Pressure Pain Threshold Assessment in Low Back Pain

A digital pressure algometer (Wagner Instruments FPX 25, Greenwich, CT) with a 1 cm diameter rubber tip was applied at 1 kgf/s to two locations: 1) locally at the low back medial to the posterior superior iliac spine on the most painful side and 2) remotely to the upper trapezius ipsilateral to the most painful side of LBP. Participants positioned in prone for the low back site and in sitting for the upper trapezius site. Participants were instructed to indicate when the sensation first changed from pressure to pain (pain threshold). This procedure was repeated two times [26 (link)] and the average PPT analyzed. PPT demonstrates excellent intra-rater reliability and good to excellent inter-rater reliability in patients with low back pain [27 (link),28 (link)].

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Wilson A.T., Riley JL I.I.I., Bishop M.D., Beneciuk J.M., Cruz-Almeida Y., Markut K., Redd C., LeBlond N., Pham P.H., Shirey D, & Bialosky J.E. (2023). Pain phenotyping and investigation of outcomes in physical therapy: An exploratory study in patients with low back pain. PLOS ONE, 18(2), e0281517.

Publication 2023

FPX 25

Digital Iliac Pain Pain in back Patients Posterior spine Pressure Rubber Trapezius

Corresponding Organization : University of Central Florida

Other organizations : University of Florida, Brooks Rehabilitation Clinical Research Center, University of Florida Health, Duke University Health System

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Variable analysis

independent variables

Location of pressure algometer application: 1) locally at the low back medial to the posterior superior iliac spine on the most painful side, and 2) remotely to the upper trapezius ipsilateral to the most painful side of LBP

dependent variables

Pain threshold

control variables

Participant positioning: prone for the low back site and sitting for the upper trapezius site
Rate of pressure algometer application: 1 kgf/s
Diameter of rubber tip: 1 cm

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