If Individuals at risk of developing chronic pain could be recognized early in a pain episode, treatment could be tailored on the basis of risk. Responses to psychophysical tests differ in persons with chronic pain vs pain-free controls and therefore appear promising as indicators of susceptibility to chronic pain. In a cohort of 157 patients making their first primary care visit during a back pain episode, the authors explored the relationships of psychophysical test responses (pressure pain thresholds at low back and thenar sites, cold pressor pain ratings, conditioned pain modulation, and mechanical temporal summation) to baseline measures of pain and psychological distress and assessed whether test responses predicted clinically significant back pain 4 months later. Examiner-standardized pressure pain thresholds were significantly (P < .05) correlated with baseline back pain severity and diffuseness of bodily pain (Pearson correlations = −.21 to −.35). Lower baseline pressure pain thresholds significantly predicted back pain at 4 months (odds ratio [95% confidence interval]: low back, .66 [.44, .96]; thenar, .62 [.40, .92]); although, after controlling for participant age and sex, these associations were no longer significant. Cold pressor pain, conditioned pain modulation, and mechanical temporal summation weren’t significant predictors of 4-month back pain in either model.
Psychophysical Tests as Predictors of Back Pain Chronicity in Primary Care.
In this month's Members topic we are exploring the foot and ankle with a focus on achilles tendinopathy. This month we have exclusive access to:
- 2 FREE chapters from text books Maitland's Peripheral Manipulation by Hengeveld & Banks 2014 and A Practical Approach to Orthopaedic Medicine by Atkins, Kerr and Goodlad. 2010
- 4 FREE journal articles from The Foot
- An interview with Maitland expert Elly Hengeveld