scholarly journals Topographic mapping of pain sensitivity of the lower back – a comparison of healthy controls and patients with chronic non-specific low back pain

2019 ◽  
Vol 19 (1) ◽  
pp. 25-37 ◽  
Author(s):  
Søren O’Neill ◽  
Johanne Brinch Larsen ◽  
Casper Nim ◽  
Lars Arendt-Nielsen
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Sensitivity ◽  
Heat Pain ◽  
Lumbar Region ◽  
Low Back ◽  
Pain Thresholds ◽  
Lower Back ◽  
Clinical Source ◽  
Pain Patients

AbstractBackground and aimsThe choice of testing site for quantitative sensory testing (QST) of pain sensitivity is important and previous studies have demonstrated patterns in pain sensitivity within discrete areas in different body regions. Some areas are characterized by a relatively high degree of spatial pain discrimination and recognizable patterns of pain referral, whilst others are not. The lumbar region is likely to have relatively low pain acuity and overlapping of pain referral. The current study was conducted to determine whether patterns of pain sensitivity (detection thresholds) could be identified in the lower back, whether differences in such patterns exist between different groups and whether such patterns could help identify a clinical source of pain and localized increased pain sensitivity.MethodsTwenty-one patients with non-specific chronic low back pain and 21 healthy controls were tested for pressure and heat pain thresholds on 30 pre-defined locations over the mid and lower back. Topographical maps of mean pain thresholds and variability were produced, inspected visually and analyzed statistically. Between group differences in pain threshold were analyzed statistically as an indicator of widespread increased pain sensitivity. Evidence of segmental increased pain sensitivity was examined by group statistical comparison of mid-line lower range.ResultsA clear pattern of higher pain thresholds in the mid-line was evident in both groups and for both pain modalities. No discernible patterns were evident for variability within groups, but marked differences were seen between groups: variability for pressure pain thresholds appeared similar between groups, however for heat pain threshold, variability was uniformly low in the control group and uniformly high in the patient group. A highly significant (p<0.0001) difference in pain thresholds for pressure and heat was found with patients exhibiting lower thresholds than controls. No between group difference was found for mid-line lower range for either modality (p>0.05).ConclusionsThe current study supports previous findings of widespread, increased pain sensitivity in chronic non-specific low-back pain patients. It also indicates that there are discernible and similar topographical patterns of pain sensitivity in the dorsal area in both groups, but that this pattern is related to the lateral position of the test site and not the segmental level. Specific segments with increased pain sensitivity could not be identified in the patient group, which casts doubt on the utility of pressure and heat pain thresholds as indicators of the clinical source of spinal pain – at least in a population of chronic non-specific low-back pain.ImplicationsIn a cohort of chronic non-specific low-back pain patients and with the chosen methodology, topographical QST mapping in the lumbar region does not appear useful for identifying the spinal segment responsible for clinical pain, but it does demonstrate widespread group differences in pain sensitivity.

scholarly journals ¿Existe alguna relación entre la posición del ciclismo y la aparición de dolor lumbar? Una revisión sistematizada (Is there any relation between the position of cycling and the appearance of lower pain? A systematized Review)

Retos ◽  
2021 ◽  
Vol 43 ◽  
pp. 651-659
Author(s):  
Andrés Fuentes ◽  
Luciano Martínez ◽  
Esteban Aedo-Muñoz ◽  
Ciro Brito ◽  
Bianca Miarka ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pelvic Tilt ◽  
Web Of Science ◽  
Lumbar Region ◽  
Low Back ◽  
The Road ◽  
Lower Back ◽  
Maximum Angle ◽  
Lower Pain

