CENTRAL MECHANISMS OF BODY BASED INTERVENTION FOR MUSCULOSKELETAL LOW BACK PAIN: Feasibility Assessment of Neurophysiological Measurement in Veterans With Low Back Pain
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Low Back Pain
- Sponsor
- University of Florida
- Enrollment
- 3
- Locations
- 1
- Primary Endpoint
- fMRI during testing of pain changes from approximately Day 3 and Day 5
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
This is study testing the feasibility of collecting neurophysiological measures of outcome related to body-based interventions for low back pain. The investigators will collect fMRI and psychophysical data about pain sensitivity before and after the interventions. Participants will be randomly assigned to either spinal manipulation or therapeutic touch groups. Participants will attend two practice sessions prior to the first data collection. There will be two follow-up assessments.
Detailed Description
Participants will be enrolled from VA pain clinical at the North Florida/South George VA Medical Center. The investigators will collect functional magnetic resonance imaging data of resting state and pain-related events (i.i. during thermal pain sensitivity testing, as well as psychophysical data to determine pain sensitivity. Pain sensitivity will be measured using thermal and mechanical stimuli. These data will be collected before and after the interventions, in addition to two follow-up sessions after intervention. In addition, clinical measures of pain intensity in the low back, as well as trunk range of motion and strength will also be collected.
Investigators
Eligibility Criteria
Inclusion Criteria
- •complaints of current back pain that they rate at least 40 on a 101-point numeric rating scale
- •Participants must able to understand written and spoken English
Exclusion Criteria
- •currently receiving treatment for LBP or have received SMT for LBP in the past year
- •Quebec Task Force on Spinal Disorders (QTFSD) to identify patients with pre-existing nerve root compression, spinal stenosis, or post-surgery
- •any chronic medical conditions that may affect pain perception (e.g., diabetes, high blood pressure, fibromyalgia, headaches)
- •any contraindication to MRI
Outcomes
Primary Outcomes
fMRI during testing of pain changes from approximately Day 3 and Day 5
Time Frame: Change from approximately Day 3 and Day 5
fMRI during quite rest changes from approximately Day 3 and Day 5
Time Frame: Change from approximately Day 3 and Day 5
Pain Sensitivity Testing changes from Day 3, Day 4 and Day 5
Time Frame: Change from Day 3, Day 4 and Day 5
This measure thermal threshold and tolerance using continuous heat stimulus delivered to the participants' dominant arm. The stimulus will start at 35°C and will be increased at a rate of 0.5°C with participants terminating the stimulus when the temperature reached pain threshold ("when the sensation first transitions from heat to pain") and tolerance ("when the sensation becomes so strong you want to remove it from your skin"). Threshold and tolerance measures will also be collected using mechanical pressure applied using a Fischer Dolorimeter. During Dolorimeter testing, force is slowly increased until the subject indicates that the sensation changes from pressure to pain.
Secondary Outcomes
- Oswestry Disability Questionnaire (ODQ)(Change from Day 3, Day 4 and Day 5)
- Pain Intensity(Change from Day 3, Day 4 and Day 5)
- McGill Pain Questionnaire-2(Change from Day 3, Day 4 and Day 5)
- Physical Impairment(Change from Day 3, Day 4 and Day 5)