Short summary

Low back pain is the leading cause of disability worldwide. Albeit primarily benign, the pain is often adopted as chronic possibly due to the excitablity in the central neural pathways which conduct and modulate the pain stimulus and leads to increased transmission of nociceptive sensory input, which in turn causes central hypersensitivity and an attenuation of descending pain-inhibiting mechanisms. Overall, this results in enhanced pain responses 

This analysis between objectively measured and self-reported central sensitization will give insight into correctly classyfing low back patients with central sensitization. 

Rationale

Low back pain (LBP) is currently the leading cause of disability worldwide.  Evidence suggests that central pain-modulating mechanisms as well as pain cognitions play an important role in the development of chronic disabling low back pain.

Central Sensitization (CS) is an example of such a mechanism. CS is believed to be part of the mechanism in the transition process from acute to chronic pain, as well as amplification of pain in existing chronic pain conditions. Recognizing and quantifying symptoms of CS could play an important role in the prevention, diagnosis, prognosis and treatment of patients with chronic LBP. However, we currently lack a gold standard for quantifying symptoms of CS among patients.

The Central Sensitization Inventory (CSI) is a two-part questionnaire developed in 2011, with the aim of quantifying CS. The CSI has been shown to a  correlation with other validated self-report measures, but uncertainty remains regarding its correlation with psychophysical measures of pain sensitivity, such as pain pressure thresholds and tests of conditioned pain modulation. Researchers have called for future studies to take more  psychophysical measures into account when assessing the convergent validity of the CSI.

Quantitative Sensory Testing (QST) is another method used for quantifying symptoms of CS, involving a variety of psychophysical test procedures. The convergent validity between the CSI and a full QST-profile in a cohort of LBP patients has  not previously been studied to our knowledge.

The aim of this study is to evaluate the convergent validity of the CSI, by investigating the correlation with a QST­profile of patients presenting with LBP. 

Description of the cohort

Adults with low back pain seen at multidisciplinary secondary care Spinecenter in Denmark. 

Data and biological material

Experimental data and questionnaires

Collaborating researchers and departments

Department of Regional Health Research, University of Southern Denmark

• Stud. cand. manu, undergraduate Researcher, Liam Holm

• PhD student, Casper Glissmann Nim,  MSc

• PhD student, Johanne Brinch Filtenborg, MSc

• Chiropractor, PhD, Søren O'Neill 

Department of Sports Science and Clinical Biomechanics, University of Southern Denmark

• Chiropractor Henrik Hein Lauridsen, PhD

Publications associated with the project

O'Neill S, Holm L, Filtenborg JB, Arendt-Nielsen L, Nim CG. The inhibitory effect of conditioned pain modulation on temporal summation in low-back pain patients. Scand J Pain. 2021 May 27;21(3):606-616. doi: 10.1515/sjpain-2021-0025. PMID: 34043891.

Holm LA, Nim CG, Lauridsen HH, Filtenborg JB, O'Neill SF. "Convergent validity of the central sensitization inventory and experimental testing of pain sensitivity". Scand J Pain. 2021 Oct 19. doi: 10.1515/sjpain-2021-0090. Epub ahead of print. PMID: 34668367.