Predicting transition from acute to chronic low back pain with quantitative sensory tests - a prospective cohort study in the primary care setting

Müller, M; Curatolo, M; Limacher, A; Neziri, A; Treichel, F; Battaglia, M; Arendt-Nielsen, L; Jüni, P (2019). Predicting transition from acute to chronic low back pain with quantitative sensory tests - a prospective cohort study in the primary care setting. European journal of pain, 23(5), pp. 894-907. Wiley-Blackwell 10.1002/ejp.1356

[img] Text
Mueller EurJPain 2018.pdf - Accepted Version
Restricted to registered users only until 29 December 2019.
Available under License Publisher holds Copyright.

Download (521kB) | Request a copy
[img] Text
Müller EurJPain 2019.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (748kB) | Request a copy

BACKGROUND It would be desirable to identify patients with acute low back pain who are at high risk for transition to chronic pain early in the course of their disease. This would enable early preventive or therapeutic interventions. Patients with chronic low back pain (CLBP) display signs of central hypersensitivity. This may contribute to the transition to CLBP. We tested the hypothesis that central hypersensitivity as assessed by quantitative sensory tests predicts transition to CLBP. METHODS We performed a prospective cohort study in 130 patients with acute low back pain recruited in a primary care setting to determine the ability of 14 tests using electrical, pressure and temperature stimulation to predict transition to CLBP after six months. We assessed the association of tests with transition to CLBP in multivariable analyses adjusted for socio-demographic, psychological and clinical characteristics, quantified the performance of tests using receiver operating characteristics (ROC) curves, and calculated likelihood ratios for different cut-off values for most promising tests. RESULTS None of the evaluated tests showed a statistically significant or clinically relevant ability to predict the transition to CLBP, with 95% CI of crude and adjusted associations of all tests including one as measure of no association. Corresponding estimates of areas under the ROC curves were below 0.5 and none of the 95% CI crossed the pre-specified boundary of clinical relevance set at 0.70. CONCLUSIONS We found no evidence to support a clinically relevant ability of current quantitative sensory tests to predict the transition from acute to CLBP. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Endometriose und gynäkologische Onkologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Endometriose und gynäkologische Onkologie

UniBE Contributor:

Müller, Monika; Curatolo, Michele; Limacher, Andreas; Neziri, Alban Y. and Treichel, Fabienne

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1090-3801

Publisher:

Wiley-Blackwell

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

17 Jan 2019 13:37

Last Modified:

31 Jul 2019 11:14

Publisher DOI:

10.1002/ejp.1356

PubMed ID:

30592349

Uncontrolled Keywords:

Central hypersensitivity, Chronic low back pain, Prognosis Quantitative Sensory Tests

BORIS DOI:

10.7892/boris.123519

URI:

https://boris.unibe.ch/id/eprint/123519

Actions (login required)

Edit item Edit item
Provide Feedback