Photo Credit: Nastco

The following is a summary of “Influence of pain hypersensitivity and psychological factors on pain and disability in the transition from acute to chronic low back pain: a longitudinal exploratory investigation and cluster analysis,” published in the May 2024 issue of Pain by Chang et al.

Acute low back pain (LBP) can sometimes lead to chronic pain. Recent studies suggest that some people with acute LBP experience a heightened sensitivity to pain, which may be a risk factor for developing chronic LBP.

Researchers conducted a retrospective study to investigate if pain hypersensitivity in patients with acute LBP affects recovery at six months and how it influences the course of pain and disability over time.

They included 118 participants with acute non-specific LBP (<6 weeks after pain onset). Quantitative sensory testing and questionnaires were compared between recovered and unrecovered participants at baseline and longitudinally (at three and six months). The study used k-means clustering to identify subgroups based on baseline sensory measures and psychological factors and compared pain and disability outcomes between subgroups.

The results showed that k-means clustering was used to identify subgroups based on baseline sensory measures and psychological factors, and pain and disability outcomes were compared between subgroups. Baseline sensory measures in participants did not differ between recovered (N=50) and unrecovered (N=68) at any time. Subgrouping based on baseline sensory measures alone did not differentiate pain or disability outcomes at any time point. Participants with high psychological distress (N=19) had more significant disability at all time points but not pain, compared to those with low psychological distress, regardless of pain sensitivity levels.

Investigators concluded that acute LBP pain hypersensitivity wasn’t linked to worse recovery at six months or different pain/disability trajectories, but high psychological distress predicted persistent and severe disability.

Source: jpain.org/article/S1526-5900(24)00519-4/abstract