizing thoughts and the ability to dampen pain via endogenous descending inhibition. Half of the participants are persons with chronic low back pain and the other half are age and gender-matched controls

Full description

Pain catastrophizing is a cognitive feature commonly seen in various musculoskeletal pain population and is considered an important factor to account for in rehabilitation. The ability to dampen pain via endogenous pain modulatory mechanisms is likewise known to be reduced in musculoskeletal pain conditions.

Studies utilizing functional magnetic resonance imaging (fMRI) have demonstrated that the supraspinal areas involved in pain-related cognitive processing to a great extent overlap with those involved in endogenous pain modulation. Therefore, it is plausible that factors such as pain catastrophizing thoughts may affect the nervous systems ability to dampen pain.

Chronic low back pain is the single clinical problem with the biggest impact in the modern society. Previous studies have demonstrated that pain catastrophizing and reduced endogenous pain inhibition are part of the clinical picture. However, previous studies have never investigated a potential relationship between these two factors.

Enrollment: 44 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

Low back pain group:

• chronic low back pain ( lasting more than 3 months)
• intensity of ≥ 3/10 on a numeric rating scale
• pain is located in the area between the gluteal folds below to the thoracolumbal junction above.

Controls:

No current or previous history of musculoskeletal pain of ongoing nature

Exclusion criteria

Applies for both groups:

• Signs of radicular pain or other specific medical conditions e.g. rheumatologic disease or diabetes
• Pregnancy

Trial design

Primary purpose: Diagnostic

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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44 participants in 2 patient groups

Chronic low back pain

Active Comparator group

Description:

Individuals with chronic low back pain. Baseline assessment of pain intensity, function, pain duration and pain catastrophizing thoughts is performed Pain sensitivity at the back and lower leg is measured at baseline and immediately after performing the cold pressor test

Treatment:

Diagnostic Test: PPT measurement

Diagnostic Test: Pain catastrophizing scale

Procedure: Cold Pressor Test

Healthy controls

Active Comparator group

Description:

Healthy, pain-free individuals who are age and gender matched to the low back pain group fill out the pain catastrophizing scale Pain sensitivity at the back and lower leg is measured at baseline and immediately after performing the cold pressor test

Treatment:

Diagnostic Test: PPT measurement

Diagnostic Test: Pain catastrophizing scale

Procedure: Cold Pressor Test