Abstract
BackgroundPeople with chronic low back pain (LBP) typically have increased pain sensitivity compared to healthy controls, however its unknown if pain sensitivity differs based on LBP trajectory at baseline or after manual therapy interventions. We aimed to compare baseline pressure pain threshold (PPT) and temporal summation (TS) between people without LBP, with episodic LBP, and with persistent LBP, and to compare changes over time in PPT and TS after a lumbar spinal manipulation or sham manipulation in those with LBP.MethodsParticipants were aged 18–59, with or without LBP. Those with LBP were categorised as having either episodic or persistent LBP. PPT and TS were tested at baseline. LBP participants then received a lumbar spinal manipulation or sham, after which PPT and TS were re-tested three times over 30 min. Generalised linear mixed models were used to analyse data.ResultsOne hundred participants (49 female) were included and analysed. There were 20 non-LBP participants (mean age 31 yrs), 23 episodic LBP (mean age 35 yrs), and 57 persistent LBP (mean age 37 yrs). There were no significant differences in PPT or TS between groups at baseline. There was a non-significant pattern of lower PPT (higher sensitivity) from the non-LBP group to the persistent LBP group at baseline, and high variability. Changes in PPT and TS after the interventions did not differ between the two LBP groups.DiscussionWe found no differences between people with no LBP, episodic LBP, or persistent LBP in baseline PPT or TS. Changes in PPT and TS following a lumbar manual therapy intervention do not appear to differ between LBP trajectories.Trial registrationThe trial was prospectively registered with ANZCTR (ACTRN12617001094369).
Highlights
People with chronic low back pain (LBP) typically have increased pain sensitivity compared to healthy controls, its unknown if pain sensitivity differs based on LBP trajectory at baseline or after manual therapy interventions
One participant with LBP was excluded from analyses as they were uncontactable for the 24 h follow-up call, leaving a total of 20 non-LBP participants, 23 episodic LBP participants, and 57 persistent LBP participants
Baseline pressure pain threshold (PPT) data were missing for two participants, and 30 min PPT data were missing for three other participants
Summary
People with chronic low back pain (LBP) typically have increased pain sensitivity compared to healthy controls, its unknown if pain sensitivity differs based on LBP trajectory at baseline or after manual therapy interventions. Recent research on individuals’ experiences of nonspecific LBP over time is leading away from the traditional model of LBP in three potential stages, acute, sub-acute, and chronic. There is evidence suggesting that an individual’s LBP trajectory tends to stay relatively stable over time [3, 5], supporting the clinical usefulness of trajectories to predict patient outcomes and plan management strategies. It has been suggested that the trajectories approach offers a more useful and nuanced framework for research and clinical decision making around LBP compared to the traditional model [3, 6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
