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Skorupska E, Jokiel M, Rychlik M, et al. Female Overrepresentation in Low Back-Related Leg Pain: A Retrospective Study of the Autonomic Response to a Minimally Invasive Procedure. J Pain Res. 2020;13:3427-3435doi: 10.2147/JPR.S282233.
Skorupska, E., Jokiel, M., Rychlik, M., Łochowski, R., & Kotwicka, M. (2020). Female Overrepresentation in Low Back-Related Leg Pain: A Retrospective Study of the Autonomic Response to a Minimally Invasive Procedure. Journal of pain research, 133427-3435. https://doi.org/10.2147/JPR.S282233
Skorupska, Elzbieta, et al. "Female Overrepresentation in Low Back-Related Leg Pain: A Retrospective Study of the Autonomic Response to a Minimally Invasive Procedure." Journal of pain research vol. 13 (2020): 3427-3435. doi: https://doi.org/10.2147/JPR.S282233
Skorupska E, Jokiel M, Rychlik M, Łochowski R, Kotwicka M. Female Overrepresentation in Low Back-Related Leg Pain: A Retrospective Study of the Autonomic Response to a Minimally Invasive Procedure. J Pain Res. 2020 Dec 18;13:3427-3435. doi: 10.2147/JPR.S282233. eCollection 2020. PMID: 33376388; PMCID: PMC7755343.
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J Pain Res. 2020 Dec 18;13:3427-3435. doi: 10.2147/JPR.S282233. eCollection 2020.

Female Overrepresentation in Low Back-Related Leg Pain: A Retrospective Study of the Autonomic Response to a Minimally Invasive Procedure.

Journal of pain research

Elzbieta Skorupska, Marta Jokiel, Michał Rychlik, Rafał Łochowski, Małgorzata Kotwicka

Affiliations

  1. Department of Physiotherapy, Poznan University of Medical Sciences, Poznan, Poland.
  2. Department of Orthopedics, Traumatology and Hand Surgery Poznan University of Medical Sciences, Poznan, Poland.
  3. Department of Virtual Engineering, Poznan University of Technology, Poznan, Poland.
  4. Department of Mathematics and Mathematical Economics, Warsaw School of Economics, Warsaw, Poland.
  5. Department of Cell Biology, Poznan University of Medical Sciences, Poznan, Poland.

PMID: 33376388 PMCID: PMC7755343 DOI: 10.2147/JPR.S282233

Abstract

BACKGROUND: The newly proposed low back pain treatment requires case classification according to the pain mechanism (nociceptive, neuropathic or nociplastic) to determine the most effective therapeutic approach. However, there is a lack of objective tools for distinguishing these pain mechanisms. The aim of the study was to identify which symptoms, signs, and standard diagnostic parameters would allow predicting the nociplastic pain (NP) subtype among low back leg pain (LBLP) patients.

METHODS: A retrospective analysis of an LBLP case-control study database was carried out. The presence of NP was assumed if the patient presented with myofascial pain syndrome (MPS) and developed a short-term intensive vasodilatation reaction in the perceived lower leg pain area after provocation by a minimally invasive procedure. Clinical data and standard LBLP diagnostic parameters were analyzed to classify patients as NP (+) vs NP (-). Next, to predict NP probability, logistic regression analysis and a diagnostic classification tree were constructed.

RESULTS: NP was confirmed in 43.75% of LBLP patients. Women represented 95.24% of all NP (+) patients. The diagnostic classification tree indicated that NP was highly probable if the LBLP subject was female and the result of a positive straight leg raise (SLR) test was lower than 45 degrees. If the SLR test result was greater than or equal to 45 degrees, a negative result on the Bragard test would have diagnostic value. This classification tree was approved to a certain extent in the logistic regression model (deviance residuals, min: -1.8519; 1Q: -0.5551; median: -0.1907; 3Q: 0.6565 and max: 2.1058) but should be verified in a larger group of subjects.

CONCLUSION: Female sex, but not clinical data or standard diagnostic parameters, is indicative of nociplastic pain in LBLP patients. More sophisticated statistical methods, based on directly measurable parameters, should be proposed to distinguish NP involvement in LBLP.

© 2020 Skorupska et al.

Keywords: central sensitization; low back pain; myofascial pain syndrome; nociplastic pain; thermovision

Conflict of interest statement

No significant financial support was provided for this work that could have influenced its outcome. The authors report no conflicts of interest in this work.

References

  1. Pain Physician. 2014 Sep-Oct;17(5):447-57 - PubMed
  2. Korean J Pain. 2011 Jun;24(2):100-4 - PubMed
  3. Childs Nerv Syst. 2003 Feb;19(2):82-5 - PubMed
  4. Curr Pain Headache Rep. 2003 Oct;7(5):355-61 - PubMed
  5. JAMA. 2000 Jul 5;284(1):79-84 - PubMed
  6. Best Pract Res Clin Rheumatol. 2019 Jun;33(3):101415 - PubMed
  7. Clin J Pain. 2019 Nov;35(11):869-879 - PubMed
  8. Clin J Pain. 2018 May;34(5):409-414 - PubMed
  9. Pain. 2017 Nov;158(11):2129-2136 - PubMed
  10. BMJ Open. 2020 Mar 8;10(3):e031592 - PubMed
  11. Man Ther. 2012 Aug;17(4):336-44 - PubMed
  12. J Biomech. 2017 Oct 3;63:55-60 - PubMed
  13. Biomed Res Int. 2015;2015:546497 - PubMed
  14. Pain Med. 2014 Jan;15(1):4-15 - PubMed
  15. Man Ther. 2009 Apr;14(2):222-30 - PubMed
  16. J Back Musculoskelet Rehabil. 2012;25(4):215-23 - PubMed
  17. BMC Complement Altern Med. 2015 Mar 20;15:72 - PubMed
  18. BMC Med Res Methodol. 2010 Jul 03;10:62 - PubMed
  19. Sleep. 2019 Feb 1;42(2): - PubMed
  20. Clin J Pain. 2001 Mar;17(1):11-9 - PubMed
  21. Curr Pain Headache Rep. 2009 Oct;13(5):376-8 - PubMed
  22. PM R. 2016 Nov;8(11):1055-1064 - PubMed
  23. Man Ther. 2012 Aug;17(4):352-7 - PubMed
  24. Br J Anaesth. 2013 Jul;111(1):52-8 - PubMed
  25. Obstet Gynecol Clin North Am. 1990 Dec;17(4):889-903 - PubMed
  26. Pain. 2011 Mar;152(3 Suppl):S2-15 - PubMed
  27. Curr Opin Neurol. 2009 Jun;22(3):254-61 - PubMed

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