Article

Patients with chronic low back pain often report that they do not perceive their
painful back accurately.
Previous studies confirmed that sensory dissociation
and/or discrepancy between perceived body image and actual size is one of the
specific traits of patients with chronic pain. Current approaches for measuring
sensory dissociation are limited to two-point-discrimination or rely on pain
drawings not allowing for quantitative analysis.
This case study reports the
sensory dissociation of two cases with chronic low back pain using a recently
published test (point-to-point-test (PTP)) and a newly developed test
(two-point-estimation (TPE)). Both patients mislocalized tactile stimuli
delivered to the painful location compared to non-painful locations (PTP test).
In addition, both patients perceived their painful lumbar region differently from
non-painful sites above and below and contralateral to the painful site. TPE data
showed two distinct clinical patterns of sensory dissociation: one patient
perceived the two-point distance in the painful area as expanded, while the other
patient perceived it as shrunk. The latter pattern of sensory dissociation (i.e.,
pattern shrunk) is likely to respond to sensory training. Whether enlarged
patterns of sensory dissociation are more resistant to treatment remains unknown
but would explain the low effectiveness of previous studies using sensory
training in chronic low back pain populations. Subgrouping patients according to
their sensory discrimination pattern could contribute to the choice and
effectiveness of the treatment approach.

Langue : ANGLAIS