scholarly journals The Rationale for the Automation of a New Diagnostic Thermography Protocol to Confirm a Chronic-Low-Back-Pain Subtype Related to Nociplastic Pain

BioMed ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 99-111
Author(s):  
Elzbieta Skorupska ◽  
Tomasz Dybek
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Central Sensitization ◽  
Invasive Procedure ◽  
Trigger Points ◽  
International Classification Of Diseases ◽  
Autonomic Response ◽  
Target Area ◽  
Low Back ◽  
Classification Of Diseases

Gluteal syndrome (GS), a new low-back-pain subtype mimicking sciatica, has been included in the 11th Revision of the International Classification of Diseases (ICD-11). Low back pain is a symptom, not a disease, and the main problem associated with it is pain complexity. A plausible pain generator of gluteal syndrome is the central sensitization process and the therapeutic target area, which are trigger points located within the gluteal muscles. It has been hypothesized that dysregulated immune and autonomic nervous systems (ANS) are involved in central sensitization development. Changes in ANS regulation, mainly through the sympathetic branch, provoke nociceptor activation indirectly by a vasoconstriction–vasodilatation imbalance, or directly by sympathetic–nociceptor activation resulting in widespread pain, hyperalgesia, and allodynia. The minimally invasive procedure (MIP) uses thermography to confirm a completely new biological phenomenon, which suggests a pathological autonomic response to noxious stimuli and can possibly become an objective marker of some nociplastic pain subtypes related to trigger points. This review provides the biological and technical rationale for the automation of the MIP—a possible future diagnostic tool for an objective gluteal syndrome confirmation.

scholarly journals The Automatization of a New Thermography Method Using Invasive Nociceptive Stimulation to Confirm an Autonomic Phenomenon within a Trigger Point Referred Pain Zone

2021 ◽  
Vol 11 (7) ◽  
pp. 893
Author(s):  
Elżbieta Skorupska ◽  
Tomasz Dybek ◽  
Michał Rychlik ◽  
Marta Jokiel ◽  
Paweł Dobrakowski
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Trigger Point ◽  
Invasive Procedure ◽  
Trigger Points ◽  
International Classification Of Diseases ◽  
Referred Pain ◽  
Low Back ◽  
Classification Of Diseases ◽  
Software Utility

The trigger points (TrPs) related to chronic low back pain that mimic sciatica have been lately recognized and included in the International Classification of Diseases, 11th Revision. This study examined the MATLAB software utility for the objective stratification of low back pain patients using the Minimally Invasive Procedure (MIP). The two diagnostic MIP parameters were: average temperature (ΔTavr) and autonomic referred pain (AURP). Chronic sciatica patients with TrPs (n = 20) and without TrPs (n = 20) were examined using the MIP. A significant increase in both parameters was confirmed for the thigh ROI of the TrP-positive patients, with ΔTavr being the leading parameter (p = 0.016, Exp(β) = 2.603). A continued significance of both parameters was confirmed from 6′00″ to 15′30″ (p < 0.05). The maximum AURP value was confirmed at 13′30″ (p < 0.05) (TrPs(+) 20.4 ± 19.9% vs. TrPs(-) 3.77 ± 9.14%; p = 0.000; CI (0.347,0.348)).

scholarly journals The genetic influence of the brain-derived neurotrophic factor Val66Met polymorphism in chronic low back pain

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Angela Shiratsu Yamada ◽  
Flavia Tasmim Techera Antunes ◽  
Camila Ferraz ◽  
Alessandra Hubner de Souza ◽  
Daniel Simon
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Neurotrophic Factor ◽  
Central Sensitization ◽  
Low Back ◽  
Bdnf Gene ◽  
Val66met Polymorphism ◽  
Bdnf Val66met Polymorphism ◽  
The Brain

Abstract Background The Val66Met polymorphism of the brain-derived neurotrophic factor (BDNF) gene is a potential biomarker of vulnerability to pain. Thus, the present study aimed to investigate the association of this polymorphism with clinical and biopsychosocial factors in patients with chronic low back pain (CLBP). Methods A total of 107 individuals with CLBP answered questionnaires that were validated and adapted for the Brazilian population, including the Brief Inventory of Pain, the Central Sensitization Inventory, the Roland Morris Disability Questionnaire, the Tampa Scale for Kinesiophobia, the Pain Catastrophizing Scale, the Survey of Pain Attitude-Brief, and the Hospital Anxiety and Depression Scale. All of the subjects were genotyped for the BDNF Val66Met polymorphism. Results The sample showed moderate scores of disability, central sensitization, and kinesiophobia, in addition to mild anxiety, hopelessness, and ruminant thoughts. No significant association was observed between the Val66Met polymorphism and the variables analyzed. Besides, there was no relationship between the BDNF Val66Met polymorphism with CSI, catastrophization, or disabilities that were generated by CLBP. Conclusion The results showed that the Val66Met polymorphism of the BDNF gene was not associated with clinical and biopsychosocial characteristics of CLBP in the sample studied.

scholarly journals Influence of pilates method on the treatment of nonspecific chronic low back pain: a protocol study for a randomized, controlled, blind trial

