Oral Presentation 51st International Society for the Study of the Lumbar Spine Annual Meeting 2025

Quantitative Sensory Testing in a Community Sample of Individuals with Chronic Low Back Pain (115631)

Michael Schneider 1 , Carol Greco 1 , Gwendolyn Sowa 1 , Nam Vo 1 , Paul Pilkonis 1 , Nathan Dodds 1 , Jessa Darwin 1 , Kevin Bell 1 , William Anderst 1 , Charity Moore 1 , Gina McKernan 1 , Ajay Wasan 1 , Amanda Acevedo 2 , Lan Yu 1 , Anthony Delitto 1 , Sara Piva 1 , John Jakicic 3
  1. University of Pittsburgh, Pittsburgh, PA, United States
  2. Behavioral Research Program, National Cancer Institute, Rockville, MD, USA
  3. Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, USA

Introduction: The University of Pittsburgh Mechanistic Research Center conducted a prospective, observational cohort study involving the phenotyping of over 1,000 participants with chronic low back pain (cLBP). The study is entitled, “Low Back Pain: Biological, Biomechanical, Behavioral Phenotypes (LB3P).” Quantitative Sensory Testing (QST) was conducted on these participants as part of the behavioral core of this project. This article reports on the results of the QST procedures performed at the initial in-person LB3P baseline visit. 

 Methods: A set of four4 QST procedures were administered to participants of the LB3P study at their baseline visit: 1) Pain pressure thresholds (PPT) over the site of lumbar pain and control site (trapezius) using an analog algometer; 2) Temporal summation (TS) over the site of lumbar pain and control site (forearm) using a Neuropen with a 40-gram monofilament: 3) Conditioned pain modulation (CPM) using a cold water (5°C) immersion tank; and 4) Cold water tolerance time. A subset of LB3P participants was excluded from the CPM and cold-water immersion procedures due to medical comorbidities such as cardio-vascular disease and diabetic neuropathy. 

 Results: The final cohort of QST participants was 1000612 adults (Mean age= 58.2; 62.8% female). Means and standard deviations (SD) were calculated from 3 trials of PPT and TS, 2 trials of CPM, and 1 trial of cold immersion time. TS was calculated by subtracting the numeric pain scores (0-10 scale) from the 10th and 1st pinpricks. CPM was calculated by subtracting the mean trapezius algometer readings during/after cold-water immersion from those derived during the baseline PPT procedure. The mean/SD of lumbar and trapezius PPTs were 4.6 (2.4) kg/cm2 and 4.4 (21.09) kg/cm2 respectively. The mean/SD of lumbar and forearm TS were 1.6 (2.0) and 1.32 (1.8). Lingering pain after the 10th pinprick (after-sensations) was reported by 169.3% and 195.6% of patients after a series of 10 pinpricks was applied to the site of lumbar pain and control site, respectively.  The cold-water tolerance test resulted in a bimodal distribution, 82% of participants had an average immersion time of 35 seconds and the remaining 18% reached the maximum immersion time of 180 seconds. The mean/SD of CPM was 0.9 (1.12) with a wide range of CPM values from -2.2 to 5.9. 

 Discussion: These QST data were collected from of a large cohort of individuals with chronic low back pain (cLBP) who participated in the LB3P observational study. The results will be incorporated as variables in a comprehensive statistical analysis, combined with other behavioral, biomechanical and biological variables for deep phenotyping of cLBP.