Research Centre for Health Care Innovations, University of Applied Sciences Rotterdam, Rotterdam, The Netherlands.
Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy.
Clin J Pain. 2022 Jun 1;38(6):381-387. doi: 10.1097/AJP.0000000000001038.
Quantitative Sensory Testing (QST) is used to test somatosensory functioning in on people with chronic LBP in secondary/tertiary health care facilities. Studies using QST-testing on LBP populations in primary care are scarce. Central Sensitization Inventory (CSI) measures central sensitization (CS)-related symptoms and studies investigating the differences between QST-testing and participants with LBP with a positive and negative score on the CSI questionnaire are also rare. This case-control study investigates differences of an extensive QST-measurement between patients with acute, chronic LBP, and pain-free controls (PFCs) in primary care. Secondary aim is to investigate differences of an extensive QST-measurement between "CS" and "no-CS" group.
Participants with LBP were recruited from November 2016 to October 2019. Demographic and clinical information was collected and a standardized QST protocol was taken. Data analysis involved determining differences between groups.
Data of 100 participants with LBP and 50 PFCs were analyzed. Heat pain thresholds, pressure pain threshold, and conditioned pain modulation local and remote were significantly moderately to relatively strongly affected by acute, chronic LBP and PFCs (P<0.001 to 0.001). Lumbar temporal summation was significantly moderately affected by acute, chronic LBP, and PFCs (P=0.001). Only pressure pain threshold showed significant difference between "CS" and "no-CS" group (P=0.001 to 0.002).
Signs of enhanced nociceptive processing and disturbed top-down nociceptive modulation are apparent in people with acute and chronic LBP in primary care. Results indicate existence of central mechanisms in LBP in primary care.
定量感觉测试（QST）用于测试慢性下腰痛（LBP）患者的躯体感觉功能，主要在二级/三级医疗机构进行。在初级保健中，使用 QST 测试 LBP 人群的研究很少。中枢敏化量表（CSI）用于测量与中枢敏化（CS）相关的症状，研究 QST 测试与 CSI 问卷评分阳性和阴性的 LBP 患者之间差异的研究也很少。本病例对照研究调查了初级保健中急性、慢性 LBP 患者与无疼痛对照者（PFC）之间广泛 QST 测量的差异。次要目的是调查“CS”和“非-CS”组之间广泛 QST 测量的差异。
从 2016 年 11 月至 2019 年 10 月招募了 LBP 患者。收集了人口统计学和临床信息，并进行了标准化 QST 方案。数据分析涉及确定组间差异。
分析了 100 名 LBP 患者和 50 名 PFC 的数据。热痛阈值、压痛阈值和局部及远处条件性疼痛调制在急性、慢性 LBP 和 PFC 中受到显著影响（P<0.001 至 0.001）。腰椎时间总和在急性、慢性 LBP 和 PFC 中受到显著中度影响（P=0.001）。只有压痛阈值在“CS”和“非-CS”组之间显示出显著差异（P=0.001 至 0.002）。
在初级保健中，急性和慢性 LBP 患者存在增强的伤害性加工迹象和受损的下行性疼痛调节。结果表明，初级保健中存在 LBP 的中枢机制。