2020 ◽  
Vol 18 ◽  
pp. 1-5
Author(s):  
Bianca Martins de Souza ◽  
Daiane Oliveira da Silva ◽  
Lais Paraguai Justo ◽  
Leandro Lazzareschi ◽  
Daniela Aparecida Biasotto-Gonzalez ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Central Sensitization ◽  
Personal Information ◽  
Treatment Session ◽  
Control Group ◽  
Low Back ◽  
Pilates Method ◽  
Type Of Exercise ◽  
And Function

Background: Low back pain is one of the most common musculoskeletal problems among workers. Studies estimate that 90% of the adults will suffer at least one episode of low back pain in life that will lead to the temporary interruption of work. A type of exercise that has gained increasing popularity among individuals with low back pain in the last decade is the Pilates method. Objective: Determine the influence of the Pilates method on improvements in pain, kinesiophobia, central sensitization and function in patients with chronic nonspecific low back pain. Methods: Thirty-four male and female volunteers between 18 and 35 years of age with a complaint of nonspecific low back pain for at least three months will be divided into two groups: Pilates method and control group. An evaluation chart created by the authors will be used to collect data on personal information, history of diseases, alcohol use, smoking, pain intensity (visual analog scale) and medications used. The Tampa Scale for Kinesiophobia, Central Sensitization Questionnaire and Oswestry Disability Index will also be administered. Pilates exercises will be performed three time per week for four weeks and administered by a researcher with adequate training in the method. Reevaluations will be performed after the sixth treatment session in the Pilates group, two weeks after the initial evaluation in the control group, after the 12th session in the Pilates group and after four weeks in the control group. Another reevaluation will be performed three months after treatment. Results: The data will be submitted to statistical analysis and the level of significance will be set to 5%. Conclusion: Based on the results analyzed it will be possible to determine the influence of Pilates Method on improvements in pain, kinesiophobia, central sensitization and function in patients with chronic nonspecific low back pain.

Central Sensitization and Altered Central Pain Processing in Chronic Low Back Pain

2013 ◽  
Vol 29 (7) ◽  
pp. 625-638 ◽  
Author(s):  
Nathalie A. Roussel ◽  
Jo Nijs ◽  
Mira Meeus ◽  
Veit Mylius ◽  
Cécile Fayt ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Central Sensitization ◽  
Pain Processing ◽  
Central Pain ◽  
Low Back ◽  
Central Pain Processing

Central sensitization in chronic lumbar spine pain – pathophysiology and diagnostics

Ból ◽  
2020 ◽  
Vol 21 (1) ◽  
pp. 1-9
Author(s):  
Barabara Kosińska ◽  
Paweł Turczyn ◽  
Krzysztof Wesołowski ◽  
Beata Tarnacka ◽  
Małgorzata Malec-Milewska
Keyword(s):  
Chronic Pain ◽  
Low Back Pain ◽  
Back Pain ◽  
Central Sensitization ◽  
Clinical Problem ◽  
Low Back ◽  
Spine Pain ◽  
High Prevalence ◽  
Pain Symptoms ◽  
Patients Experience

Chronic low back pain is a substantial clinical problem because of its high prevalence, incidence, complex and heterogeneous symptomatology. The majority of patients experience nociceptive pain only, but in almost 40% of patients neuropathic component may be present. In many patients with low back pain symptoms associated with central sensitization may be present as well and therefore their pain can be classified as nocyplastic. (functional) This paper describes how clinicians can differentiate these types of pain, taking into account that in a given patient several mechanisms may contribute to chronic pain development, and pain results from complex mechanisms. In the second part, therapeutic options are presented for people with symptoms of central sensitization, with emphasis on non-pharmacological methods.

scholarly journals Accuracy of intraoperative neuromonitoring during percutaneous cement discoplasty

2021 ◽  
Vol 78 (3) ◽  
pp. 257-263
Author(s):  
Gaston Oscar Camino Willhuber ◽  
Mariana Bendersky ◽  
Carolina Vilte ◽  
Gonzalo Kido ◽  
Matias Pereira Duarte ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Minimally Invasive ◽  
Predictive Value ◽  
Invasive Procedure ◽  
Intraoperative Neuromonitoring ◽  
Neurological Injury ◽  
Low Back ◽  
Minimally Invasive Procedure ◽  
Percutaneous Cement Discoplasty

Introduction: Percutaneous cement discoplasty is a minimally invasive procedure to treat low back pain due to advanced degenerative disc disease in elderly patients. Complications of this procedure has been described such as infection, vertebral fracture, cement leakage and nerve injury. Intraoperative neuromonitoring is used to detect the latter. The objective of this study was to assess the usefulness of neuromonitoring during discoplasty to detect new neurological compromise. Methods: 100 consecutive patients were included in this retrospective study, (30 males and 70 females, mean age of 76.3 ± 5.71 years) with mechanical low back pain who underwent percutaneous cement discoplasty. Results: Sensitivity to detect neurological injury was 82% (CI 95% 66-98), specificity was of 99% (CI 95%98-100) with a positive predictive value of 0.95 (CI 95% 85-100) and a negative predictive value of 0.97 (CI 95% 95-99). In 5 patients neurological compromise was not detected by neuromonitoring. Discussion: Our study showed high sensitivity and specificity of neuromonitoring to detect neurological irritation during percutaneous discoplasty. Intraoperative neuromonitoring resulted an effective assistance during this minimally invasive procedure.  

Sign in / Sign up

Export Citation Format

Share Document