Articles: low-back-pain.
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This study set out to investigate in a population-based longitudinal cohort, whether chronification of back pain (BP) is related to structural gray matter changes in corticolimbic brain structures. Gray matter volume (GMV) was measured in participants with chronic BP (CBP, n = 168) and controls without chronic pain (n = 323) at 2 time points with an interval of 7 years (baseline t1, follow-up t2). Over this time period, participants with CBP showed an increase of GMV in the left ventral striatum, whereas controls showed a decrease. ⋯ Those with emerging CBP had less GMV in the right entorhinal area, right amygdala, and left medial frontal cortex. Additional variables differing between those who had BP at t1 and later developed CBP or not were pain intensity, body mass index, and depression score. In sum, these findings are in accordance with the notion that limbic brain properties are both predisposing risk factors and drivers of brain reorganization during the development of CBP.
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Randomized Controlled Trial
Combined Transcranial Direct Current Stimulation and Pain Neuroscience Education for Chronic Low Back Pain: A Randomized Controlled Trial.
Priming the neural circuity likely targeted by pain neuroscience education (PNE), using transcranial direct current stimulation (tDCS) may enhance the efficacy of PNE. The aim of this study was to compare the effects of active tDCS + PNE to sham tDCS + PNE on measures of pain, pain behaviors, and cognitive function in participants with chronic low back pain (CLBP) and high pain catastrophizing. ⋯ NCT05571215, The Effect of Combining Pain Neuroscience Education and Transcranial Direct Current Stimulation on Pain Catastrophizing, Kinesiophobia, and Pain in Patients With Chronic Low Back Pain, https://classic.clinicaltrials.gov/ct2/show/NCT05571215.
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Clinical Trial
Twelve-Month Clinical Trial Results of a Novel, Dorsal Horn Dendrite Stimulation Waveform for Chronic Neuropathic Low Back Pain.
The aim of this study was to evaluate the effectiveness and safety of a novel subperception spinal cord stimulation (SCS) waveform paradigm designed to target the dorsal horn dendrites for treating chronic neuropathic low back pain (LBP). The final 12-month results are reported here. ⋯ The Clinicaltrials.gov registration number for the study is ACTRN12618000647235 (anzctr.org.au).
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To translate and culturally adapt the Core Outcome Measures Index for the back (COMI-back) into Thai and to evaluate its psychometric properties in Thai-speaking patients with low back pain (LBP). ⋯ The Thai COMI-Back shows strong psychometric properties, making it suitable for clinical and research use in Thailand.
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In recent years, delayed elective care and growing waiting lists increasingly resulted in postponed surgeries for patients with chronic back and leg pain. ⋯ A novel triage tool was developed to identify patients with chronic back and leg pain for an early referral to SCS. This tool, evaluated for feasibility, reliability, and predictive accuracy, shows promise in reducing waiting times and improving patient selection. It can be a prelude to the further development of decision support for SCS and an acceleration in the care process for SCS candidates.