信息对实验性诱导的急性下背痛发作期间疼痛时间进程的影响——一项随机试验

The Effect of Information on the Time Course of Pain During an Episode of Acute Experimentally Induced Low Back Pain-A Randomised Experiment.

作者信息

Travers M, Wand B M, Hince D, Gibson W, Hansen S Meldgaard, Sigurðsson T, Sorensen S, Palsson T Skuli

机构信息

School of Health Sciences, The University of Notre Dame, Fremantle, Australia.

Institute of Health Research, The University of Notre Dame, Australia.

出版信息

Eur J Pain. 2025 May;29(5):e70011. doi: 10.1002/ejp.70011.

DOI:10.1002/ejp.70011

PMID:40254726

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12010030/

Abstract

BACKGROUND

We compared the time course of pain intensity ratings between two groups who were given different information during an episode of acute experimentally induced LBP.

METHODS

Fifty weight-training naive and pain-free people participated in this randomised clinical experiment. Immediately after performing a back exercise intended to cause delayed onset muscle soreness, one group was told that their muscles had been damaged and advised they needed to protect their back over the coming days. The other group's symptoms were described in terms of tissue sensitisation, and they were advised to keep moving. The primary outcome was movement-evoked low back pain intensity measured using an 11-point numeric rating scale (NRS 0-10). Pain intensity was recorded at baseline, immediately after the intervention and then daily for 7 days. The method of generalised estimating equations (GEE) was used to estimate treatment effects for average daily pain.

RESULTS

Movement-evoked pain intensity scores changed over time in both groups (main effect of time: χ^2(7) = 246.2, p < 0.001). However, the intervention did not affect movement-evoked pain intensity scores (main effect of group: χ^2(1) = 0.02, p < 0.895). The adjusted mean difference between the groups was only -0.05/10 (95% CI -0.72 to 0.63, p = 0.895) when averaged across all time points.

CONCLUSIONS

We simulated an episode of low back pain and found that information based on tissue sensitivity and advice to remain active did not improve pain compared to information referencing tissue damage and advice to rest and protect the back.

SIGNIFICANCE STATEMENT

Contemporary clinical guidelines and models of care recommend avoiding pathoanatomical diagnostic labels and encourage clinicians to advise patients to stay active during an episode of acute low back pain (LBP). We simulated an episode of acute LBP and found that information based on tissue sensitivity and advice to remain active did not improve pain compared to information referencing tissue damage and advice to rest and protect the back. The results could be different if repeated in a clinical population.

摘要

背景

我们比较了两组在急性实验性诱发下背痛发作期间获得不同信息时疼痛强度评分的时间进程。

方法

50名未进行过重量训练且无疼痛的人参与了这项随机临床实验。在进行旨在引起延迟性肌肉酸痛的背部锻炼后，一组被告知其肌肉已受损，并建议他们在接下来的几天里保护背部。另一组的症状则根据组织致敏来描述，并建议他们继续活动。主要结局是使用11点数字评分量表（NRS 0 - 10）测量的运动诱发的下背痛强度。在基线、干预后立即以及随后7天每天记录疼痛强度。使用广义估计方程（GEE）方法估计平均每日疼痛的治疗效果。

结果

两组的运动诱发疼痛强度评分均随时间变化（时间的主效应：χ²(7) = 246.2，p < 0.001）。然而，干预并未影响运动诱发疼痛强度评分（组的主效应：χ²(1) = 0.02，p < 0.895）。在所有时间点进行平均时，两组之间的调整后平均差异仅为 -0.05/10（95% CI -0.72至0.63，p = 0.895）。