Comparing Movement Patterns and Physical Function Between Chronic Low Back Pain Patients With Nociplastic and...

Area of Science:

• Biomedical Science
• Pain Research
• Clinical Diagnostics

Background:

• Chronic low back pain (LBP) presents with significant physical dysfunction, often difficult to diagnose due to its heterogeneous nature.
• Differentiating pain categories is crucial for targeted treatment and understanding underlying mechanisms.

Purpose of the Study:

• To compare objective and subjective physical function between nociceptive (NC) and nociplastic (NP) chronic low back pain categories.
• To investigate the association of demographic, psychological, and biomechanical factors with these pain categories.

Main Methods:

• Assessed 256 patients with chronic low back pain for NC or NP categories using validated surveys.
• Evaluated anxiety, depression, and fear avoidance using standard surveys.
• Measured physical function via sit-to-stand (STS) tests (marker-less motion capture) and PROMIS-physical function surveys.

Main Results:

• The NP group was older and reported higher anxiety, depression, and worse perceived physical function (PROMIS-PF) compared to the NC group.
• STS test times were slower in the NP group, yet their biomechanical function (K-score) was closer to controls.
• Regression models showed PROMIS-PF, but not objective biomechanical measures, significantly differed between pain categories after adjusting for covariates.

Conclusions:

• Nociplastic pain is associated with greater perceived functional limitations and psychological distress.
• Objective biomechanical performance in chronic low back pain may not reliably distinguish between nociceptive and nociplastic pain categories.
• Perceived physical function (PROMIS-PF) is more strongly linked to pain category than objective biomechanical measures.