From Acute to Chronic Back Pain Risk Factors, Mechanisms,

and Clinical Implications - 1st Edition

Visit the link below to download the full version of this book:

https://medipdf.com/product/from-acute-to-chronic-back-pain-risk-factors-mechani
sms-and-clinical-implications-1st-edition/

Click Download Now

 Preface

Chronic back pain has been and continues to be a major cause of distress (both to people with
persistent pain and their significant others), disability, work loss, and costs to society. Moreover,
with the aging population, it is becoming even more prevalent and as a consequence is having an
escalating impact upon the healthcare systems and society as a whole worldwide. A significant
issue concerns understanding why, although the majority of people with acute back symptoms
recover in a reasonable time, a significant minority evolve into patients with chronic pain and
prolonged pain-related disability. Understanding the variables that contribute to chronicity could
serve as a basis for early intervention to prevent the downward spiral. A growing number of stud-
ies have been conducted designed to discover predictors of chronicity and clinical trials have been
initiated in an attempt to identify targets for intervention. To date there have been no volumes
that have attempted to compile this research in a single source or that integrate the results of
available studies in order to facilitate prevention and intervention in practice.
The identification of clinically relevant risk factors in low back pain has broad practical impli-
cations for the healthcare system globally. During the past 15 years, psychosocial risk factors and
psychobiological mechanisms have been identified as important risk factors and have led to the
development of early screening methods (e.g. ‘yellow flag’ diagnostics) and new psychosocial
interventions by targeting treatment modalities to patients’ particular characteristics and needs
(risk factor-based interventions for pain and pain-related disability). Research is evolving from
asking ‘What treatments work?’ to a set of inter-related questions: ‘What treatments are most
effective to people with what set of characteristics, provided when, on what outcome measures,
compared to what alternatives, and at what costs?’. However, substantial aspects of the pathway
from acute to chronic pain still remain unexplained. Recent neurobiological paradigms investi-
gating genetic, neurophysiological, and biomechanical processes elucidate important mecha-
nisms of chronic back pain, which represent important pathways from acute to chronic pain.
We hope that these paradigms will lead to the development of new pharmacological and non-
pharmacological treatment approaches, which might establish evidence that supports a compre-
hensive approach to assessment and treatment of back pain spanning the entire spectrum
from acute through prevention and treatment of chronic pain and disability. Early and more
appropriate interventions are needed to prevent long-term, disabling back pain with accompany-
ing socioeconomic consequences.
This book was conceived following a series of discussions at international conferences and
symposia about the future of evidence-based pain science and research between the three of us
several years ago. We felt that there was an absence of a single volume that integrated the large but
disparate body of knowledge of numerous specialties—medicine, psychology, and physiotherapy.
The major aim of the symposia that preceded the development of the current publication was to
present advances in basic pain research with a view to their relevance for the transition from acute
to chronic pain. Thus, the meetings presented an opportunity for some of the most prominent
pain scientists to present and critically discuss their current findings in an interdisciplinary set-
ting. These conferences proved to be extremely stimulating to all parties and it revealed that much
knowledge needs to be synthesized and transferred from research to the clinical practice. We hope
that this book will fill a void by translating basic pain research to clinical practice in back pain.
vi PREFACE

