Inﬂammatory pain pattern and pain with lumbar extension associated with Modic 1 changes on MRI: a prospective case–control study of 120 patients
The purpose of this case–control study was to compare, clinical characteristics of patients with low back pain (LBP) with and without Modic 1 signal changes on MRI. Modic changes represent the signal intensity changes of vertebral end plates and subchondral bone on MRI. Modic 1 changes are frequently associated with low back pain (LBP), therefore subgrouping patients may be important because symptoms and treatment may differ according to Modic changes.
120 patients were included in the study (60 patients in each group) The inflammatory pain pattern which is at least one of the following symptoms: morning stiffness for more than 60 minutes, waking at night or maximal pain when waking up was significantly greater in the group with Modic 1 changes. Back extensions during the physical examination were significantly more painful in the Modic 1 group. Oral corticosteroids were more often prescribed with a good effect in the Modic 1 group, whereas NSAID´s did not make a difference between the two groups.
The study concludes that there is evidence of a specific pain pattern for this group of patients, which includes back extension and the inflammatory pattern. > From: Bailly et al., Eur Spine J 23 (2014) 493–497. All rights reserved to Springer-Verlag.
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