Lifestyle Factors and Psychological Factors Are Associated with Central Pain Processing in Service Members with Persistent Low-back Pain: A Cross-sectional Exploratory Study

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2023 Dec 22

PMID 38134068

Authors

Julia M Prent

Peter van der Wurff

Gwendolyne G M Scholten-Peeters

Affiliations

Soon will be listed here.

Abstract

Persistent low-back pain (LBP) is highly prevalent in the military. Altered central pain processing is one of the mechanisms found to underlie persistent LBP. Our aim was to explore which factors are associated with altered pain processing in Dutch service members with persistent LBP. This knowledge may guide clinicians in what factors to address in the treatment of dysfunctional pain processing in service members with persistent LBP. Twenty-one service members with persistent LBP (mean age 34.0 years, 18 males) were included in this cross-sectional exploratory study. Participants completed questionnaires regarding lifestyle and psychological factors. Altered central pain processing was measured by temporal summation of pain to examine the function of the pain facilitatory system and by conditioned pain modulation to examine the pain inhibitory function. Univariable and multivariable linear regression analyses were performed. A higher local temporal summation of pain was associated with a longer sitting time, a higher level of physical activity and a higher level of pain catastrophizing. A higher local conditioned pain modulation was associated with a higher level of pain catastrophizing, anxiety and depression symptoms, and with a lower sleep quality. A higher remote conditioned pain modulation effect was associated with a higher level of physical activity, a higher body mass index and a shorter sitting time. This study succeeded in identifying lifestyle and psychological factors associated with altered pain processing in service members with persistent LBP. Prospective studies are needed to examine causality in these relationships.

Citing Articles

Association between pain intensity and body composition in adults with chronic non-specific low back pain: A systematic review and meta-analysis.

Liechti M, Menegon M, Schurz A, Taeymans J, Baur H, Clijsen R Obes Rev. 2024; 26(4):e13875.

PMID: 39622629 PMC: 11884966. DOI: 10.1111/obr.13875.

References

Owens M, Bulls H, Trost Z, Terry S, Gossett E, Wesson-Sides K . An Examination of Pain Catastrophizing and Endogenous Pain Modulatory Processes in Adults with Chronic Low Back Pain. Pain Med. 2016; 17(8):1452-64. PMC: 6398918. DOI: 10.1093/pm/pnv074. View

Rolke R, Baron R, Maier C, Tolle T, Treede -, Beyer A . Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values. Pain. 2006; 123(3):231-243. DOI: 10.1016/j.pain.2006.01.041. View

Farrar J, Young Jr J, Lamoreaux L, Werth J, Poole M . Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001; 94(2):149-158. DOI: 10.1016/S0304-3959(01)00349-9. View

van Griensven H, Schmid A, Trendafilova T, Low M . Central Sensitization in Musculoskeletal Pain: Lost in Translation?. J Orthop Sports Phys Ther. 2020; 50(11):592-596. DOI: 10.2519/jospt.2020.0610. View

Neelapala Y, Bhagat M, Frey-Law L . Conditioned Pain Modulation in Chronic Low Back Pain: A Systematic Review of Literature. Clin J Pain. 2019; 36(2):135-141. DOI: 10.1097/AJP.0000000000000778. View

Saunders J, Aasland O, Babor T, De la Fuente J, Grant M . Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993; 88(6):791-804. DOI: 10.1111/j.1360-0443.1993.tb02093.x. View

Graeff P, Itter A, Wach K, Ruscheweyh R . Inter-Individual Differences Explain More Variance in Conditioned Pain Modulation Than Age, Sex and Conditioning Stimulus Intensity Combined. Brain Sci. 2021; 11(9). PMC: 8468738. DOI: 10.3390/brainsci11091186. View

Mousavi S, van Dieen J, Anderson D . Low back pain: Moving toward mechanism-based management. Clin Biomech (Bristol). 2018; 61:190-191. DOI: 10.1016/j.clinbiomech.2018.12.010. View

Naugle K, Ohlman T, Naugle K, Riley Z, Keith N . Physical activity behavior predicts endogenous pain modulation in older adults. Pain. 2017; 158(3):383-390. DOI: 10.1097/j.pain.0000000000000769. View

10.

Sluka K, Frey-Law L, Hoeger Bement M . Exercise-induced pain and analgesia? Underlying mechanisms and clinical translation. Pain. 2018; 159 Suppl 1:S91-S97. PMC: 6097240. DOI: 10.1097/j.pain.0000000000001235. View

11.

Gracely R, Geisser M, Giesecke T, Grant M, Petzke F, Williams D . Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain. 2004; 127(Pt 4):835-43. DOI: 10.1093/brain/awh098. View

12.

Starkweather A, Heineman A, Storey S, Rubia G, Lyon D, Greenspan J . Methods to measure peripheral and central sensitization using quantitative sensory testing: A focus on individuals with low back pain. Appl Nurs Res. 2016; 29:237-41. DOI: 10.1016/j.apnr.2015.03.013. View

13.

Maher C, Underwood M, Buchbinder R . Non-specific low back pain. Lancet. 2016; 389(10070):736-747. DOI: 10.1016/S0140-6736(16)30970-9. View

14.

Stolzman S, Hoeger Bement M . Lean mass predicts conditioned pain modulation in adolescents across weight status. Eur J Pain. 2016; 20(6):967-76. DOI: 10.1002/ejp.821. View

15.

Toblin R, Quartana P, Riviere L, Walper K, Hoge C . Chronic pain and opioid use in US soldiers after combat deployment. JAMA Intern Med. 2014; 174(8):1400-1. DOI: 10.1001/jamainternmed.2014.2726. View

16.

Ramchand R, Rudavsky R, Grant S, Tanielian T, Jaycox L . Prevalence of, risk factors for, and consequences of posttraumatic stress disorder and other mental health problems in military populations deployed to Iraq and Afghanistan. Curr Psychiatry Rep. 2015; 17(5):37. DOI: 10.1007/s11920-015-0575-z. View

17.

Ramaswamy S, Wodehouse T . Conditioned pain modulation-A comprehensive review. Neurophysiol Clin. 2020; 51(3):197-208. DOI: 10.1016/j.neucli.2020.11.002. View

18.

Naugle K, Riley 3rd J . Self-reported physical activity predicts pain inhibitory and facilitatory function. Med Sci Sports Exerc. 2013; 46(3):622-9. PMC: 3906218. DOI: 10.1249/MSS.0b013e3182a69cf1. View

19.

Plinsinga M, Vuvan V, Maclachlan L, Klyne D, Graven-Nielsen T, Vicenzino B . Pain-related cognitions and emotional distress are not associated with conditioned pain modulation: an explorative analysis of 1142 participants with acute, subacute, and chronic pain. Pain. 2023; 164(7):1593-1599. DOI: 10.1097/j.pain.0000000000002864. View

20.

Schoneboom B, Perry S, Barnhill W, Giordano N, Wiltse Nicely K, Polomano R . Answering the call to address chronic pain in military service members and veterans: Progress in improving pain care and restoring health. Nurs Outlook. 2016; 64(5):459-84. DOI: 10.1016/j.outlook.2016.05.010. View