Psychological, disability, and somatosensory characteristics across different risk levels in individuals with low back pain: A cross-sectional study.
Hester L den Bandt, Kelly Ickmans, Ronald Buyl and 3 others
PMID 39938245WHAT IT FOUND
Higher risk scores on the Start Back Screening Tool and Central Sensitization Inventory were linked to greater pain, disability, fear of movement, and lower pain thresholds.
However, the two questionnaires disagreed on who belonged to which risk group, so they identify different problems rather than the same subgroup.
Key findings
01Patients classified as higher risk on the Start Back Screening Tool had significantly higher scores for kinesiophobia, pain catastrophizing, pain intensity, and disability, as well as lower heat and pressure pain thresholds in several body sites.
02Patients with higher severity scores on the Central Sensitization Inventory showed significantly higher scores for kinesiophobia, pain catastrophizing, pain intensity, and disability, and significantly lower pressure pain thresholds at all three tested sites.
03There was no agreement between the Start Back Screening Tool and the Central Sensitization Inventory in identifying risk subgroups, indicating they measure different constructs.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was cross-sectional, so it cannot prove that high risk scores cause increased pain sensitivity or disability; it only shows an association. The number of participants in the high-risk subgroups was very small (e.g., only 1 acute patient was high risk on the SBT), which makes the results for these groups less reliable. The SBT and CSI did not agree on subgroup classification, so clinicians cannot assume a patient identified as high risk by one tool is the same as high risk by the other. Some quantitative sensory testing results were inconsistent, with no significant trends for temporal summation, suggesting these tests may not uniformly reflect the underlying pain mechanisms in this population.
The easy way to misread this
Do not assume that a high score on the Start Back Screening Tool means the patient has the same profile as one with a high score on the Central Sensitization Inventory. The study found no agreement between the two tools, so they are measuring different aspects of the patient's condition. Using them interchangeably could lead to incorrect assumptions about the patient's pain mechanism or prognosis.