Dr Jacqui Clark
Physiotherapist, The Physio Shed, Tauranga, NZ
Jacqui Clark PhD, Jo Nijs PhD, Gillian Yeowell PhD, Paul Holmes PhD, Peter Goodwin PhD,
Introduction: This 40-minute presentation will outline a series of new studies from Europe investigating relationships between trait sensory profiles, trait anxiety-related personality types and the extent of central sensitisation (CS) symptoms in individuals with non-specific chronic low back pain (NSCLBP). CS is a pain mechanism common to many chronic musculoskeletal pain conditions, the aetiology of which remains unclear.
Aims: The overall objectives of the study series were to 1) identify four trait sensory profiles, trait anxiety and four personality types, 2) investigate the relationships between these trait characteristics and the extent of CS symptoms; and 3) explore the context of pre-morbid lived experiences in which CS pain developed.
Methods: Mixed methods using cross-sectional observational studies across 3 countries and a qualitative study using semi-structured interviews.
Results: In a NSCLBP population with CS pain significant relationships exist between extremes of trait sensory hyper- and hypo-sensitivity with a passive adaptive response, defensive high anxious personality type and the extent of CS symptoms. Furthermore, themes of sensitivity, developmental learning differences, trauma and personal characteristics of low confidence and control highlighted the context in which CS pain developed.
Conclusions: Pre-morbid contexts and specific trait characteristics may lead to heightened physiological arousal to stressors, and a personality type-dependent response based on attention towards, and interpretation for, threat-related stimuli, in people with NSCLBP. Understanding sensitivity-related characteristics and the nature of individual personality types in people with NSCLBP may lead to the development of appropriate clinical management strategies to reduce the impact of CS pain.
References: Nijs, J., et al., Low back pain: guidelines for the clinical classification of predominant neuropathic, nociceptive, or central sensitization pain. Pain Physician, 2015. 18(3): p. E333-46.Clark, J., et al., What Are the Predictors of Altered Central Pain Modulation in Chronic Musculoskeletal Pain Populations? A Systematic Review. Pain Physician, 2017. 20(6): p. 487-500.