• Isabelle Myriam Larsen
  • Mette Mebus Laustsen
4. Term, Master of Pain Science and Multidisciplinary Pain (Continuing Education) (Continuing Education Programme (Master))
Background: Quantitative sensory tests (QST) have shown changes in pain sensitivity in patients with chronic low back pain (cLBP). Despite increasing evidence about serious side effects on long-term opioid use, including opioid induced hyperalgesia (OIH), the subscription of opioids for cLBP has increased dramatically.
Aim: This study investigates if opioid treatment in cLBP patients leads to changes in pain sensitivity.
Study design: A gender and age matched case-control study.
Method: QST measurements were performed by cuff algometry, on the lower leg to assess pressure pain threshold (cPPT), pressure pain tolerance (cPTT) and temporal summation of pain (TSP) in three groups (27 cLBP patients on opioid treatment, 27 cLBP patients on non-opioids and 27 healthy controls (HC)). Demographic data, clinical pain characteristics and psychological parameters are collected for both patient groups, by questionnaires.
Results: cLBP patients in opioid treatment have lower cPTT compared to HC (P = 0,031). Both patient groups have significant higher pain scores measured by visual analog scale (VAS) at pain tolerance (VAScPTT) (P = 0,005) and significant facilitated TSP compared with HC (P ˂ 0,001). No difference is shown for cPPT between the patient groups and HC. There was no significant difference between the patient groups regarding experimental pain sensitivity parameters, clinical pain characteristics or psychological parameters.
Conclusion: Despite the finding that demonstrates reduced pain tolerance between opioid treated patients and healthy controls, this study showed no difference in pain sensitivity in cLBP patients on opioid treatment compared to cLBP on non-opioid treatment. Both groups of cLBP patients showed facilitated TSP compared to HC.
Keywords: Chronic low back pain, pain sensitivity, temporal summation of pain, cuff algometry, opioid induced hyperalgesia.
Publication date17 May 2016
Number of pages29
ID: 233530213