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Experimental Brain Research

, Volume 233, Issue 8, pp 2391–2399 | Cite as

Central sensitization and changes in conditioned pain modulation in people with chronic nonspecific low back pain: a case–control study

  • Juliana Barbosa Corrêa
  • Leonardo Oliveira Pena Costa
  • Naiane Teixeira Bastos de Oliveira
  • Kathleen A. Sluka
  • Richard Eloin LiebanoEmail author
Research Article

Abstract

Quantitative sensory testing is widely used in human research to investigate the state of the peripheral and central nervous system contributions in pain processing. It is a valuable tool to help identify central sensitization and may be important in the treatment of low back pain. The aim of this study was to evaluate changes in local and segmental hypersensitivity and endogenous pain inhibition in people with chronic nonspecific low back pain. Thirty patients with chronic low back pain and thirty healthy subjects were studied. Pressure pain thresholds (PPTs) were measured from the lumbar region and over the tibialis anterior muscle (TA). A cold pressor test was used to assess the activation of conditioned pain modulation (CPM), and PPTs in the lumbar region were recorded 30 s after immersion of participant’s foot in a bucket with cold water. People with chronic low back pain have significantly lower PPT than controls at both the lumbar region [89.5 kPa (mean difference) 95 % CI 40.9–131.1 kPa] and TA [59.45 kPa (mean difference) 95 % CI 13.49–105.42 kPa]. During CPM, people with chronic low back pain have significantly lower PPT than controls in lumbar region [118.6 kPa (mean difference) 95 % CI 77.9–159.2 kPa]. Women had significantly lower PPTs than men in both lumbar region [101.7 kPa (mean difference) 95 % CI 37.9–165.7 kPa] and over the TA [189.7 kPa (mean difference) 95 % CI 14.2–145.2 kPa]. There was no significant difference in PPTs in men between healthy controls and those with low back pain, suggesting the significant differences are mediated primarily by difference between women.

Keywords

Low back pain Central nervous system sensitization Hyperalgesia Diffuse noxious inhibitory controls Pain inhibition 

Notes

Acknowledgments

This study was supported by the São Paulo Research Foundation (Fundação de Amparo à Pesquisa do Estado de São Paulo—FAPESP), Brazil, funder approval number: 2012/13910-2 and the National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico—CNPq), Brazil, funder approval number: 473929/2012-0.

Conflict of interest

The authors have no conflict of interest to disclose.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Juliana Barbosa Corrêa
    • 1
  • Leonardo Oliveira Pena Costa
    • 1
    • 2
  • Naiane Teixeira Bastos de Oliveira
    • 1
  • Kathleen A. Sluka
    • 3
  • Richard Eloin Liebano
    • 1
    Email author
  1. 1.Master’s and Doctoral Programs in Physical TherapyUniversidade Cidade de São PauloTatuapéBrazil
  2. 2.Musculoskeletal DivisionThe George Institute for Global HealthSydneyAustralia
  3. 3.Graduate Program in Physical Therapy and Rehabilitation Science, College of MedicineUniversity of IowaIowa CityUSA

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