Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations.

The potential to classify low back pain as being characterised by dominant nociceptive, neuropathic, or nociplastic mechanisms is a clinically relevant issue. Preliminary evidence suggests that these low back pain phenotypes might respond differently to treatments; however, more research must be done before making specific recommendations. Accordingly, the low back pain phenotyping (BACPAP) consortium was established as a group of 36 clinicians and researchers from 13 countries (five continents) and 29 institutions, to apply a modified Nominal Group Technique methodology to develop international and multidisciplinary consensus recommendations to provide guidance for identifying the dominant pain phenotype in patients with low back pain, and potentially adapt pain management strategies.

Nociplastic Pain Criteria or Recognition of Central Sensitization? Pain Phenotyping in the Past, Present and Future.

Recently, the International Association for the Study of Pain (IASP) released clinical criteria and a grading system for nociplastic pain affecting the musculoskeletal system. These criteria replaced the 2014 clinical criteria for predominant central sensitization (CS) pain and accounted for clinicians' need to identify (early) and correctly classify patients having chronic pain according to the pain phenotype. Still, clinicians and researchers can become confused by the multitude of terms and the variety of clinical criteria available.

Evaluating sensory profiles in nociplastic chronic low back pain: a cross-sectional validation study.

Background: Sensory profiles (SPs) may be useful in classifying patients based on sensory sensitivity and behavioral responses to stimuli to develop personalized treatments for nonspecific chronic low back pain (CLBP). The Adolescent/Adult Sensory Profile (AASP) identifies four sensitivity and behavioral response-related quadrants: Sensory Sensitive, Sensation Avoiding, Low Registration, and Sensation Seeking. It is an appropriate questionnaire for evaluating SPs; however, it has not been validated in CLBP.

Trait Sensitivity, Anxiety, and Personality Are Predictive of Central Sensitization Symptoms in Patients with Chronic Low Back Pain.

Background: Sensitivity-related trait characteristics involving physical and emotional sensitivities and high trait anxiety personality types have been observed in individuals with nonspecific chronic low back pain (NSCLBP). High trait sensitivity to sensory stimulation combined with interpretation biases based on personality type may contribute to the development of central sensitization (CS) symptoms. To date, there is limited research that has considered both sensitivity levels and personality type in NSCLBP with CS.

Prevalence of Extreme Trait Sensory Profiles and Personality Types in Nonspecific Chronic Low Back Pain with Predominant Central Sensitization: Secondary Analysis of an International Observational Study.

Background: Individuals with nonspecific chronic low back pain (NSCLBP) and central sensitization (CS) exhibit sensory hypersensitivity that may be related to pre-existing trait characteristics. Sensory profiles and trait anxiety-related characteristics have sensory sensitivity in common with CS.

Objectives: The objectives of this study were 1) to observe the prevalence of 4 personality types and extreme scores of 4 trait sensory profiles in people with NSCLBP and predominant CS; and 2) to compare these between 2 subgroups based on high and low self-reported CS symptoms.

Exploring the pre-morbid contexts in which central sensitisation developed in individuals with non-specific chronic low back pain. A qualitative study.

Background: Central sensitisation pain is a predominant mechanism in a proportion of individuals with non-specific chronic low back pain and is associated with poor outcomes. It is proposed that the pre-morbid experiences and contexts may be related to the development of central sensitisation.

Objectives: The objective of this study was to explore the pre-morbid experiences and personal characteristics of participants with central sensitisation pain from a non-specific chronic low back pain population.

Trait anxiety and sensory processing profile characteristics in patients with non-specific chronic low back pain and central sensitisation - A pilot observational study.

Introduction: People with non-specific chronic low back pain (NSCLBP) and central sensitisation (CS) exhibit sensory processing alterations, somatosensory hypersensitivity and differences in the brain's emotional networks. The concept that CS relates to pre-morbid trait sensory processing and anxiety characteristics is unknown. The aims of this pilot observational study were to test concept plausibility in a NSCLBP population with central sensitisation by investigating: 1) the range of Central Sensitisation Inventory scores, to determine the extent of symptoms of central sensitisation, 2) whether there are identifiable patient characteristics of trait anxiety and trait sensory profile differences; and 3) whether potential relationships exist between trait anxiety, trait sensory profiles and the extent of symptoms of central sensitisation.

In the spine or in the brain? Recent advances in pain neuroscience applied in the intervention for low back pain.

Conservative, surgical and pharmacological strategies for chronic low back pain (CLBP) management offer at best modest effect sizes in reducing pain and related disability, indicating a need for improvement. Such improvement may be derived from applying contemporary pain neuroscience to the management of CLBP. Current interventions for people with CLBP are often based entirely on a "biomedical" or "psychological" model without consideration of information concerning underlying pain mechanisms and contemporary pain neuroscience.

What Are the Predictors of Altered Central Pain Modulation in Chronic Musculoskeletal Pain Populations? A Systematic Review.

Background: Altered central pain modulation is the predominant pain mechanism in a proportion of chronic musculoskeletal pain disorders and is associated with poor outcomes. Although existing studies predict poor outcomes such as persistent pain and disability, to date there is little consensus on what factors specifically predict altered central pain modulation.

Objectives: To review the existing literature on the predictive factors specifically for altered central pain modulation in musculoskeletal pain populations.

Patient-centeredness in physiotherapy: What does it entail? A systematic review of qualitative studies.

Purpose: The literature review is aimed at examining and summarizing themes related to patient-centeredness identified in qualitative research from the perspectives of patients and physiotherapists. Following the review, a secondary aim was to synthesize the themes to construct a proposed conceptual framework for utilization within physiotherapy.

Methods: A systematic search of qualitative studies was conducted including all articles up to 2015 September.

Low back pain: guidelines for the clinical classification of predominant neuropathic, nociceptive, or central sensitization pain.

Background: Low back pain (LBP) is a heterogeneous disorder including patients with dominant nociceptive (e.g., myofascial low back pain), neuropathic (e.

Applying modern pain neuroscience in clinical practice: criteria for the classification of central sensitization pain.

Background: The awareness is growing that central sensitization is of prime importance for the assessment and management of chronic pain, but its classification is challenging clinically since no gold standard method of assessment exists.

Objectives: Designing the first set of classification criteria for the classification of central sensitization pain.

Methods: A body of evidence from original research papers was used by 18 pain experts from 7 different countries to design the first classification criteria for central sensitization pain.