Pain Mechanisms in Adolescent Females with Chronic Low Back Pain Compared with Healthy Controls

Laursen, Fridel ; Harring, Stine Ibsen ; McGirr, Katherine Anne

4. term

Clinical Science and Technology, Master

2015

2015-06-03

66

Baggrund: Kroniske lændesmerter (CLBP) påvirkes af biologiske, psykologiske og sociale faktorer. Hos voksne ses ofte øget følsomhed i nervesystemet (perifer og central sensibilisering). Hos unge ved man mindre om disse mekanismer, muskelspænding og smertekatastrofering (tendens til at bekymre sig og forvente det værste om smerte). Metode: 33 unge i alderen 15–19 år (alle kvinder; CLBP n = 22) deltog. Håndholdt og computerstyret trykalgometri blev brugt til at undersøge lokal og udbredt hyperalgesi (forhøjet smertefølsomhed). Den computerstyrede test vurderede også temporal summation (om gentagne tryk føles mere smertefulde) og conditioned pain modulation (kroppens evne til at dæmpe smerte efter en anden smertepåvirkning). En myotonometer målte muskeltonus. Pain Catastrophizing Scale (PCS) vurderede katastrofetænkning om smerte. Resultater: CLBP-gruppen havde lavere tryksmertegrænser end kontrolgruppen, dvs. de følte smerte ved lavere tryk. Muskeltonus var signifikant højere i venstre m. gluteus medius i CLBP-gruppen end i kontrolgruppen. Temporal summation og conditioned pain modulation var til stede i begge grupper, uden signifikante forskelle mellem dem. PCS-scorer var signifikant højere i CLBP-gruppen, men der var ingen signifikant sammenhæng mellem PCS og temporal summation eller conditioned pain modulation. Konklusion: Unge kvinder med CLBP deler nogle smertekarakteristika med voksne, herunder perifer sensibilisering og udbredt hyperalgesi. Der er behov for mere forskning i, hvordan smertekatastrofering kan påvirke temporal summation og conditioned pain modulation. Øget muskeltonus i venstre gluteus medius kan være forbundet med CLBP og kan være en risikofaktor, hvilket bør undersøges i fremtidige studier.

Background: Chronic low back pain (CLBP) is shaped by biological, psychological, and social factors. In adults, pain mechanisms often include increased nervous system sensitivity (peripheral and central sensitization). Much less is known about these mechanisms, muscle tension, and pain catastrophizing (a tendency to worry and expect the worst about pain) in adolescents. Methods: Thirty-three females aged 15–19 years (CLBP n = 22) participated. Handheld and computerized pressure algometry were used to assess local and widespread hyperalgesia (heightened pain sensitivity). The computerized test also measured temporal summation (whether repeated pressure becomes increasingly painful) and conditioned pain modulation (the body’s ability to dampen pain after another painful stimulus). A myotonometer measured muscle tone, and the Pain Catastrophizing Scale (PCS) assessed catastrophic thinking about pain. Results: Compared with controls, the CLBP group had lower pressure pain thresholds, meaning they felt pain at lower pressure. They also had significantly higher muscle tone in the left gluteus medius muscle. Temporal summation and conditioned pain modulation were present in both groups, with no significant differences between them. PCS scores were significantly higher in the CLBP group, but PCS was not significantly related to temporal summation or conditioned pain modulation. Conclusion: Adolescent females with CLBP share pain features seen in adults, including peripheral sensitization and widespread hyperalgesia. Further research is needed to clarify how pain catastrophizing may influence temporal summation and conditioned pain modulation. Elevated tone in the left gluteus medius may be linked to CLBP and could be a risk factor, which should be tested in future studies.

[This abstract was generated with the help of AI]

Kronisk Smerte ; Unge ; Ryg

Download
View record in AAU Student Projects