Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations.
[en] The potential to classify low back pain as being characterised by dominant nociceptive, neuropathic, or nociplastic mechanisms is a clinically relevant issue. Preliminary evidence suggests that these low back pain phenotypes might respond differently to treatments; however, more research must be done before making specific recommendations. Accordingly, the low back pain phenotyping (BACPAP) consortium was established as a group of 36 clinicians and researchers from 13 countries (five continents) and 29 institutions, to apply a modified Nominal Group Technique methodology to develop international and multidisciplinary consensus recommendations to provide guidance for identifying the dominant pain phenotype in patients with low back pain, and potentially adapt pain management strategies. The BACPAP consortium's recommendations are also intended to provide direction for future clinical research by building on the established clinical criteria for neuropathic and nociplastic pain. The BACPAP consortium's consensus recommendations are a necessary early step in the process to determine if personalised pain medicine based on pain phenotypes is feasible for low back pain management. Therefore, these recommendations are not ready to be implemented in clinical practice until additional evidence is generated that is specific to these low back pain phenotypes.
Disciplines :
Orthopedics, rehabilitation & sports medicine
Author, co-author :
Nijs, Jo; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium, Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium, Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden. Electronic address: jo.nijs@vub.be
Kosek, Eva; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
Chiarotto, Alessandro; Erasmus MC, University Medical Center Rotterdam, Department of General Practice, Rotterdam, Netherlands, Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, Netherlands
Cook, Chad; Department of Orthopaedic Surgery, Duke University, Durham, NC, USA, Duke Clinical Research Institute, Duke University, Durham, NC, USA, Department of Population Health Sciences, Duke University, Durham, NC, USA
Danneels, Lieven ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation ; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
Fernández-de-Las-Peñas, César; Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
Hodges, Paul W; School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
Koes, Bart; Erasmus MC, University Medical Center Rotterdam, Department of General Practice, Rotterdam, Netherlands, Research Unit of General Practice, Department of Public Health and Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
Louw, Adriaan; Department of Pain Science, Evidence in Motion, Story City, IA, USA
Ostelo, Raymond; Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, Netherlands, Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, Netherlands
Scholten-Peeters, Gwendolyne G M; Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, Netherlands
Sterling, Michele; RECOVER Injury Research Centre, University of Queensland, Brisbane, QLD, Australia
Alkassabi, Othman; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium, Physiotrio, Riyadh, Saudi Arabia, Research Chair for Healthcare Innovation, College of Applied Medical Sciences, Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia
Alsobayel, Hana; Research Chair for Healthcare Innovation, College of Applied Medical Sciences, Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia
Beales, Darren; Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia, Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
Bilika, Paraskevi; Clinical Exercise Physiology and Rehabilitation Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, Greece
Clark, Jacqui R; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium, Pains and Brains specialist pain physiotherapy clinic, Tauranga, New Zealand
De Baets, Liesbet; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium
Demoulin, Christophe ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation > Kinésithérapie spécifique et réadaptation motrice
de Zoete, Rutger M J; School of Allied Health Science and Practice, University of Adelaide, Adelaide, SA, Australia
Elma, Ömer; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium, Department of Rehabilitation and Sport Sciences, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
Gutke, Annelie; Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
Hanafi, Rikard; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium, Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden, Medical Unit Medical Psychology, Karolinska University Hospital, Stockholm, Sweden
Hotz Boendermaker, Sabina; University of Applied Sciences ZHAW, School of Health Professions, Institute of Physiotherapy, Winterthur, Switzerland
Huysmans, Eva; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium, Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium, Research Foundation-Flanders, Brussels, Belgium
Kapreli, Eleni; Clinical Exercise Physiology and Rehabilitation Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, Greece
Lundberg, Mari; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium, Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden, University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Malfliet, Anneleen; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium, Research Foundation-Flanders, Brussels, Belgium
Meziat Filho, Ney; Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta-UNISUAM, Rio de Janeiro, Brazil
Reis, Felipe J J; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium, Physical Therapy Department of Instituto Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Voogt, Lennard; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Belgium, University of Applied Sciences, Rotterdam, Netherlands
Zimney, Kory; Department of Physical Therapy, University of South Dakota, Vermillion, SD, USA
Morlion, Bart; The Leuven Centre for Algology and Pain Management, University Hospitals Leuven, Belgium, Department of Cardiovascular Sciences, Unit Anaesthesiology and Algology, KU Leuven, Belgium
de Vlam, Kurt; Division of Rheumatology, University Hospitals Leuven, Belgium, Skeletal Biology and Engineering Research Center, Dept of Development and Regeneration, KU Leuven, Belgium
George, Steven Z; Department of Orthopaedic Surgery, Duke University, Durham, NC, USA, Duke Clinical Research Institute, Duke University, Durham, NC, USA, Department of Population Health Sciences, Duke University, Durham, NC, USA
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