The volume should be of equal interest to clinicians from multiple and diverse specialties who are
involved in the treatment of back pain patients, as well as to pain researchers. Clinicians working
with back pain patients and wanting to understand more about the basic mechanisms underlying
back pain as well as novel developments in the clinical science will find a wealth of information in
this book. To our knowledge, no other book has exactly this focus, and we hope that it may
contribute to further increase the collaboration and the exchange of information between back
pain experts and basic pain scientists.
We focused on three main themes in conceptualizing this text: (1) the mechanisms involved in
the transition from acute to persistent pain; (2) the concept of treatment-relevant subgroups; and
(3) how available research evidence can inform the prevention management of acute and chronic
back pain. The volume brings together an internationally renowned group of contributors who
are recognized as experts in their fields. It is organized in six inter-related sections. In Part 1, we
introduced current developments in pain epidemiology. We also included chapters on recent
neurobiological paradigms investigating genetic, neurophysiological (Part 2), biomechanical
processes (Part 3), and psychosocial mechanisms including fear-avoidance, endurance, cognitive
processing, and significant others/behavioral (Part 4) that may represent important pathways
from acute to chronic pain. Part 5 delineates important advances in the practitioner’s role in the
process of care. Parts 6 to 9 summarize important advances to diagnostics and treatment of acute,
subacute, and chronic back pain. In these final sections we extended the approach of treatment-
relevant subgroups further and provide ideas on how to relate those findings to the prevention
management of acute, sub-acute, and chronic back pain and disability.
Multi-author books take some years from initial conceptualization to publication. Hopefully,
that wait will have been worthwhile, both for those readers who have been aware of impending
completion of the text and for the authors themselves. When drafting the first outline of the
current edited volume, we intended to develop a book that would stimulate discussion and offers
avenues of future investigation and collaboration. Publication of this volume should be viewed as
a status report and serve as a stimulus for additional research as there remains much that is not
understood and much needs to be learned to prevent chronic pain and pain-related disability.
Clinicians should find the materials as a useful guide for approach patients with acute, subacute,
and chronic pain but they need to continue to follow research developments to enhance their
approaches as evidence becomes available.
Monika I. Hasenbring
Adina C. Rusu
Dennis C. Turk
Bochum, Germany and Seattle, Washington, USA March 2011
 Contents

List of Contributors xi
List of Abbreviations xv

Part 1 Current Developments in Epidemiology

1 Epidemiology of Back Pain, from the Laboratory to the Bus Stop:
Psychosocial Risk Factors, Biological Mechanisms, and Interventions in Population-
Based Research 3
Blair H. Smith, Nicola Torrance, and Gary J. Macfarlane
2 Defining Chronic Pain by Prognosis 21
Kate M. Dunn, Michael Von Korff, and Peter R. Croft

Part 2 Risk Factors of Chronic Back Pain and Disability:

Biological Mechanisms
3 Genetic Factors Modulating Chronic Back Pain 43
Julia Metzner and Irmgard Tegeder
4 Peripheral and Central Sensitization as Risk Factors of Low Back Pain 55
Hermann O. Handwerker
5 Dysfunction of the Hypothalamic–Pituitary–Adrenal Axis and Associated Stress
Axes in the Development of Chronic Low Back Pain 69
John McBeth and Andrea Power
6 Central Imaging of Pain and the Process of Chronicity 89
Sandra Kamping and Herta Flor
7 Structural Brain Changes in Patients with Chronic Back Pain 105
Arne May and A. Vania Apkarian
8 The Psychophysiology of Chronic Back Pain Patients 115
Kati Thieme and Richard H. Gracely

Part 3 Risk Factors of Chronic Back Pain and Disability:

Biomechanical Mechanisms
9 Electromyographically-Determined Muscular Fatigue in Low Back Pain 155
Anne F. Mannion and David O’Riordan
10 Unmasking the Deconditioning Paradigm for Chronic Low Back Pain
Patients 185
Jeanine Verbunt, Rob J.E.M. Smeets, and Harriet Wittink
viii CONTENTS

Part 4 Risk Factors of Chronic Back Pain and Disability:

