The Effect of Information on the Time Course of Pain During an Episode of Acute Experimentally Induced Low Back Pain—A Randomised Experiment

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-04-20 DOI:10.1002/ejp.70011

M. Travers, B. M. Wand, D. Hince, W. Gibson, S. Meldgaard Hansen, T. Sigurðsson, S. Sorensen, T. Skuli Palsson

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Abstract

Background

We compared the time course of pain intensity ratings between two groups who were given different information during an episode of acute experimentally induced LBP.

Methods

Fifty weight-training naive and pain-free people participated in this randomised clinical experiment. Immediately after performing a back exercise intended to cause delayed onset muscle soreness, one group was told that their muscles had been damaged and advised they needed to protect their back over the coming days. The other group's symptoms were described in terms of tissue sensitisation, and they were advised to keep moving.

The primary outcome was movement-evoked low back pain intensity measured using an 11-point numeric rating scale (NRS 0–10). Pain intensity was recorded at baseline, immediately after the intervention and then daily for 7 days. The method of generalised estimating equations (GEE) was used to estimate treatment effects for average daily pain.

Results

Movement-evoked pain intensity scores changed over time in both groups (main effect of time: χ^2(7) = 246.2, p < 0.001). However, the intervention did not affect movement-evoked pain intensity scores (main effect of group: χ^2(1) = 0.02, p < 0.895). The adjusted mean difference between the groups was only −0.05/10 (95% CI –0.72 to 0.63, p = 0.895) when averaged across all time points.

Conclusions

We simulated an episode of low back pain and found that information based on tissue sensitivity and advice to remain active did not improve pain compared to information referencing tissue damage and advice to rest and protect the back.

Significance Statement

Contemporary clinical guidelines and models of care recommend avoiding pathoanatomical diagnostic labels and encourage clinicians to advise patients to stay active during an episode of acute low back pain (LBP).

We simulated an episode of acute LBP and found that information based on tissue sensitivity and advice to remain active did not improve pain compared to information referencing tissue damage and advice to rest and protect the back. The results could be different if repeated in a clinical population.

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急性实验性腰痛发作时，信息对疼痛时间过程的影响——一个随机实验

背景我们比较了两组人在急性实验性腰痛发作期间获得不同信息后疼痛强度评级的时间过程。方法 50 名未参加过负重训练且无疼痛感的人参加了这项随机临床实验。一组人在进行了旨在引起迟发性肌肉酸痛的背部训练后，立即被告知他们的肌肉已经受损，并建议他们在未来几天内需要保护背部。另一组人的症状被描述为组织过敏，建议他们继续运动。主要结果是运动诱发的腰痛强度，采用 11 点数字评分量表（NRS 0-10）进行测量。疼痛强度在基线、干预后立即记录，然后在 7 天内每天记录。采用广义估计方程（GEE）的方法来估计平均每日疼痛的治疗效果。结果两组患者的运动诱发疼痛强度评分都随时间发生了变化（时间的主效应：χ^2(7) = 246.2, p < 0.001）。然而，干预并未影响运动诱发的疼痛强度评分（组别的主效应：χ^2(1) = 0.02，p < 0.895）。在所有时间点上的平均值为-0.05/10 (95% CI -0.72 to 0.63, p = 0.895)。结论我们模拟了一次腰背痛发作，发现基于组织敏感性的信息和保持活跃的建议与提及组织损伤的信息和休息及保护背部的建议相比，并不能改善疼痛。意义声明当代临床指南和护理模式建议避免病理解剖学诊断标签，并鼓励临床医生建议患者在急性腰背痛（LBP）发作期间保持活动。我们模拟了一次急性腰背痛的发作，发现基于组织敏感性的信息和保持活动的建议与参考组织损伤的信息和休息及保护背部的建议相比，并不能改善疼痛。如果在临床人群中重复使用，结果可能会有所不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.