Background

Research suggests that the prognosis of chronic non-specific low back pain is poor when there is an alteration in the central pain processing pathway. This alteration creates a cascade of events leading to poor outcomes. An overview of the predictors which increase this heightened pain perception is needed.

Objectives

To identify the predictors for altered central main modulation in individuals with non-specific chronic low back pain.

Design

Systematic review.

Methods

PubMed, Cochrane Library, Science Direct, Scopus, Ovid, Embase, Web of Science and CINAHL were searched from inception to 25th May 2021. Titles, abstracts, and full text were searched for the eligible articles which met the set criteria. Research articles that have employed outcome measure specific to altered central pain modulation and assessed at least one predictor were included.

Results

6 studies (n=1389) were included in this review. The following 5 groups of predictors were identified: 1) psychological 2) psychosocial (education, employment status, pain catastrophizing and kinesiophobia) and 3) sensory profile 4) gender and 5) others (illness and cognitive factors). Positive evidence of association was found for psychological predisposition and psychosocial (pain catastrophizing and employment & education status) whereas, no evidence of association was found for kinesiophobia and cognitive factors.

Conclusion

This review identified the predictors for altered central pain modulation in chronic non-specific low back pain. This alteration could be responsible for the suspected poor outcomes even post-treatment. Furthermore, the knowledge of predictors could potentially aid the therapist in planning a treatment regime when poor outcomes are suspected.