Este trabajo analizó la relación entre la posición de flexión mantenida durante la práctica de ciclismo y la posible relación con dolor lumbar. Se llevó a cabo una revisión sistematizada a través del proceso PRISMA® entre 2015-2020, en las bases de datos PubMed, PEDro, Scopus y Web of Science, empleando los términos; “cycling”, “cyclist”, “position”, “positioning”, “overuse injury”, “spinal biomechanic”, “lower back”, “lower back pain”. Se seleccionaron 5 artículos que cumplieron con todos los criterios de inclusión. Los artículos seleccionados mostraron cambios en la inclinación pélvica, ángulos de flexión de tronco en tomadas medias y bajas del manillar de bicicleta de ruta y bicicleta de montaña, variaciones del asiento más arriba o atrás de la posición adecuada según longitud entrepiernas, la posición de rodilla 40º y tronco 35º de manera simultánea cuando el pedal está en 180º, mientras que en posición anatómica se describieron; ángulo máximo de inclinación de pelvis en anteversión, ángulo máximo de inclinación de pelvis en retroversión y ángulo máximo de flexión lumbar se asocian con molestias o dolor lumbar. Sin embargo, es posible establecer que la asociación entre la práctica de ciclismo y el dolor lumbar no ha sido suficientemente estudiada, lo que nos hace inferir que surge la necesidad de actualizar la información con el objetivo de prevenir este tipo de lesiones asociadas a la posición en ciclismo.  Abstract. This article analyzed the relationship between the flexion position maintained during cycling and the possible relationship with low back pain. A systematic review was carried out through the PRISMA process between 2015-2020, in the PubMed, PEDro, Scopus and Web of Science databases, using the terms; "cycling", "cyclist", "position", "positioning", "injury from overuse", "biomechanics of the spine", "lumbar region", "low back pain". Five articles were selected that met all the inclusion criteria. Selected articles showed changes in pelvic tilt, torso flexion angles in medium and low strokes of the handlebars of the road bike and mountain bike, variations of the highest seat or the appropriate backrest according to the groin length, knee position 40 and trunk 35º simultaneously when the pedal is at 180º, while in anatomical position they have been described; The maximum angle of pelvic tilt in anteversion, the maximum angle of pelvic tilt in retroversion and the maximum angle of lumbar flexion are associated with pain or discomfort in the lumbar region. However, it is possible to establish that the association between cycling and low back pain has not been sufficiently studied, which leads us to infer that there is a need to update the information in order to prevent this type of injury associated with the position in cycling.

scholarly journals LATIHAN PEREGANGAN PADA PENDERITA NYERI PUNGGUNG BAWAH

2018 ◽  
Vol 11 (1) ◽  
pp. 046-052
Author(s):  
Fitra Puspita Sari
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Standard Deviation ◽  
Sampling Technique ◽  
Pain Scale ◽  
Low Back ◽  
Lower Back ◽  
Post Test ◽  
Pain Patients ◽  
Stretching Exercises

The incidence of low back pain is about 80% of the population have sufferedfrom low back pain. Data of low back pain patients within 6 months (April to September2016) as many as 72 visits in Poly Saraf RSUD Bengkulu City. The purpose of the studyto determine the effect of stretching on the reduction of the scale of pain in low back painpatients in Poly Saraf RSUD Bengkulu City. The type of research is pre-experiment withone group pre-test post-test design. Respondents were lower back pain patients as manyas 32 people taken with purposive sampling technique. Data collection was done byinterview using numerical pain scale. The result showed that the average of pain scalebefore stretching was 4.81 with a standard deviation of 0.592, the pain scale afterstretching was 3.34 with a standard deviation of 0.701. Stretching exercises have asignificant effect on decreasing the scale of low back pain (p = 0.000 ≤ α 5%). It isdesirable for nurses to apply stretching exercises as an initial measure to lower the scaleof low back pain.

