Pain Sensory Profile Changes Following Treatment of Chronic Low Back Pain
Condition: Low Back Pain
MeSH terms: Back Pain; Low Back Pain
Study type: Observational

Summary: 
      Several cross-sectional studies have demonstrated that patients with chronic low back pain
      have higher levels of pain sensitivity (local and widespread) when compared to controls. It
      is unclear however, if improvements in pain and function are reflected in a decrease in the
      sensitivity of pain mechanisms. This study compares the pain sensory profile in patients with
      chronic low back pain before and after a period of physiotherapy treatment. To account for
      natural fluctuations in pain sensitivity, healthy age matched controls are also measured
      twice
    

Detailed description: 
      The sensitivity of pain mechanisms has consistently been shown to be increased in people
      suffering from chronic low back pain. This includes both sensitivity in the painful region
      but also in areas distant indicating widespread pain sensitivity. It is less clear whether
      this is normalized following a successful treatment intervention.

      This study is recruiting people with low back pain and healthy, age matched controls. At
      baseline, the following measurements are made:

        -  the sensitivity to pressure (at the low back and at the shoulder)

        -  the pain detection threshold and pain tolerance threshold at the lower legs

        -  the temporal summation of pain

        -  conditioned pain modulation

        -  Fear-avoidance beliefs

        -  Disability (Roland-Morris Disability Questionnaire)

        -  The Orebro musculoskeletal pain questionnaire

      During their enrollment, the patients report their weekly pain electronically

      All quantitative sensory testing (QST) and questionnaire data are blind to the principal
      investigator until data collection has been finished

      After the baseline measurements, the patients are offered physiotherapy treatment. The
      treatment protocol (dosage and type of intervention) is designed based on individual needs
      following an assessment by a musculoskeletal physiotherapist. The number of sessions and time
      between treatment sessions depend on how the patients respond to the chosen intervention.
      Patients are discharged from treatment when:

        1. they have made sufficient recovery (their back pain is no longer a problem)

        2. the chosen intervention(s) have failed to affect their condition

        3. no more recovery is expected

      The quantitative sensory testing measurements are performed again after discharge
    

Intervention name(s): Physiotherapy
Intervention type(s): Procedure
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Low back pain group Males and females who have had low back pain lasting 3 - 60 months. The
        reason for onset (traumatic/non-traumatic) is registered but not used for
        inclusion/exclusion

        Control group Healthy males and females with no current or previous history of
        musculoskeletal pain. Previous history is defined as pain of on-going nature (lasting 3
        months or more) in the low back and/or in general