L3 Low Back Phenotyping

Question 1

nociceptive pain characteristics

Answer 1

1. pain from noxious stimulus
2. pain < 3mo
3. pain in discrete distribution
4. pain improves with time

Question 2

nociplastic pain characteristics

Answer 2

1. daily pain >3 mo or 50% days >6 mo
2. widespread pain
3. not more likely explained by nociceptive or neuropathic pain
4. pain hypersensitivity: allodynia to mechanical or temp
5. history of hypersensitivity in LB
6. increased sensitivity to: light, sound, odor; or sleep disorder, fatigue, or cognitive problem

Question 3

treatment approach for nociplastic LB pain

Answer 3

non pharm interventions
pain neuroscience education
exercise
multidisciplinary approach to target sleep, mental health
discourage excessive medication and imaging
if pharm: SNRIs, TCAs, target nervous system

Question 4

risk factors for nociplastic pain

Answer 4

female
early life stress
sedentary
heightened somatic awareness
hx of chronic pain