Central sensitization is considered to have a pathophysiological role in chronic low back pain (LBP). Whether individuals with increased central sensitization early in their condition are more likely to develop persistent pain or whether it increases over time is unclear. This study aimed to determine whether sensory profiles during acute LBP differ between individuals who did and did not recover by 6 months and to identify subgroups associated with outcomes. Individuals with acute LBP (<2 weeks of onset; N = 99) underwent pain threshold (heat/cold/pressure) and conditioned pain modulation testing after completing questionnaires related to pain/disability, sleep, and psychological status. Sensory measures were compared during the acute phase (baseline) and longitudinally (baseline/6 months) between unrecovered (greater or unchanged pain and disability), partially recovered (improved but not recovered pain and/or disability), and recovered (no pain and disability) participants at 6 months. We assessed baseline patterns of sensory sensitivity alone, and with psychological and sleep data, using hierarchical clustering and related the clusters to outcome (pain/disability) at 3 and 6 months. No sensory measure at either time point differed between groups. Two subgroups were identified that associated with more ("high sensitivity") or less ("high sensitivity and negative psychological state") recovery. These data seem to suggest that central sensitization during the acute phase resolves for many patients, but is a precursor to the transition to chronicity when combined with other psychological features. PERSPECTIVE: Central sensitization signs during early acute LBP does not necessarily precede poor outcome, but may be sustained in conjunction with other psychological factors and facilitate pain persistence.

中文翻译：

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急性腰痛中中枢敏感的迹象是否是预后不良的先兆？

中枢致敏被认为在慢性腰痛 (LBP) 中具有病理生理学作用。早期中枢敏化增加的个体是否更有可能出现持续性疼痛，或者是否随着时间的推移而增加尚不清楚。本研究旨在确定在 6 个月内恢复和未恢复的个体在急性 LBP 期间的感觉特征是否不同，并确定与结果相关的亚组。急性 LBP 患者（<2 周发作；N = 99）在完成与疼痛/残疾、睡眠和心理状态相关的问卷后，接受了疼痛阈值（热/冷/压力）和条件性疼痛调节测试。在急性期（基线）和纵向（基线/6 个月）期间比较未恢复（更大或未改变的疼痛和残疾）、部分恢复（改善但未恢复的疼痛和/或残疾）和恢复（没有疼痛和残疾）参与者在 6 个月。我们单独评估了感官敏感性的基线模式，并使用心理和睡眠数据，使用分层聚类并将聚类与 3 个月和 6 个月的结果（疼痛/残疾）相关联。两组之间在任一时间点的感官测量均无差异。确定了与更多（“高敏感性”）或更少（“高敏感性和消极心理状态”）恢复相关的两个亚组。这些数据似乎表明，许多患者在急性期的中枢敏化会消退，但是当与其他心理特征结合时，它是向慢性过渡的先兆。观点：早期急性 LBP 期间的中枢敏化征兆不一定先于不良结果，但可能与其他心理因素一起持续存在并促进疼痛持续。