Sociodemographic and Psychosocial Mechanisms
11 Screening of Psychosocial Risk Factors (Yellow Flags) for Chronic Back Pain
and Disability 203
Chris J. Main, Nicholas A.S. Kendall, and Monika I. Hasenbring
12 Dispositional Fear, Anxiety Sensitivity, and Hypervigilance 231
R. Nicholas Carleton and Gordon J.G. Asmundson
13 Processes Underlying the Relation between Catastrophizing and
Chronic Pain: Implications for Intervention 251
Michael J.L. Sullivan and Marc O. Martel
14 Fear-Avoidance as a Risk Factor for the Development of Chronic Back
Pain and Disability 269
Linda Vancleef, Ida Flink, Steven J. Linton, and Johan Vlaeyen
15 Endurance-Related Pain Responses in the Development of
Chronic Back Pain 295
Monika I. Hasenbring, Dirk Hallner, and Adina C. Rusu
16 Cognitive Processing and Self-Pain Enmeshment in Chronic Back Pain 315
Adina C. Rusu and Tamar Pincus
17 Significant Others in the Chronicity of Pain and Disability 339
Annmarie Cano and Laura Leong
18 Effects of Workers’ Compensation Systems on Recovery from
Disabling Injuries 355
James P. Robinson and John D. Loeser
19 Work-Related Risk Factors for Transition to Chronic Back Pain
and Disability 377
William S. Shaw, Glenn S. Pransky, and Chris J. Main

Part 5 Practitioner’s Role in the Process of Care

20 The Physician as Disability Advisor for Back Pain Patients 391
James Rainville, Glenn S. Pransky, Sarah Gibson, and Pradeep Suri
21 The Attitudes and Beliefs of Clinicians Treating Back Pain: Do They
Affect Patients’ Outcome? 405
Tamar Pincus, Rita Santos, and Steven Vogel

Part 6 Clinical Implications: New Approaches to

Diagnostics and Treatment
22 International Guidelines for the Diagnostics and Treatment of Acute,
Subacute, and Chronic Back Pain 419
Maurits van Tulder and Bart Koes
 CONTENTS ix

Part 7 Clinical Approaches for Patients with Acute

and Subacute Low Back Pain
23 Engaging Patients in their Own Care for Back Care: The Role of Education
and Advice in the Prevention of Chronic Pain and Disability 433
Chris J. Main and Kim Burton
24 Motivational Issues in Pain Management 453
Robert D. Kerns, Mark P. Jensen, and Warren R. Nielson
25 Pharmacotherapy of Low Back Pain 471
Kay Brune and Bertold Renner

Part 8 Subgroup-Specific Approaches for Patients at

Risk For or With Chronic Pain
26 Reviewing the Concept of Subgroups in Subacute and Chronic Pain and
the Potential of Customizing Treatments 485
Adina C. Rusu, Katja Boersma, and Dennis C. Turk
27 Risk Factor-Based Cognitive-Behavioural Therapy for Acute and Subacute
Back Pain 513
Monika I. Hasenbring, Bernhard W. Klasen, and Adina C. Rusu

Part 9 Clinical Approaches for Patients with Established

Pain and Disability
28 Physical Exercise Interventions and Low Back Pain 531
J. Bart Staal, Chris G. Maher, and William S. Shaw
29 Contextual Cognitive-Behavioural Therapy for Chronic Pain (Including
Back Pain) 547
Lance M. McCracken
30 Rehabilitation Programmes to Prevent Severely Disabling Chronic
Back Pain 565
Michael K. Nicholas and Rob J.E.M. Smeets

