Subgrouping of Low Back Pain Patients for Targeting Treatments: Evidence from Genetic, Psychological, and Activity-related Behavioral Approaches
Abstract
INTRODUCTION: Many patients with low back pain (LBP) are treated in a similar manner as if they were a homogenous group. However, scientific evidence is available that pain is a complex perceptual experience influenced by a wide range of genetic, psychological, and activity-related factors. The leading question for clinical practice should be what works for whom. OBJECTIVES: The main aim of the present review is to discuss the current state of evidence of subgrouping based on genetic, psychosocial, and activity-related factors in order to understand their contribution to individual differences. RESULTS: Based on these perspectives, it is important to identify patients based on their specific characteristics. For genetics, very promising results are available from other chronic musculoskeletal pain conditions. However, more research is warranted in LBP. With regard to subgroups based on psychosocial factors, the results underpin the importance of matching patients' characteristics to treatment. Combining this psychosocial profile with the activity-related behavioral style may be of added value in tailoring the patient's treatment to his/her specific needs. CONCLUSIONS: For future research and treatment it might be challenging to develop theoretical frameworks combining different subgrouping classifications. On the basis of this framework, tailoring treatments more specifically to the patient needs may result in improvements in treatment programs for patients with LBP.
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Compared with males, females show greater sensitivity to pain-induced muscle reflexes, greater pupil dilation, and amplified cerebral activation in response to pain.
“Compared with males, females demonstrate increased sensitivity to pain-induced muscle reflexes 165 and show increased pupil dilation 166 as well as amplified cerebral activation in response to pain 167.”
From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [165]
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Evaluating psychosocial contributions to chronic pain outcomes
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Psychological Assessment and Behavioral Management of Spine Pain
Kulich, R. J., Patterson, E. S., Hernández-Nuño de la Rosa, M. F., Roselli, M., & Wawrzyniak, K. M. (2020) · Spine Pain Care · doi:10.1007/978-3-030-27447-4_35 · Cited by 1 · see citing works
- Authors
- Huijnen, I. P. J., Rusu, A. C., Scholich, S., Meloto, C. B., & Diatchenko, L.
- Affiliations
- University of London (GB)
- Ruhr University Bochum (DE)
- McGill University (CA)
- Corresponding author
- Huijnen, Ivan P.J.
- Venue
- The Clinical Journal of Pain
- Published
- 2015-02
- Volume
- 31
- Issue
- 2
- Pages
- 123-132
- ISSN
- 0749-8047 (ISSN-L)
- OpenAlex
- W2331959627
- Cited by
- 44
- References
- 109
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 3 · 2019: 4 · 2018: 5 · 2017: 5 · 2016: 7 · 2015: 3
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- low back pain, patient subgrouping, personalized treatment, genetic factors, psychosocial factors, behavioral styles, chronic musculoskeletal pain, individual differences, treatment targeting
- MeSH terms
- Animals, Humans, Individuality, Low Back Pain, Genetic Predisposition to Disease, Musculoskeletal Pain
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