Skip to main content
Top
Published in: European Spine Journal 12/2011

01-12-2011 | Original Article

Low pressure pain thresholds are associated with, but does not predispose for, low back pain

Authors: Søren O’Neill, Per Kjær, Thomas Graven-Nielsen, Claus Manniche, Lars Arendt-Nielsen

Published in: European Spine Journal | Issue 12/2011

Login to get access

Abstract

Chronic pain is often associated with hyperalgesia in cross-sectional studies. In the present study, a random cohort of 40-year-old individuals (n = 264) from the general population was assessed for low back pain (LBP) status and pressure pain threshold (PPT), with follow-up assessment 4 and 8 years later. Low PPT at baseline as a potential risk factor for the development of LBP was investigated longitudinally and the association between LBP and hyperalgesia was studied cross-sectionally at baseline and 8-year follow-up. Generalized (p  < 0.03) and localized pressure hyperalgesia (p < 0.02) was found in participants with long-lasting LBP, but not with recent LBP (p > 0.08). Of the participants without recent or long-lasting LBP, those with a low PPT at baseline (lower 10% percentile) had no increased risk of developing LBP (p > 0.05). The findings indicate that PPT decreases as a consequence of long-lasting pain, whereas a low PPT seems not to constitute a separate risk factor for the development of LBP.
Appendix
Available only for authorised users
Literature
1.
go back to reference Arendt-Nielsen L, Yarnitsky D (2009) Experimental and clinical applications of quantitative sensory testing applied to skin, muscles and viscera. J Pain 10(6):556–572PubMedCrossRef Arendt-Nielsen L, Yarnitsky D (2009) Experimental and clinical applications of quantitative sensory testing applied to skin, muscles and viscera. J Pain 10(6):556–572PubMedCrossRef
2.
go back to reference Bakker EWP, Verhagen AP, van Trijffel E, Lucas C, Koes BW (2009) Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine (Philadelphia, PA, 1976) 34(8):E281–E293CrossRef Bakker EWP, Verhagen AP, van Trijffel E, Lucas C, Koes BW (2009) Spinal mechanical load as a risk factor for low back pain: a systematic review of prospective cohort studies. Spine (Philadelphia, PA, 1976) 34(8):E281–E293CrossRef
3.
go back to reference Buchgreitz L, Lyngberg AC, Bendtsen L, Jensen R (2008) Increased pain sensitivity is not a risk factor but a consequence of frequent headache: a population-based follow-up study. Pain 137(3):623–630PubMedCrossRef Buchgreitz L, Lyngberg AC, Bendtsen L, Jensen R (2008) Increased pain sensitivity is not a risk factor but a consequence of frequent headache: a population-based follow-up study. Pain 137(3):623–630PubMedCrossRef
4.
go back to reference Cherkin DC, Deyo RA, Street JH, Barlow W (1996) Predicting poor outcomes for back pain seen in primary care using patients’ own criteria. Spine (Philadelphia, PA, 1976) 21(24):2900–2907CrossRef Cherkin DC, Deyo RA, Street JH, Barlow W (1996) Predicting poor outcomes for back pain seen in primary care using patients’ own criteria. Spine (Philadelphia, PA, 1976) 21(24):2900–2907CrossRef
5.
go back to reference Clauw D, Williams D, Lauerman W, Dahlman M, Aslami A, Nachemson A, Kobrine A, Wiesel S (1999) Pain sensitivity as a correlate of clinical status in individuals with chronic low back pain. Spine 24(19):2035–2041PubMedCrossRef Clauw D, Williams D, Lauerman W, Dahlman M, Aslami A, Nachemson A, Kobrine A, Wiesel S (1999) Pain sensitivity as a correlate of clinical status in individuals with chronic low back pain. Spine 24(19):2035–2041PubMedCrossRef
6.
go back to reference Dagenais S, Caro J, Haldeman S (2008) A systematic review of low back pain cost of illness studies in the united states and internationally. Spine J 8(1):8–20PubMedCrossRef Dagenais S, Caro J, Haldeman S (2008) A systematic review of low back pain cost of illness studies in the united states and internationally. Spine J 8(1):8–20PubMedCrossRef
7.
go back to reference Giesecke T, Gracely R, Grant M, Nachemson A, Petzke F, Williams D, Clauw D (2004) Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis Rheum 50(2):613–623PubMedCrossRef Giesecke T, Gracely R, Grant M, Nachemson A, Petzke F, Williams D, Clauw D (2004) Evidence of augmented central pain processing in idiopathic chronic low back pain. Arthritis Rheum 50(2):613–623PubMedCrossRef