Index 581
This page intentionally left blank
 List of Contributors

A. Vania Apkarian Ida Flink

Department of Physiology Center for Health and Medical
Northwestern University Psychology
Feinberg School of Medicine Örebro University
Chicago, IL, USA Örebro, Sweden
Gordon J.G. Asmundson Herta Flor
Department of Psychology Department of Cognitive and
University of Regina Clinical Neuroscience
Regina, SK, Canada Central Institute of Mental Health
Katja Boersma University of Heidelberg
Örebro University Mannheim, Germany
Center for Health and Medical Sarah Gibson
Psychology (CHAMP) Meli Orhtopedics
Örebro, Sweden Ft Lauderdale, FL, USA
Kay Brune Richard H. Gracely
Department of Experimental and Clinical Center for Neurosensory Disorders
Pharmacology and Toxicology University of North Carolina
FAU Erlangen-Nuremberg Chapel Hill, NC, USA
Erlangen, Germany Dirk Hallner
Kim Burton Department of Medical Psychology
Spinal Research Unit and Medical Sociology
University of Huddersfield Faculty of Medicine
Huddersfield, UK Ruhr-University of Bochum
Annmarie Cano Bochum, Germany
Department of Psychology Hermann O. Handwerker
Wayne State University Department of Physiology &
Detroit, MI, USA Pathophysiology
R. Nicholas Carleton Friedrich-Alexander Universität
Department of Psychology Erlangen/Nürnberg
University of Regina Erlangen, Germany
Regina, SK, Canada Monika I. Hasenbring
Peter R. Croft Department of Medical Psychology
Arthritis Research Campaign and Medical Sociology
National Primary Care Centre Faculty of Medicine
Keele University Ruhr-University of Bochum
Keele, UK Bochum, Germany

Kate M. Dunn Mark P. Jensen

Arthritis Research Campaign Department of Rehabilitation
National Primary Care Centre Medicine
Keele University University of Washington
Keele, UK Seattle, WA, USA
xii LIST OF CONTRIBUTORS

Sandra Kamping Gary J. Macfarlane

Department of Cognitive and Aberdeen Pain Research Collaboration
Clinical Neuroscience Epidemiology Group
Central Institute of Mental Health University of Aberdeen
University of Heidelberg Aberdeen, UK
Mannheim, Germany Chris G. Maher
Nicholas A.S. Kendall The George Institute for
Health Services Consultant International Health
Surbiton, Surrey, UK The University of Sydney
Robert D. Kerns Sydney, Australia
Departments of Psychiatry, Neurology, Chris J. Main
and Psychology Arthritis Research Campaign
Yale University National Primary Care Centre
West Haven, CT, USA; and Keele University
VA Central Office, and Keele, UK
Psychology Service Anne F. Mannion
VA Connecticut Healthcare System Spine Center Division
West Haven, CT, USA Department of Research and Development
Bernhard W. Klasen Schulthess Klinik
Department of Medical Psychology Zürich, Switzerland
and Medical Sociology Marc O. Martel
Faculty of Medicine Department of Psychology
Ruhr-University of Bochum McGill University
Bochum; and Montreal, QC, Canada
Algesiologikum
Munich, Germany Arne May
Department of Systems Neuroscience
Bart Koes University of Hamburg
Department of General Practice Hamburg, Germany
ErasmusMC-University Medical
Center Rotterdam John McBeth
Rotterdam, The Netherlands Arthritis Research UK
Epidemiology Unit
Laura Leong University of Manchester
Department of Psychology Manchester, UK
Wayne State University
Detroit, MI, USA Lance M. McCracken
Health Psychology Section
Steven J. Linton Department of Psychology
Center for Health and Medical Psychology Institute of Psychiatry
Örebro University King's College London
Örebro, Sweden London, UK
John D. Loeser Julia Metzner
Departments of Neurological Surgery and Institute of Pharmaceutical Chemistry
Anesthesiology and Pain Medicine, Goethe-University,
University of Washington, Frankfurt, Germany
Seattle, WA, USA
 LIST OF CONTRIBUTORS xiii

Michael K. Nicholas Adina C. Rusu

Pain Management Research Institute Department of Medical Psychology
University of Sydney at Royal North and Medical Sociology
Shore Hospital Faculty of Medicine
St Leonards, NSW, Australia Ruhr-University
Warren R. Nielson Bochum, Germany;
Department of Medicine (Rheumatology) Department of Psychology,
University of Western Ontario and Royal Holloway,
St Joseph’s Health Care University of London,
London, ON, Canada London, UK

David O’Riordan Rita Santos

Spine Center Division Department of Psychology
Department of Research and Development Royal Holloway
Schulthess Klinik University of London
Zürich, Switzerland London, UK

