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dc.contributor.advisorMeints, Samantha M.en_US
dc.contributor.advisorMcKnight, C. Jamesen_US
dc.contributor.authorIssenman, Josephineen_US
dc.date.accessioned2021-11-23T19:23:24Z
dc.date.available2021-11-23T19:23:24Z
dc.date.issued2021
dc.identifier.urihttps://hdl.handle.net/2144/43402
dc.description.abstractBACKGROUND: Chronic low back pain (CLBP) is the leading cause of disability in the United States. People suffering from CLBP often have multiple comorbidities including depression, anxiety, and substance use disorder (SUD). Although the opioid epidemic has intensified the search for new treatment options, both pharmacological and other, opioids still remain the most common treatment for chronic pain. Long-term opioid therapy (LTOT) has been shown to lead to opioid-induced hyperalgesia (OIH), an increased sensitivity to painful stimuli. It remains unclear, however, the extent to which reductions in opioid dose impact OIH. METHODS: This is a longitudinal cohort study whose primary aim is to determine how changes in opioid doses are associated with changes in psychosocial and quantitative sensory testing (QST) variables. Participants were 24 adults with CLBP being treated with LTOT and visits were conducted on a monthly basis for six months. All 24 participants were included in the analysis of demographic and psychosocial variables (disability, anxiety, depression, opioid misuse, pain severity, pain interference, and catastrophizing). A subset of 13 participants were included in the analysis of QST variables. RESULTS: We found that pressure pain thresholds at the thumb and the trapezius, and heat pain threshold significantly (p < 0.05) improved between visit 1 and visit 6. We also found that a decrease in morphine equivalent doses (MED) is correlated (coefficient > 0.2) with improvements in punctuate probe rating, pain pressure at the thumb, and maximum cold ratings. DISCUSSION: Our results show that reductions in opioid dose are associated with reduced pain sensitivity, even while the psychosocial variables studied (including subjective pain score, depression, and anxiety) remain stable.en_US
dc.language.isoen_US
dc.subjectMedicineen_US
dc.subjectChronic low back painen_US
dc.subjectDisabilityen_US
dc.subjectLong-term opioid therapyen_US
dc.subjectOpioid induced hyperalgesiaen_US
dc.subjectPain sensitivityen_US
dc.subjectQuantitative sensory testingen_US
dc.titleOpioid dose reductions associated with reduced pain sensitivity in adults with chronic low back painen_US
dc.typeThesis/Dissertationen_US
dc.date.updated2021-11-19T23:15:47Z
etd.degree.nameMaster of Scienceen_US
etd.degree.levelmastersen_US
etd.degree.disciplineMedical Sciencesen_US
etd.degree.grantorBoston Universityen_US


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