The following is a summary of “Association between conditioned pain modulation and psychological factors in people with chronic spinal pain: A systematic review,” published in the January 2024 issue of Pain by Mansfield et al.

Despite known psychological influences on pain tolerance, the link between these factors and conditioned pain modulation (CPM), a measure of descending pain control in chronic spinal pain sufferers, remains unclear.

Researchers conducted a retrospective study to explore how psychological factors influence CPM response in individuals with chronic spinal pain.

They searched literature databases, including MEDLINE, EMBASE, CINAHL, and PubMed (October 23, 2023). Eligible studies evaluated the connection between CPM response and psychological factors in individuals with chronic spinal pain. Meta-analysis synthesized data, evaluating methodological quality with the AXIS tool and assessing certainty of evidence via GRADE.

The results showed 2,172 records and seven studies (n = 598), with moderate quality studies. There was a very low certainty of evidence indicating no statistical associations between depression (r = 0.01 [95% CI −0.10 to 0.12], I ² = 0%), anxiety (r = −0.20 [95% CI −0.56 to 0.16], I ²= 84%), and fear avoidance (r = −0.10 [95% CI −0.30 to 0.10], I ²= 70%) with CPM responder status. Higher pain catastrophizing was linked to CPM non-responder status (r = −0.19; 95% CI: −0.37 to −0.02; n = 545; I ²: 76%) with a very low certainty of evidence assessed by GRADE.

Investigators concluded that despite the presence of chronic pain, managing individual symptoms irrespective of psychological factors remains crucial until more vital evidence emerges for targeted interventions.

Source: journals.sagepub.com/doi/10.1177/20494637241229970