Background: People with chronic low back pain (LBP) typically have increased pain sensitivity compared to healthy controls, however its unknown if pain sensitivity differs based on LBP trajectory at baseline or after manual therapy interventions. We aimed to compare baseline pressure pain threshold (PPT) and temporal summation (TS) between people without LBP, with episodic LBP, and with persistent LBP, and to compare changes over time in PPT and TS after a lumbar spinal manipulation or sham manipulation in those with LBP.
Methods: Participants were aged 18–59, with or without LBP. Those with LBP were categorised as having either episodic or persistent LBP. PPT and TS were tested at baseline. LBP participants then received a lumbar spinal manipulation or sham, after which PPT and TS were re-tested three times over 30 min. Generalised linear mixed models were used to analyse data.
Results: One hundred participants (49 female) were included and analysed. There were 20 non-LBP participants (mean age 31 yrs), 23 episodic LBP (mean age 35 yrs), and 57 persistent LBP (mean age 37 yrs). There were no significant differences in PPT or TS between groups at baseline. There was a non-significant pattern of lower PPT (higher sensitivity) from the non-LBP group to the persistent LBP group at baseline, and high variability. Changes in PPT and TS after the interventions did not differ between the two LBP groups.
Discussion: We found no differences between people with no LBP, episodic LBP, or persistent LBP in baseline PPT or TS. Changes in PPT and TS following a lumbar manual therapy intervention do not appear to differ between LBP trajectories.
The trial was prospectively registered with ANZCTR (ACTRN12617001094369).
Author keywords: Low back pain —Trajectories — Quantitative sensory testing — Spinal manipulation — Pressure pain threshold, temporal summation — Sensitization — Sensitisation — Hyperalgesia
Author affiliations: SLA, AJ, CL-Y, SJE, BFW: College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia; CL-Y: Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
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