Tamar Pincus William S. Shaw

Department of Psychology Liberty Mutual Research Institute
Royal Holloway for Safety
University of London Hopkinton; and
London, UK University of Massachusetts
Medical School
Andrea Power Worcester, MA, USA
Human Pain Research Group
Hope Hospital Rob J.E.M. Smeets
Salford, UK Centre of Expertise in Rehabilitation and
Audiology
Glenn S. Pransky Adelante, Hoensbroek; and
Liberty Mutual Research Institute for Safety Department of Rehabilitation Medicine
Hopkinton; and Caphri, Maastricht University,
University of Massachusetts Medical School Maastricht University Medical Centre
Worcester, MA, USA Maastricht, The Netherlands
James Rainville Blair H. Smith
Department of Physical Medicine and Medical Research Institute
Rehabilitation University of Dundee
Harvard Medical School, Boston; Dundee, UK
New England Baptist Hospital
Boston, MA, USA J. Bart Staal
Scientific Institute for Quality of Healthcare
Bertold Renner Radboud University Medical Centre
Department of Experimental and Nijmegen, The Netherlands
Clinical Pharmacology and Toxicology
FAU Erlangen-Nuremberg Michael J.L. Sullivan
Erlangen, Germany Departments of Psychology, Medicine
and Neurology
James P. Robinson McGill University
Department of Rehabilitation Medicine Montreal, QC, Canada
University of Washington
Seattle, WA, USA
xiv LIST OF CONTRIBUTORS

Pradeep Suri Jeanine Verbunt

Department of Physical Medicine and Adelante, Center of Expertise in
Rehabilitation Rehabilitation and Audiology,
Harvard Medical School Adelante, Hoensbroek; and
Boston, MA USA; and Department of Rehabilitation Medicine,
VA Boston Healthcare System Maastricht University and Maastricht
Boston, MA, USA University Medical Center, Maastricht, the
Irmgard Tegeder Netherlands
Institute of Clinical Pharmacology Johan Vlaeyen
Goethe-University, Pain and Disability Research Program
Frankfurt, Germany University of Leuven
Kati Thieme Leuven, Belgium; and
Department of Medical Psychology Department Clinical Psychological Science
Philipps-University Marburg Faculty of Psychology and Neuroscience
Marburg, Germany Maastricht University
Maastricht, The Netherlands
Nicola Torrance
Medical Research Institute Steven Vogel
University of Dundee British School of Osteopathy,
Dundee, UK London, UK

Dennis C. Turk Michael Von Korff

Department of Anesthesiology Group Health Research Institute
University of Washington Seattle, WA, USA
Seattle, WA, USA Harriet Wittink
Linda Vancleef Research group Lifestyle and Health
Department Clinical Psychological Science Utrecht University of Applied Sciences
Faculty of Psychology and Neuroscience Utrecht, The Netherlands
Maastricht University
Maastricht, The Netherlands
Maurits van Tulder
Department of Health Sciences and EMGO
Institute for Health and Care Research
Faculty of Earth & Life Sciences
VU University
Amsterdam, The Netherlands
 List of abbreviations

