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A Comparison of Pressure Pain Detection Thresholds in People With Chronic Low Back Pain and Volunteers Without Pain

RJS Giesbrecht, MScPT, BA, is Manager of Rehabilitation Services, Prairie North Health Region, Saskatchewan, Canada. At the time of the study, he was a student in the Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
MC Battié, PT, PhD, is Professor and Canada Research Chair in Common Spinal Disorders, Faculty of Rehabilitation Medicine, University of Alberta

Address all correspondence to Mr Giesbrecht at Box 12147, Lloydminster, Alberta, Canada, T9V 3C4 (jngiesbrecht{at}shaw.ca)

Background and Purpose. Palpation is often utilized in the physical examination of patients with low back pain. The purpose of this study was to compare the pressure pain detection threshold (PPDT) of people with chronic low back pain (CLBP) and subjects without pain. Subjects and Methods. Thirty female subjects with CLBP were recruited from the offices of primary care physicians and physical therapists and compared with 30 female volunteers without pain for differences in PPDT at 6 sites tested bilaterally. Results. A significantly lower mean PPDT was found for all test site groups in subjects with CLBP compared with subjects without pain. A lower global PPDT was found in subjects with CLBP compared with subjects without pain (5.6 lb/cm² versus 6.9 lb/cm²). This also was the case for PPDT for the group of test sites unrelated to the lumbar spine (5.1 lb/cm² versus 6.1 lb/cm²) and for PPDT related to the lumbar spine (5.9 lb/cm² versus 8.0 lb/cm²). Discussion and Conclusion. Neurobiological or biopsychosocial influences may have contributed to the lower PPDT evident in subjects with CLBP. Subjects with CLBP demonstrated a lower global PPDT compared with subjects without pain, which should be taken into account when interpreting findings of pain or tenderness from palpation.

Key Words: Chronic low back pain • Pain threshold

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