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Disturbed endogenous pain modulation is likely one of the mechanisms underlying central hypersensitivity and might be a contributing factor for the development and maintenance of chronic pain.
A way to study
the endogenous pain inhibition ability of the subject is catered via
conditioned pain modulation (paradigm used in lab). This present study deals
with the functionality of the endogenous modulation.
Disturbed
endogenous pain modulation is likely one of the mechanisms underlying central
hypersensitivity and might be a contributing factor for the development and
maintenance of chronic pain. To our knowledge, no study has investigated
endogenous pain modulation in both acute and chronic low back pain (LBP). We
tested the hypothesis that endogenous pain inhibition is impaired in patients
with acute and chronic LBP.
We evaluated 40 patients
with acute LBP, 34 patients with chronic LBP and 30 pain-free controls for
their conditioned pain modulation (CPM), with pressure pain tolerance and cold
pressor as test and conditioning stimulus, respectively. Measurements were
repeated up to 10 minutes after cold pressor test.
There was no
difference in CPM among the groups immediately after cold pressor test.
However, the decline in CPM effect was significantly faster in chronic and
acute LBP patients than in controls, with no evidence for differences between
pain groups.
The present study
provides evidence for some alterations of endogenous modulation in both acute
and chronic LBP. CPM was still detected in both patient groups, indicating that
endogenous modulation, although effective for a shorter duration, is partially
functioning in patients with LBP.
Clinical Journal of Pain 2016; 32(2): 116-21
Conditioned Pain Modulation in Patients with Acute and Chronic Low Back Pain
Sabine Mlekusch et al.
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