8.
go back to reference Graven-Nielsen T, Arendt-Nielsen L (2010) Assessment of mechanisms in localized and widespread musculoskeletal pain. Nat Rev Rheumatol 6(10):599–606PubMedCrossRef Graven-Nielsen T, Arendt-Nielsen L (2010) Assessment of mechanisms in localized and widespread musculoskeletal pain. Nat Rev Rheumatol 6(10):599–606PubMedCrossRef
9.
go back to reference Hartvigsen J, Bakketeig LS, Leboeuf-Yde C, Engberg M, Lauritzen T (2001) The association between physical workload and low back pain clouded by the “healthy worker” effect: population-based cross-sectional and 5-year prospective questionnaire study. Spine (Philadelphia, PA, 1976) 26(16):1788–1792CrossRef Hartvigsen J, Bakketeig LS, Leboeuf-Yde C, Engberg M, Lauritzen T (2001) The association between physical workload and low back pain clouded by the “healthy worker” effect: population-based cross-sectional and 5-year prospective questionnaire study. Spine (Philadelphia, PA, 1976) 26(16):1788–1792CrossRef
10.
go back to reference Hestbaek L, Leboeuf-Yde C, Kyvik KO, Vach W, Russell MB, Skadhauge L, Svendsen A, Manniche C (2004) Comorbidity with low back pain: a cross-sectional population-based survey of 12- to 22-year-olds. Spine (Philadelphia, PA, 1976) 29(13):1483–1491CrossRef Hestbaek L, Leboeuf-Yde C, Kyvik KO, Vach W, Russell MB, Skadhauge L, Svendsen A, Manniche C (2004) Comorbidity with low back pain: a cross-sectional population-based survey of 12- to 22-year-olds. Spine (Philadelphia, PA, 1976) 29(13):1483–1491CrossRef
11.
go back to reference Hestbaek L, Leboeuf-Yde C, Manniche C (2003) Is low back pain part of a general health pattern or is it a separate and distinctive entity? A critical literature review of comorbidity with low back pain. J Manipul Physiol Ther 26(4):243–252CrossRef Hestbaek L, Leboeuf-Yde C, Manniche C (2003) Is low back pain part of a general health pattern or is it a separate and distinctive entity? A critical literature review of comorbidity with low back pain. J Manipul Physiol Ther 26(4):243–252CrossRef
12.
go back to reference Hestbaek L, Leboeuf-Yde C, Manniche C (2003) Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J 12(2):149–165PubMed Hestbaek L, Leboeuf-Yde C, Manniche C (2003) Low back pain: what is the long-term course? A review of studies of general patient populations. Eur Spine J 12(2):149–165PubMed
13.
go back to reference Hoogendoorn WE, van Poppel MN, Bongers PM, Koes BW, Bouter LM (2000) Systematic review of psychosocial factors at work and private life as risk factors for back pain. Spine (Philadelphia, PA, 1976) 25(16):2114–2125CrossRef Hoogendoorn WE, van Poppel MN, Bongers PM, Koes BW, Bouter LM (2000) Systematic review of psychosocial factors at work and private life as risk factors for back pain. Spine (Philadelphia, PA, 1976) 25(16):2114–2125CrossRef
14.
go back to reference Hüppe A, Brockow T, Raspe H (2004) Chronic widespread pain and tender points in low back pain: a population-based study. Z Rheumatol 63(1):76–83PubMedCrossRef Hüppe A, Brockow T, Raspe H (2004) Chronic widespread pain and tender points in low back pain: a population-based study. Z Rheumatol 63(1):76–83PubMedCrossRef
15.
go back to reference Jensen OK, Nielsen CV, Stengaard-Pedersen K (2010) Low back pain may be caused by disturbed pain regulation: a cross-sectional study in low back pain patients using tender point examination. Eur J Pain 14(5):514–522PubMedCrossRef Jensen OK, Nielsen CV, Stengaard-Pedersen K (2010) Low back pain may be caused by disturbed pain regulation: a cross-sectional study in low back pain patients using tender point examination. Eur J Pain 14(5):514–522PubMedCrossRef
16.
go back to reference Jensen TS, Kjaer P, Korsholm L, Bendix T, Sorensen JS, Manniche C, Leboeuf-Yde C (2010) Predictors of new vertebral endplate signal (modic) changes in the general population. Eur Spine J 19(1):129–135PubMedCrossRef Jensen TS, Kjaer P, Korsholm L, Bendix T, Sorensen JS, Manniche C, Leboeuf-Yde C (2010) Predictors of new vertebral endplate signal (modic) changes in the general population. Eur Spine J 19(1):129–135PubMedCrossRef
17.
go back to reference Kjaer P, Leboeuf-Yde C, Korsholm L, Sorensen JS, Bendix T (2005) Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine 30(10):1173–1180PubMedCrossRef Kjaer P, Leboeuf-Yde C, Korsholm L, Sorensen JS, Bendix T (2005) Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine 30(10):1173–1180PubMedCrossRef
