Electrical (Pain) Thresholds and Conditioned Pain Modulation in Patients with Low Back–Related Leg Pain and Patients with Failed Back Surgery Syndrome: A Cross-Sectional Pilot Study. Issue 3 (5th June 2019)

• Record Type: Journal Article
• Authors: Goudman, Lisa; Huysmans, Eva; Coppieters, Iris; Ickmans, Kelly; Nijs, Jo; Buyl, Ronald; Putman, Koen; Moens, Maarten
• Is Part Of: Pain medicine. Volume 21:Issue 3(2020)
• Page Start: 538
• Page End: 547
• Publication Date: 2019-06-05
• Subjects: Pain Thresholds -- Low Back Pain -- Conditioned Pain Modulation -- Neuropathic Pain -- Quantitative Sensory Testing -- Pain Mechanisms; Pain -- Periodicals; Pain -- Treatment -- Periodicals; Analgesics -- Periodicals; Pain -- Periodicals; Pain Management -- Periodicals; Douleur -- Périodiques; Douleur -- Traitement -- Périodiques; Analgésiques -- Périodiques; Analgésique; Soulagement de la douleur; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.047205
• DOI: 10.1093/pm/pnz118
• Languages: English
• ISSNs: 1526-2375

Abstract

Abstract: Objective: When evaluating sensory dysfunctions and pain mechanisms in patients with low back pain (LBP), a specific subgroup of patients with radicular symptoms is often excluded. Comparative studies that evaluate sensory sensitivity in patients with a dominant nociceptive and neuropathic pain component are rarely performed. Therefore, the goal of this study was to examine differences in electrical thresholds and conditioned pain modulation (CPM) between patients with low back–related leg pain (LBRLP) and patients with failed back surgery syndrome (FBSS). Design: Cross-sectional study. Setting: University Hospital Brussels. Subjects: Twenty-one patients with LBRLP and 21 patients with FBSS were included. Methods: Electrical detection thresholds (EDTs), electrical pain thresholds (EPTs), and CPM were evaluated on the symptomatic and nonsymptomatic sides. Within- and between-group differences were evaluated for all parameters. Results: No between-group differences were found for EDT and EPT at both sides. On the nonsymptomatic side, a significantly lower CPM effect was found in the FBSS group ( P = 0.04). The only significant within-group difference was an increased EDT at the symptomatic side in patients with FBSS ( P = 0.01). Conclusions: LBP patients with a primary neuropathic pain component revealed altered detection sensitivity at the symptomatic side, without severe indications for altered nociceptive processing, compared with LBP patients without a dominant neuropathic pain component. Endogenous modulation is functioning in LBP patients, although it is possible that it might only be functioning partially in patients with a dominant neuropathic pain component.