scholarly journals Segmental Chiropractic Spinal Manipulation Does not Reduce Pain Amplification and the Associated Pain-Related Brain Activity in a Capsaicin-Heat Pain Model

2021 ◽  
Vol 2 ◽  
Author(s):  
Benjamin Provencher ◽  
Stéphane Northon ◽  
Mathieu Piché
Keyword(s):  
Back Pain ◽  
Central Sensitization ◽  
Spinal Manipulation ◽  
Chronic Back Pain ◽  
Brain Activity ◽  
Heat Pain ◽  
Pain Model ◽  
Pain Hypersensitivity ◽  
Clinical Pain ◽  
Primary Hyperalgesia

Musculoskeletal injuries lead to sensitization of nociceptors and primary hyperalgesia (hypersensitivity to painful stimuli). This occurs with back injuries, which are associated with acute pain and increased pain sensitivity at the site of injury. In some cases, back pain persists and leads to central sensitization and chronic pain. Thus, reducing primary hyperalgesia to prevent central sensitization may limit the transition from acute to chronic back pain. It has been shown that spinal manipulation (SM) reduces experimental and clinical pain, but the effect of SM on primary hyperalgesia and hypersensitivity to painful stimuli remains unclear. The goal of the present study was to investigate the effect of SM on pain hypersensitivity using a capsaicin-heat pain model. Laser stimulation was used to evoke heat pain and the associated brain activity, which were measured to assess their modulation by SM. Eighty healthy participants were recruited and randomly assigned to one of the four experimental groups: inert cream and no intervention; capsaicin cream and no intervention; capsaicin cream and SM at T7; capsaicin cream and placebo. Inert or capsaicin cream (1%) was applied to the T9 area. SM or placebo were performed 25 min after cream application. A series of laser stimuli were delivered on the area of cream application (1) before cream application, (2) after cream application but before SM or placebo, and (3) after SM or placebo. Capsaicin cream induced a significant increase in laser pain (p < 0.001) and laser-evoked potential amplitude (p < 0.001). However, SM did not decrease the amplification of laser pain or laser-evoked potentials by capsaicin. These results indicate that segmental SM does not reduce pain hypersensitivity and the associated pain-related brain activity in a capsaicin-heat pain model.

scholarly journals Chiropractic Spinal Manipulation Prevents Secondary Hyperalgesia Induced by Topical Capsaicin in Healthy Individuals

2021 ◽  
Vol 2 ◽  
Author(s):  
Carlos Gevers-Montoro ◽  
Benjamin Provencher ◽  
Stéphane Northon ◽  
João Paulo Stedile-Lovatel ◽  
Arantxa Ortega de Mues ◽  
...  
Keyword(s):  
Back Pain ◽  
Central Sensitization ◽  
Spinal Manipulation ◽  
Brain Activity ◽  
Experimental Studies ◽  
Gamma Oscillations ◽  
Secondary Hyperalgesia ◽  
Vertebral Level ◽  
Pressure Pain Thresholds ◽  
Topical Capsaicin

Background and Aims: Spinal manipulation (SM) is currently recommended for the management of back pain. Experimental studies indicate that the hypoalgesic mechanisms of SM may rely on inhibition of segmental processes related to temporal summation of pain and, possibly, on central sensitization, although this remains unclear. The aim of this study was to determine whether experimental back pain, secondary hyperalgesia, and pain-related brain activity induced by capsaicin are decreased by segmental SM.Methods: Seventy-three healthy volunteers were randomly allocated to one of four experimental groups: SM at T5 vertebral level (segmental), SM at T9 vertebral level (heterosegmental), placebo intervention at T5 vertebral level, or no intervention. Topical capsaicin was applied to the area of T5 vertebra for 40 min. After 20 min, the interventions were administered. Pressure pain thresholds (PPTs) were assessed outside the area of capsaicin application at 0 and 40 min to examine secondary hyperalgesia. Capsaicin pain intensity and unpleasantness were reported every 4 min. Frontal high-gamma oscillations were also measured with electroencephalography.Results: Pain ratings and brain activity were not significantly different between groups over time (p > 0.5). However, PPTs were significantly decreased in the placebo and control groups (p < 0.01), indicative of secondary hyperalgesia, while no hyperalgesia was observed for groups receiving SM (p = 1.0). This effect was independent of expectations and greater than placebo for segmental (p < 0.01) but not heterosegmental SM (p = 1.0).Conclusions: These results indicate that segmental SM can prevent secondary hyperalgesia, independently of expectations. This has implications for the management of back pain, particularly when central sensitization is involved.