18.
go back to reference Korff MV, Saunders K (1996) The course of back pain in primary care. Spine (Philadelphia, PA, 1976) 21(24):2833–2837CrossRef Korff MV, Saunders K (1996) The course of back pain in primary care. Spine (Philadelphia, PA, 1976) 21(24):2833–2837CrossRef
19.
go back to reference Kosek E, Ordeberg G (2000) Abnormalities of somatosensory perception in patients with painful osteoarthritis normalize following successful treatment. Eur J Pain 4(3):229–238PubMedCrossRef Kosek E, Ordeberg G (2000) Abnormalities of somatosensory perception in patients with painful osteoarthritis normalize following successful treatment. Eur J Pain 4(3):229–238PubMedCrossRef
20.
go back to reference Linton SJ (2000) A review of psychological risk factors in back and neck pain. Spine (Philadelphia, PA, 1976) 25(9):1148–1156CrossRef Linton SJ (2000) A review of psychological risk factors in back and neck pain. Spine (Philadelphia, PA, 1976) 25(9):1148–1156CrossRef
21.
go back to reference McIntosh G, Hall H, Boyle C (2006) Contribution of nonspinal comorbidity to low back pain outcomes. Clin J Pain 22(9):765–769PubMedCrossRef McIntosh G, Hall H, Boyle C (2006) Contribution of nonspinal comorbidity to low back pain outcomes. Clin J Pain 22(9):765–769PubMedCrossRef
22.
go back to reference O’Neill S, Manniche C, Graven-Nielsen T, Arendt-Nielsen L (2007) Generalized deep-tissue hyperalgesia in patients with chronic low-back pain. Eur J Pain 11(4):415–420PubMedCrossRef O’Neill S, Manniche C, Graven-Nielsen T, Arendt-Nielsen L (2007) Generalized deep-tissue hyperalgesia in patients with chronic low-back pain. Eur J Pain 11(4):415–420PubMedCrossRef
23.
go back to reference Pincus T, Burton AK, Vogel S, Field AP (2002) A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine (Philadelphia, PA, 1976) 27(5):E109–E120CrossRef Pincus T, Burton AK, Vogel S, Field AP (2002) A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine (Philadelphia, PA, 1976) 27(5):E109–E120CrossRef
24.
go back to reference Rolke R, Baron R, Maier C, Tölle TR, Treede RD, Beyer A, Binder A, Birbaumer N, Birklein F, Böteför IC, Braune S, Flor H, Huge V, Klug R, Landwehrmeyer GB, Magerl W, Maihöfner C, Rolko C, Schaub C, Scherens A, Sprenger T, Valet M, Wasserka B (2006) Quantitative sensory testing in the german research network on neuropathic pain (dfns): standardized protocol and reference values. Pain 123(3):231–243PubMedCrossRef Rolke R, Baron R, Maier C, Tölle TR, Treede RD, Beyer A, Binder A, Birbaumer N, Birklein F, Böteför IC, Braune S, Flor H, Huge V, Klug R, Landwehrmeyer GB, Magerl W, Maihöfner C, Rolko C, Schaub C, Scherens A, Sprenger T, Valet M, Wasserka B (2006) Quantitative sensory testing in the german research network on neuropathic pain (dfns): standardized protocol and reference values. Pain 123(3):231–243PubMedCrossRef
25.
go back to reference Schneider S, Mohnen SM, Schiltenwolf M, Rau C (2007) Comorbidity of low back pain: representative outcomes of a national health study in the federal republic of Germany. Eur J Pain 11(4):387–397PubMedCrossRef Schneider S, Mohnen SM, Schiltenwolf M, Rau C (2007) Comorbidity of low back pain: representative outcomes of a national health study in the federal republic of Germany. Eur J Pain 11(4):387–397PubMedCrossRef
26.
go back to reference Staud R, Nagel S, Robinson ME, Price DD(2009) Enhanced central pain processing of fibromyalgia patients is maintained by muscle afferent input: a randomized, double-blind, placebo-controlled study. Pain 145(1–2):96–104PubMedCrossRef Staud R, Nagel S, Robinson ME, Price DD(2009) Enhanced central pain processing of fibromyalgia patients is maintained by muscle afferent input: a randomized, double-blind, placebo-controlled study. Pain 145(1–2):96–104PubMedCrossRef
Metadata
Title
Low pressure pain thresholds are associated with, but does not predispose for, low back pain
Authors
Søren O’Neill
Per Kjær
Thomas Graven-Nielsen
Claus Manniche
Lars Arendt-Nielsen
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 12/2011
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-011-1796-4

Other articles of this Issue 12/2011

European Spine Journal 12/2011 Go to the issue