Anger and pain sensitivity in chronic low back pain patients and pain-free controls: the role of endogenous opioids

Pain ◽  
2002 ◽  
Vol 99 (1) ◽  
pp. 223-233 ◽  
Author(s):  
Stephen Bruehl ◽  
John W. Burns ◽  
Ok Yung Chung ◽  
Pamela Ward ◽  
Benjamin Johnson
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Pain Sensitivity ◽  
Endogenous Opioids ◽  
Low Back ◽  
Pain Patients

Heart Rate Variability and Pain Sensitivity in Chronic Low Back Pain Patients Exposed to Passive Viewing of Photographs of Daily Activities

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Pâmela Martin Bandeira ◽  
Felipe José Jandre Dos Reis ◽  
Fernanda Donato Nóbrega Muniz ◽  
Anna Carolina da Silva Chaves ◽  
Orlando Fernandes Junior ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Pain Sensitivity ◽  
Daily Activities ◽  
Low Back ◽  
Passive Viewing ◽  
Pain Patients

CORE TRAINING UNDER SUSPENSION EXERCISE THERAPY ON TREATMENT OF LOW BACK PAIN

2021 ◽  
Vol 27 (7) ◽  
pp. 695-698
Author(s):  
Lei Ye ◽  
Chunyan Liu ◽  
Cunxi Jiang ◽  
Youshen Cao
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Exercise Therapy ◽  
Lower Back Pain ◽  
Core Stability ◽  
Control Group ◽  
Lumbar Region ◽  
Low Back ◽  
Lower Back ◽  
Experimental Group

ABSTRACT Introduction: The main clinical feature of chronic nonspecific low back pain (CNLBP) is lower back pain, and suspension sports therapy has a specific effect in this case. Objective: To investigate the changes of flexion-relaxation phenomenon in patients with lower back pain after core control training of suspension exercise therapy (SET). Methods: 84 subjects who met the inclusion and exclusion criteria of chronic low back pain in this experiment were randomly divided into an experimental group and a control group. The experimental group was treated with suspension training. The control group only received acupuncture. We then determined the muscle fascia tension and core stability of the lower lumbar region. Results: The visual analog scale (VAS) and Oswestry dysfunction index (ODI) evaluations of the two groups of patients were different. Conclusion: Suspended core stabilization training has a significant long-term effect in reducing lower back pain and improving waist function in patients with chronic nonspecific low back pain. Level of evidence II; Therapeutic studies - investigation of treatment results.

Exposure to Odors Increases Pain Threshold in Chronic Low Back Pain Patients

Pain Medicine ◽  
2020 ◽  
Vol 21 (10) ◽  
pp. 2546-2551
Author(s):  
Gudrun Gossrau ◽  
Daniel Baum ◽  
Thea Koch ◽  
Rainer Sabatowski ◽  
Thomas Hummel ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Chronic Back Pain ◽  
Olfactory Function ◽  
Low Back ◽  
Pain Thresholds ◽  
Test Kit ◽  
Pain Patients ◽  
Olfactory Training

Abstract Objectives Structured exposure to odors is an acknowledged therapy in patients with smell loss but has also been shown to be effective in depression. The latter might rely on connections between olfactory and emotional structures, suggesting possible effects of a similar approach in pain patients. Based on neuroanatomy, there are several interfaces between the “pain matrix” and olfactory system, such as the limbic system, hypothalamus, and mediodorsal thalamus. We aimed to investigate whether structured exposure to odors may impact perceived pain in patients with chronic low back pain. Design Randomized controlled parallel-group design. Subjects were tested on two occasions, at baseline and after four weeks. Setting Ambulatory. Subjects Forty-two patients with chronic low back pain Methods For all patients, olfactory function (using the “Sniffin’Sticks” test kit), detection, and pain thresholds for cutaneous electrical stimuli (applied to the forearm) were tested at baseline and after four weeks. Twenty-eight patients exposed themselves to four odors (rose, vanilla, chocolate, peach) every two hours over a period of four weeks (training group). Control patients (N = 14) underwent no such “olfactory training” (nontraining group). Results Pain thresholds were significantly increased in patients who performed olfactory training compared with patients who did not train with odors. Detection thresholds and olfactory function remained unchanged. Conclusions The present results indicate that regular exposure to odors increases pain thresholds in patients with chronic back pain and could be useful for general pain control in these patients. Furthermore, olfactory training in chronic pain patients might help to reduce chronification of pain by desensitization.

Sign in / Sign up

Export Citation Format

Share Document