Reduction in Pain Inhibitory Modulation and Cognitive-Behavioral Changes in Patients With Chronic Low Back Pain: A Case-Control Study

被引：9
作者：
Cardoso Moreira, Lana Paula [1 ]
Mendoza, Cristian [2 ]
Barone, Mauro [2 ]
Rocha, Raquel Sales [1 ]
dos Santos, Renato Dias [1 ]
Hazime, Fuad Ahmad [1 ,3 ]
机构：
[1] Fed Univ Delta Parnaiba, Dept Phys Therapy, Parnaiba, Piaui, Brazil
[2] Univ Gran Rosario, Dept Phys Therapy, Musculoskeletal Res Unit, UIM,Univ Ctr Assistance Teaching & Res,CUADI,UGR, Rosario, Argentina
[3] Fed Univ Delta Parnaiba, Biomed Master Sci Program, Parnaiba, Piaui, Brazil
来源：
PAIN MANAGEMENT NURSING | 2021年 / 22卷 / 05期
关键词：
CENTRAL SENSITIZATION; ENDOGENOUS PAIN; DESCENDING FACILITATION; PORTUGUESE VERSION; TAMPA-SCALE; GRAY-MATTER; MCGILL-PAIN; QUESTIONNAIRE; RESPONSIVENESS; KINESIOPHOBIA;
D O I：
10.1016/j.pmn.2021.05.004
中图分类号：
R47 [护理学];
学科分类号：
1011 ;
摘要：
Background: Recent studies indicate that the assessment of conditioned pain modulation (CPM) responses and emotional factors can provide important information regarding chronification mechanisms, choices for more efficient therapeutic strategies, and clinical variables supporting a therapeutic prognosis. Aims: To investigate the impact of nonspecific chronic low back pain (NSCLBP) on CPM and psychosocial factors in individuals with NSCLBP compared with healthy controls. Design: Case-control study. Methods: Eighteen patients with NSCLBP and 18 healthy controls were recruited for this study. Pain intensity and affective-emotional aspects of pain, functional disability, kinesiophobia, depression, anxiety, and catastrophizing pain were obtained using a questionnaire. A CPM protocol was established to assess the functioning of the descending inhibitory system, with a cold pressor test as a conditioning stimulus and pressure pain threshold as a test stimulus. The maximal isometric strength of the trunk extensors also was evaluated. Results: Healthy participants demonstrated a greater CPM response than those with NSCLBP. Patients with NSCLBP exhibited significantly lower pressure pain threshold than healthy subjects. Moreover, patients with NSCLBP presented with a considerable exacerbation of cognitive-behavioral changes. NSCLBP patients showed diminished maximal isometric strength of the trunk extensor compared to healthy subjects. Conclusions: The endogenous pain inhibition system is reduced in patients with NSCLBP, with significant cognitive-behavioral changes indicated by high levels of anxiety and moderate pain intensity. Setting: Clinical School of Physical Therapy of the Federal University of Delta of Parnaiba, Piaui - Brazil. Participants/Subjects: 36 subjects with and without NSCLBP. (C) 2021 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码：599 / 604
页数：6
相关论文
共 57 条
[41]   Affective components and intensity of pain correlate with structural differences in gray matter in chronic back pain patients [J].
Schmidt-Wilcke, T. ;
Leinisch, E. ;
Gaenssbauer, S. ;
Draganski, B. ;
Bogdahn, U. ;
Altmeppen, J. ;
May, A. .
PAIN, 2006, 125 (1-2) :89-97
[42]   Cross-Cultural Adaptation and Validation of the Brazilian Portuguese Version of the Pain Catastrophizing Scale [J].
Sehn, Francislea ;
Chachamovich, Eduardo ;
Vidor, Liliane Pinto ;
Dall-Agnol, Letizzia ;
Custodio de Souza, Izabel C. ;
Torres, Iraci L. S. ;
Fregni, Felipe ;
Caumo, Wolnei .
PAIN MEDICINE, 2012, 13 (11) :1425-1435
[43]   Evidence for Shared Pain Mechanisms in Osteoarthritis, Low Back Pain, and Fibromyalgia [J].
Staud, Roland .
CURRENT RHEUMATOLOGY REPORTS, 2011, 13 (06) :513-520
[44]   The Short-Form McGill Pain Questionnaire as an outcome measure: Test-retest reliability and responsiveness to change [J].
Strand, Liv Inger ;
Ljunggren, Anne Elisabeth ;
Bogen, Baard ;
Ask, Tove ;
Johnsen, Tom Backer .
EUROPEAN JOURNAL OF PAIN, 2008, 12 (07) :917-925
[45]   Clinically significant changes in pain along the Pain Intensity Numerical Rating Scale in patients with chronic low back pain [J].
Suzuki, Hidenori ;
Aono, Shuichi ;
Inoue, Shinsuke ;
Imajo, Yasuaki ;
Nishida, Norihiro ;
Funaba, Masahiro ;
Harada, Hidenori ;
Mori, Aki ;
Matsumoto, Mishiya ;
Higuchi, Fumihiro ;
Nakagawa, Shin ;
Tahara, Shu ;
Ikeda, Satoshi ;
Izumi, Hironori ;
Taguchi, Toshihiko ;
Ushida, Takahiro ;
Sakai, Takashi .
PLOS ONE, 2020, 15 (03)
[46]   The course of chronic and recurrent low back pain in the general population [J].
Tamcan, Oezguer ;
Mannion, Anne F. ;
Eisenring, Claudia ;
Horisberger, Bruno ;
Elfering, Achim ;
Mueller, Urs .
PAIN, 2010, 150 (03) :451-457
[47]   General versus pain-specific cognitions: Pain catastrophizing but not optimism influences conditioned pain modulation [J].
Traxler, Juliane ;
Hanssen, Marjolein M. ;
Lautenbacher, Stefan ;
Ottawa, Fabian ;
Peters, Madelon L. .
EUROPEAN JOURNAL OF PAIN, 2019, 23 (01) :150-159
[48]   Psychological approaches in the treatment of chronic pain patients - When pills, scalpels, and needles are not enough [J].
Turk, Dennis C. ;
Swanson, Kimberly S. ;
Tunks, Eldon R. .
CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE, 2008, 53 (04) :213-223
[49]   Diffuse Noxious Inhibitory Control (DNIC) as a tool for exploring dysfunction of endogenous pain modulatory systems [J].
Villanueva, Luis .
PAIN, 2009, 143 (03) :161-162
[50]   Cortical changes in chronic low back pain: Current state of the art and implications for clinical practice [J].
Wand, Benedict Martin ;
Parkitny, Luke ;
O'Connell, Neil Edward ;
Luomajoki, Hannu ;
McAuley, James Henry ;
Thacker, Michael ;
Moseley, G. Lorimer .
MANUAL THERAPY, 2011, 16 (01) :15-20
123456