背景:中枢致敏性疼痛是一部分非特异性慢性下腰痛患者的主要机制,并与不良预后相关。建议病前的经历和背景可能与中央敏感性的发展有关。
目的:本研究的目的是探索非特异性慢性下腰痛患者中枢致敏性疼痛患者的病前经历和个人特征。
方法:这是定性的,探索性研究,在混合方法协议中使用并发嵌套设计。n=9名参与者是根据感觉概况和特质焦虑相关的人格类型有目的地招募的。数据是通过半结构化访谈收集的,使用QSRNVivo10软件进行管理,并使用理论专题分析进行分析。
结果:出现了四个主题:发展学习经历,个人特征,敏感和创伤。据报道缺乏信心,低自尊和需要取悦他人,身体超敏感(气味,光,声音)和情绪敏感性(焦虑)以及身体低敏感性。参与者还遭受了情感和/或身体创伤。学习困难,感觉敏感性和创伤与自主神经应激反应有关,这反过来又与中枢致敏性疼痛中看到的生理变化有关。
结论:中枢致敏性疼痛是在与学习困难有关的感觉处理差异的背景下发展起来的,敏感性和创伤,以及低自信和控制力的个人特征,在一组非特异性慢性腰背痛的参与者中。预先存在的感官加工差异的作用,作为中枢神经系统功能改变的组成部分,关于中枢致敏性疼痛需要进一步调查。
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.
OBJECTIVE: 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.
METHODS: This was a qualitative, exploratory study, using a concurrent nested design within a mixed methods protocol. n=9 participants were recruited purposively based on sensory profiles and trait anxiety-related personality types. Data were collected through semi structured interviews, managed using QSR NVivo 10 software and analysed using theoretical thematic analysis.
RESULTS: Four themes emerged: developmental learning experiences, personal characteristics, sensitivity and trauma. Reported was lack of confidence, low esteem and a need to please others, physical hyper-sensitivities (smell, light, sound) and emotional sensitivity (anxiety) as well as physical hypo-sensitivity. Participants had also suffered emotional and/or physical trauma. Learning difficulties, sensory sensitivities and trauma are associated with autonomic stress responses, which in turn have been linked to physiological changes seen in central sensitisation pain.
CONCLUSIONS: Central sensitisation pain developed in the context of sensory processing differences related to learning difficulties, sensitivities and trauma, and personal characteristics of low confidence and control, in a group of participants with non-specific chronic low back pain. The role of pre-existing sensory processing differences, as a component of altered central nervous system function, in relation to central sensitisation pain warrants further investigation.