Is central sensitization relevant in acute low back pain?
Is central sensitization relevant in acute low back pain?
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中枢敏化与急性腰痛有关吗？
DOI：
10.1002/ejp.2092
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Curatolo,Michele
中科院分区：
文献类型：
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作者：
Curatolo,Michele
在本期的《欧洲疼痛杂志》中，Chung等人的一项研究发现，与一组无疼痛的个体相比，急性腰痛患者没有中枢致敏的证据（Chang等人，2022年）。一个亚组的患者表现出的功能，中央敏化与压力和热刺激，以及缺乏条件性疼痛调制。然而，疼痛的严重程度和残疾没有这个亚组之间的差异，没有中枢致敏的功能。这些发现可能听起来令人惊讶，与我们目前对疼痛机制的认识形成鲜明对比。急性腰痛非常普遍，但在大多数情况下会消退。为什么下背痛在某些人身上得到解决，而在其他人身上却没有？尽管经过几十年的研究，这个问题仍然悬而未决。我们还不能确定可靠地解释长期疼痛的下背部结构性损伤。人口统计学、临床和心理社会特征可预测长期腰痛，但不能解释大部分变异性。
In this issue of the European Journal of Pain, a study by Chung et al. found no evidence for central sensitization in patients with acute low back pain, as compared with a group of pain-free individuals (Chang et al., 2022). A subgroup of patients displayed features of central sensitization with pressure and heat stimulation, as well as deficient conditioned pain modulation. However, pain severity and disability did not differ between this subgroup and the one that did not have features of central sensitization. These findings may sound surprising and in contrast with our current knowledge of mechanisms of pain.Acute low back pain is very prevalent, but resolves in most cases. Why does low back pain resolve in certain individuals, and not in other ones? This questions remains open despite decades of research. We have not been able to identify structural damages of the low back that reliably explain long-term pain. Demographic, clinical and psychosocial characteristics predict long-term low back pain, but do not explain a large proportion of the variability.