Effects of Chronic Back Pain on the Perception of Experimental Heat Pain

1990 ◽  
Vol 71 (3_suppl) ◽  
pp. 1283-1292 ◽  
Author(s):  
S. Lautenbacher ◽  
G. Galfe ◽  
G. Karlbauer ◽  
A. Möltner ◽  
F. Strian
Keyword(s):  
Back Pain ◽  
Chronic Back Pain ◽  
Heat Pain ◽  
Experimental Heat

scholarly journals Lifting capacity is associated with central sensitization and non-organic signs in patients with chronic back pain

2020 ◽  
pp. 1-5
Author(s):  
Jone Ansuategui Echeita ◽  
Peter van der Wurff ◽  
Vera Killen ◽  
Mike F. Dijkhof ◽  
Floor M. Grootenboer ◽  
...  
Keyword(s):  
Back Pain ◽  
Central Sensitization ◽  
Chronic Back Pain ◽  
Lifting Capacity

scholarly journals Chronic Pain and the Emotional Brain: Specific Brain Activity Associated with Spontaneous Fluctuations of Intensity of Chronic Back Pain

2006 ◽  
Vol 26 (47) ◽  
pp. 12165-12173 ◽  
Author(s):  
M. N. Baliki ◽  
D. R. Chialvo ◽  
P. Y. Geha ◽  
R. M. Levy ◽  
R. N. Harden ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Chronic Back Pain ◽  
Brain Activity ◽  
Spontaneous Fluctuations

scholarly journals THU0483 ASSOCIATION OF CENTRAL SENSITIZATION AND ATTENTION DEFICIT IN MEDICAL STUDENTS WITH CHRONIC BACK PAIN

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 479.1-479
Author(s):  
M. E. Ibrahim ◽  
M. Hefny
Keyword(s):  
Back Pain ◽  
Medical Students ◽  
Attention Deficit ◽  
Central Sensitization ◽  
Chronic Back Pain ◽  
Pain Processing ◽  
Central Pain ◽  
Hyperactivity Disorder ◽  
And Gender ◽  
Central Pain Processing

Background:Back pain is one of the most common health complaints among university students. A subset of people suffering from chronic back pain exhibit features of increased pain sensitivity and altered pain processing, suggesting central sensitization (CS) to pain1. The mechanisms behind these processes are, to date, not fully understood2. Evidence shows that in chronic pain, cognitive factors could contribute to the occurrence of central pain sensitization3,4.Objectives:To assess the association between CS and features of adult Attention Deficit Hyperactivity Disorder (ADHD) in medical students suffering from chronic back pain.Methods:Data was collected from medical students during the academic year 2018-2019 at Suez Canal University using an online survey. The survey included a section on self-reported musculoskeletal pain including back pain lasting more than 3 months in the neck, upper back and lower back, part (A) of the central sensitization inventory (CSI) and the Adult Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS-v 1.1). Associations between CSI and ASRS-v 1.1 in students with back pain was assessed using Spearman’s correlation. Linear regression was used to estimate cross-sectional associations adjusted for age and gender.Results:Two hundred and thirty students completed the survey, 93 (40.4%) had back pain for more than 3 months. Students with back pain had significantly higher CS and attention deficit according to CSI (P<0.01), and the ASRS-v 1.1 scores (P=0.09). Correlation results showed a strong positive association between CS and ADHD in students with back pain (correlation coefficient = 0.41, P<0.001). This association remained significant after adjusting for age and gender (P<0.001).Conclusion:Results of this study suggest that in students suffering from chronic back pain, features of attention deficit are associated with elevated CS. The direction of the association requires further study and may provide novel insights into the interaction between CS and cognitive factors.References:[1]Giesecke T, Gracely RH, Grant MA, Nachemson A, Petzke F, Williams DA, Clauw DJ. Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 2004 Feb;50(2):613-23.[3]Coppieters I, Ickmans K, Cagnie B, Nijs J, De Pauw R, Noten S, Meeus M. Cognitive performance is related to central sensitization and health-related quality of life in patients with chronic whiplash-associated disorders and fibromyalgia. Pain physician. 2015;18(3):E389-401.[4]Roussel NA, Nijs J, Meeus M, Mylius V, Fayt C, Oostendorp R. Central sensitization and altered central pain processing in chronic low back pain: fact or myth?. The Clinical journal of pain. 2013 Jul 1;29(7):625-38.Disclosure of Interests: :None declared

scholarly journals Central sensitization and pain hypersensitivity: Some critical considerations.

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1325 ◽  
Author(s):  
Emanuel N. van den Broeke
Keyword(s):  
Central Sensitization ◽  
Pain Hypersensitivity ◽  
General Consensus ◽  
Clinical Pain ◽  
Wide Range ◽  
Definition Of ◽  
Clinical Domain

Since its discovery, central sensitization has gained enormous popularity. It is widely used to explain pain hypersensitivity in a wide range of clinical pain conditions. However, at present there is no general consensus on the definition of central sensitization. Moreover, the use of the term central sensitization in the clinical domain has been criticized. The aim of this paper is to foster the discussion on the definition of central sensitization and its use.

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