Related Experiment Video
Updated: Oct 6, 2025
Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation
Published on: June 26, 2018
Human assumed central sensitisation (HACS) in patients with chronic low back pain radiating to the leg (CLaSSICO
Ingrid Schuttert1, Hans Timmerman2, Gerbrand J Groen2
1Department of Anesthesiology, Pain Center, University Medical Centre Groningen, Groningen, The Netherlands i.schuttert@umcg.nl.
Insights
This study investigates human assumed central sensitisation (HACS) in chronic low back pain radiating to the leg (CLBPr). Findings may help personalize treatments for CLBPr by identifying HACS using quantitative sensory testing.
Area of Science:
- Pain Medicine
- Neurology
- Clinical Research
Background:
- Chronic low back pain radiating to the leg (CLBPr) poses diagnostic challenges.
- Central pain sensitisation, termed human assumed central sensitisation (HACS), is difficult to assess in patients.
- The role of HACS in CLBPr chronification and its interaction with interventions is largely unknown.
Purpose of the Study:
- To identify HACS in patients with CLBPr using quantitative sensory testing (QST).
- To determine associations between HACS and the effectiveness of selective nerve root blocks.
- To compare QST outcomes in CLBPr patients with healthy volunteers.
Main Methods:
- Prospective observational study of 50 CLBPr patients and 50 healthy volunteers.
- Quantitative sensory testing (QST) and Central Sensitisation Inventory administered before and after nerve root block interventions.
- Statistical analysis using analysis of variance.
Main Results:
- Accumulating evidence suggests a subset of CLBPr patients exhibit facilitated QST responses.
- This study aims to quantitatively assess HACS and its relationship with treatment outcomes.
- Comparison with healthy controls will elucidate HACS characteristics in CLBPr.
Conclusions:
- Identifying HACS may lead to more precise diagnoses for CLBPr.
- Understanding HACS could inform personalized therapeutic strategies for chronic pain.
- This research contributes to the understanding of central sensitisation mechanisms in CLBPr.
Introduction:
Patients with chronic low back pain radiating to the leg (CLBPr) are sometimes referred to a specialised pain clinic for a precise diagnosis based, for example, on a diagnostic selective nerve root block. Possible interventions are therapeutic selective nerve root block or pulsed radiofrequency. Central pain sensitisation is not directly assessable in humans and therefore the term 'human assumed central sensitisation' (HACS) is proposed. The possible existence and degree of sensitisation associated with pain mechanisms assumed present in the human central nervous system, its role in the chronification of pain and its interaction with diagnostic and therapeutic interventions are largely unknown in patients with CLBPr. The aim of quantitative sensory testing (QST) is to estimate quantitatively the presence of HACS and accumulating evidence suggest that a subset of patients with CLBPr have facilitated responses to a range of QST tests.The aims of this study are to identify HACS in patients with CLBPr, to determine associations with the effect of selective nerve root blocks and compare outcomes of HACS in patients to healthy volunteers.
Methods And Analysis:
A prospective observational study including 50 patients with CLBPr. Measurements are performed before diagnostic and therapeutic nerve root block interventions and at 4 weeks follow-up. Data from patients will be compared with those of 50 sex-matched and age-matched healthy volunteers. The primary study parameters are the outcomes of QST and the Central Sensitisation Inventory. Statistical analyses to be performed will be analysis of variance.
Ethics And Dissemination:
The Medical Research Ethics Committee of the University Medical Center Groningen, Groningen, the Netherlands, approved this study (dossier NL60439.042.17). The results will be disseminated via publications in peer-reviewed journals and at conferences.
Trial Registration Number:
NTR NL6765.
