Abstract
Chronic nonspecific low back pain is common and one of the most disabling conditions in the world. There is moderate evidence that chronic low back pain patients present altered functional connectivity in areas related to pain processing. Quantitative sensory testing is a way of clinical measure of these alterations. Although there is not enough evidence, there are some reports that electroacupuncture is supposedly more effective in relieving pain than acupuncture because the addition of electric current could optimize the effects of traditional technique. Thus, the objective of this randomized clinical trial was to verify if electroacupuncture treatment reduces pain and changes quantitative sensory testing responses in patients with chronic nonspecific low back pain. Patients were evaluated before and after 10 sessions regarding pain (11-point numerical rating pain scale) and quantitative sensory testing (pressure pain threshold, temporal summation, and conditioned pain modulation). There were 1 treatment group (electroacupuncture (EA)) and three different control groups (CTR 1, CTR 2, and CTR 3). A total of 69 patients participated in the study. No significant differences were found in pain intensity or quantitative sensory testing responses when comparing electroacupuncture group to the three control groups. There was a significant reduction in both resting and movement pain intensity in groups EA, CTR 1, and CTR3. Although ten sessions of electroacupuncture have diminished pain intensity in both resting and movement, it could not change significantly quantitative sensory testing and diminish central sensitization in patients with chronic nonspecific low back pain. The implications of this study involve the fact that, maybe, in chronic nonspecific low back pain, electroacupuncture should be associated with other treatments that target central sensitization.
Highlights
Chronic nonspecific low back pain is common and one of the most disabling conditions in the world [1, 2]
According to a systematic review, there is moderate evidence that chronic low back pain patients present brain structural changes in both gray and white matter and altered functional connectivity in areas related to pain processing [3]
These neuroplastic modifications may be clinically assessed thru quantitative sensory testing, as there is preliminary to moderate evidence demonstrating relationship between clinical pain measures and those structural and functional connectivity alterations in chronic musculoskeletal patients [4]
Summary
Chronic nonspecific low back pain is common and one of the most disabling conditions in the world [1, 2]. According to a systematic review, there is moderate evidence that chronic low back pain patients present brain structural changes in both gray and white matter and altered functional connectivity in areas related to pain processing [3]. These neuroplastic modifications may be clinically assessed thru quantitative sensory testing, as there is preliminary to moderate evidence demonstrating relationship between clinical pain measures and those structural and functional connectivity alterations in chronic musculoskeletal patients [4]. Quantitative sensory testing is a way of measuring central hypersensitivity or impaired endogenous pain modulation mechanisms, like temporal summation of pain and conditioned pain modulation, respectively
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