AAAPT Diagnostic Criteria for Acute Low Back Pain with and Without Lower Extremity Pain
Year: 2020
Type: review
Abstract: OBJECTIVE: Low back pain is one of the most common reasons for which people visit their doctor. Between 12% and 15% of the US population seek care for spine pain each year, with associated costs exceeding $200 billion. Up to 80% of adults will experience acute low back pain at some point in their lives. This staggering prevalence supports the need for increased research to support tailored clinical care of low back pain. This work proposes a multidimensional conceptual taxonomy. METHODS: A multidisciplinary task force of the ACTTION-APS-AAPM Pain Taxonomy (AAAPT) with clinical and research expertise performed a focused review and analysis, applying the AAAPT five-dimensional framework to acute low back pain. RESULTS: Application of the AAAPT framework yielded the following: 1) Core Criteria: location, timing, and severity of acute low back pain were defined; 2) Common Features: character and expected trajectories were established in relevant subgroups, and common pain assessment tools were identified; 3) Modulating Factors: biological, psychological, and social factors that modulate interindividual variability were delineated; 4) Impact/Functional Consequences: domains of impact were outlined and defined; 5) Neurobiological Mechanisms: putative mechanisms were specified including nerve injury, inflammation, peripheral and central sensitization, and affective and social processing of acute low back pain. CONCLUSIONS: The goal of applying the AAAPT taxonomy to acute low back pain is to improve its assessment through a defined evidence and consensus-driven structure. The criteria proposed will enable more rigorous meta-analyses and promote more generalizable studies of interindividual variation in acute low back pain and its potential underlying mechanisms.
Source: Pain Medicine
DOI: 10.1093/pm/pnaa239
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
Funders: National Institutes of Health, Agency for Healthcare Research and Quality, National Institute on Drug Abuse, National Institute of General Medical Sciences, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Biomedical Imaging and Bioengineering, National Center for Complementary and Integrative Health
Awards: G1012496075, Neuroimaging and Mentoring in Translational Pain Research, Nudging Primary Care Providers toward Guideline-Recommended Opioid Prescribing through Easier and More Convenient EHR Information Design, Reduced Opioid Analgesic Requirements Via Improved Endogenous Opioid Function, G5123673147, Nudging Primary Care Providers toward Guideline-Recommended Opioid Prescribing through Easier and More Convenient EHR Information Design, Central Nervous System Amplification in Lumbar Failed Back Surgery Syndrome, Psychological Risk Factors for Persistent Opioid Use and Prevention of Chronic Opioid Use and Misuse After Surgery: Postoperative Motivational Interviewing and Guided Opioid Weaning, Evaluating Specific and Non-Specific Mechanisms in Two Distinct Complementary/Int, Single Session Pain Catastrophizing Treatment: Comparative Efficacy & Mechanisms, Identifying opioid response phenotypes in low back pain electronic health data
OpenAlex ID: W3086458998