Conditioned Pain Modulation in Localized vs Widespread Chronic Low Back Pain

Recruiting

• Conditions: Chronic Low-back Pain
• Interventions: Other: Localized vs Widespread Mechanical Pain Hypersensitivity

• Registration Number: NCT05972395
• Lead Sponsor: Ahram Canadian University

Brief Summary

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.

Detailed 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.

Study Timeline

• Status Verified: 2023-07
• Study First Submitted: 2023-07-24
• Study First Submitted QC: 2023-07-24
• Last Update Submitted: 2023-07-24
• Study Start: 2023-07-28
• Study First Posted: 2023-08-02
• Last Update Posted: 2023-08-02
• Primary Completion: 2024-02-25
• Study Completion: 2024-03-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 75

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

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Localized CLBP	Localized vs Widespread Mechanical Pain Hypersensitivity	Chronic low back pain \>3 months with localized pressure pain hyperalgesia
Widespread CLBP	Localized vs Widespread Mechanical Pain Hypersensitivity	Chronic low back pain \>3 months with widespread pressure pain hyperalgesia

Primary Outcome Measures

Name	Time	Method
Conditioned Pain Modulation	Baseline	Percent change in pressure pain threshold at the lumbar region during cold water hand immersion conditioning stimulus compared to baseline pressure pain threshold at the lumbar region without the conditioning stimulus.

Secondary Outcome Measures

Name	Time	Method
Pressure Pain Thresholds	baseline	Pressure pain thresholds measured in kg/cm2 using a pressure algometer at the lumbar spine and distal sites including the upper trapezius and thumbnail.

Trial Locations

Locations (1)

Outpatient clinic of faculty of physical therapy, Ahram Canadian University; 🇪🇬 Al Ḩayy Ath Thāmin, Giza, Egypt