ABPS-MP Attitudes to Back Pain Scale for DTI diffusion tensor imaging
Musculoskeletal Practitioners EEG electroencephalography
ACT Acceptance and Commitment EER eustress-endurance response
Therapy
EMG electromyographic
ACC anterior cingulate cortex
FABQ Fear Avoidance Beliefs
ACTH adrenocorticotropin hormone Questionnaire for Health Care
ADL activity of daily living Practitioners
AEM avoidance-endurance model FAM fear-avoidance model
AEQ Avoidance-Endurance FAR fear-avoidance response
Questionnaire fMRI functional magnetic resonance
ALBP acute low back pain imaging
APAP acetaminophen (paracetamol) fMRI fibromyalgia
AS anxiety sensitivity FNE fear of negative evaluation
ASA acetylicsalicylacid FR flexion-relaxation
BBQ Back Beliefs Questionnaire GI gastrointestinal
BCI brain–computer interface GivE graded in vivo exposure
BDI Beck Depression Inventory GnIH gonadotropin inhibitory hormone
CA central augmentation GnRH gonadotropin-releasing hormone
CBA cognitive-behavioural approach GP general practitioner
CBP chronic back pain GWAS genome-wide association studies
CBT cognitive-behavioural therapy HCP healthcare professional
CCBT contextual cognitive-behavioural HC-PAIRS Health Care Providers Pain and
therapy Impairment Relationship Scale
CI confidence interval HPA hypothalamic–pituitary–adrenal
CLBP chronic low back pain HPG hypothalamic–pituitary–gonadal
COX cyclo-oxygenase HPGH hypothalamic–pituitary–growth
CPAQ Chronic Pain Acceptance hormone
Questionnaire IBCT integrative behavioural couple
CRH corticotrophin releasing hormone therapy
CSQ Coping Strategies Questionnaire IIS illness/injury sensitivity
CST coping skills training IMF initial median frequency
CT computed tomography IU intolerance of uncertainty
CV cardiovascular IW injured worker
CWP chronic widespread pain KPI Kiel Pain Inventory
DER distress-endurance response LP lumbopelvic
DHEA-s dehydroepiandrosterone-sulphate MAAS Mindful Attention Awareness Scale
DLBP disabling low back pain MEG magnetoencephalographic
DLPFC dorsolateral prefrontal cortex MET metabolic equivalent
DNIC diffuse noxious inhibitory control MF median frequency
DRAM Distress Risk Assessment Method MHPG 3-methoxy-4-hydroxyphenylglycol
xvi LIST OF ABBREVIATIONS

MMPI Minnesota Multiphasic Personality PPI proton-pump inhibitors

Inventory PPV positive predictive value
MPF mean power frequency PSOCQ Pain Stages of Change
mPFC medial prefrontal cortex Questionnaire
MPI Multidimensional Pain Inventory RCBI risk factor-based cognitive-
MPRCQ Multidimensional Pain Readiness to behavioural interventions
Change Questionnaire RCT randomized controlled trial
MRI magnetic resonance imaging RER respiratory exchange ratio
NPV negative predictive value RISC-BP RIsk SCreening of Back Pain
NSAID non-steroidal anti-inflammatory ROC receiver operator curve
drug ROM range of motion
NSAID non-steroidal, antiphlogistic, RTW return to work
inflammatory drugs
SBDT STarT Back Decision Tool
ÖMPSQ Örebro Musculoskeletal Pain
S-CST spouse-assisted coping skills training
Screening Questionnaire
sEMG surface electromyography
PAG periaqueductal grey
SEMP Schema Enmeshment Model
PAIRS Pain and Impairment Relationship
of Pain
Scale
SLC sick leave certification
PAL physical activity in daily life
SNAP Schedule for Nonadaptive and
PAL physical activity level
Adaptive Personality
PARIS-CBA pain risk screening-based
SSRI serotonin reuptake inhibitors
cognitive-behavioural approaches
SST Self-System Therapy
PASS Pain Anxiety Symptoms Scale
TMD temporomandibular disorder
PASS-20 Pain Anxiety Symptoms Scale-20
TSK Tampa Scale for Kinesiophobia
PCS Pain Catastrophizing Scale
TSS Thought Suppression Scale
PDP Pain-Disability Prevention
[Programme] TTM Transtheoretical Model of
Behaviour Change
PET positron emission tomography
UDE unwanted drug effects
PFC prefrontal cortex
VO2 maximum oxygen intake
PHODA Photograph Series of Daily Activities
WC workers' compensation
PMS Positive Mood Scale
WHO World Health Organization
POMC proopiomelanocortin
Part 1

Current Developments in
Epidemiology
This page intentionally left blank