Roger Allen, PhD, PT
Purpose: The purpose of the study was to investigate the temporal relationship between psychogenic stress and perceived intensity of chronic low back pain (LBP). LBP was chosen as a pilot condition prefacing a larger research effort to determine which variants of chronic pain may manifest latent psychogenic modulation based on previous studies of neuropathic pain conditions.
Methods: The study consisted of five subjects, one male and four females, ranging from 19-32 years old and chronicity of pain ranging from 5 months to 6+ years since diagnosis. Over 12-15 weeks, participants completed daily visual analog pain, stress, and pain-related function scales. Temporal relationships between stress and perceived pain were analyzed using serial lag correlation coefficients up to a 10-day lag. Daily medication, quality of pain perception changes, and menstrual cycles for females were reported.
Results: Serial lag correlations revealed variation between participants regarding the number of elapsed days between high stress and the strongest correlation with increased LBP intensity. Collapsed data across participants showed the strongest overall correlation at the 0-day time lag, indicating pain spikes the day of the stressful episode. Unlike previous studies involving neuropathic pain, there were no significant correlations between stress and LBP occurring ten days later.
Conclusion: Chronic low back pain does not appear to be influenced by the same delayed psychogenic neuromodulation mechanism as chronic neuropathic pain conditions previously studied. This study supports the position that not all chronic pain should be clinically approached in the same manner.
University of Puget Sound
Allen, Roger PhD, PT; Chang, Anna SPT; Mooney-Myers, Catherine SPT; and Gallison, Lauren, "Latent Effects of Stress on Delayed Modulation of Chronic Low Back Pain: Case Series" (2019). Physical Therapy Research Symposium. 55.