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Low back pain may be caused by disturbed pain regulation: A cross-sectional study in low back pain patients using tender point examination
European Journal of Pain, 10/08/09

Jensen OK et al. – The pain in patients with diffuse tenderness was rarely related to disc degeneration or nerve root affection, rather it may be caused by disturbed pain regulation.

• Patients sick–listed 3–16 weeks due to LBP with or without sciatica completed a questionnaire and went through a clinical low back examination and TP examination.
• Of 326 patients 111 had verified nerve root affection and 215 had non–specific LBP with or without radiating pain.
• Disc height reductions were estimated on lateral X–rays.

• Multivariate logistic regression analysis showed that more than 8 TPs were strongly negatively associated with disc degeneration and verified nerve root affection and were positively associated with number of years since first episode of LBP.
• Furthermore, more than 8 TPs were positively associated with widespread pain, female sex and bodily distress.
• With all patients included, bodily distress and the number of tender points were positively associated with the intensity of LBP, but disc degeneration was only positively associated with LBP in patients with less than 6 TPs.

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