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Chronic non-specific low back pain is a common health problem that significantly affects the quality of life of individuals. Increased pain intensity leads to deficiencies in the body's sensory organization, resulting in decreased awareness. This can lead to dysfunction in body awareness, which is known as the ability of individuals to perceive the sensations and conditions of their bodies. Body awareness plays a critical role in pain management and mobility. Chronic pain causes constant stimulation in the nervous system, causing central sensitization, which is when the central nervous system becomes overly sensitive to pain signals. As a result, a decrease in the pain threshold, constant pain, and increased muscle tension occur. Increased pain intensity and decreased awareness can result in a decrease in the maintenance of optimal functions, affecting muscular endurance. Inadequate muscular endurance can increase low back pain and make it difficult for individuals to perform their daily activities. Therefore, this study aims to examine the relationship between body awareness, central sensitization, disability, and muscular endurance in patients with chronic non-specific low back pain.
Body awareness plays a critical role in pain management and mobility. Individuals with high body awareness can better manage their pain, which can contribute to a decrease in disability levels. Chronic pain causes constant stimulation in the nervous system, which causes central sensitization, which is when the central nervous system becomes oversensitive to pain signals. As a result, a decrease in the pain threshold, constant pain, and increased muscle tension occur. In addition, central sensitization can cause the body to be more vulnerable to injuries due to the body being in an overstimulated state. Increased pain intensity and decreased awareness can result in a decrease in the maintenance of optimal functions, affecting muscular endurance. Inadequate muscular endurance can increase low back pain and make it difficult for individuals to perform their daily activities. The literature has attempted to emphasize the relationship between pain, disability, and body awareness in various populations. However, the relationship between body awareness and central sensitization has not been sufficiently studied. Sensitization in the body as a result of central sensitization may be associated with changes in awareness. Understanding these complex relationships is important for developing appropriate treatment strategies in the rehabilitation and clinical follow-up process. Therefore, this study aims to investigate the relationship between body awareness, central sensitization, disability and muscular endurance in patients with chronic non-specific low back pain. Patients with chronic non-specific low back pain will be included in the study. Body awareness, central sensitization, pain intensity, muscular endurance and disability levels of the patients will be evaluated. The data obtained from the study will be analyzed appropriately.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Higher sensitization | Patients with chronic non-specific low back pain with high sensitization will be included. | ||
| Normal sensitization | Patients with chronic non-specific low back pain with normal sensitization will be included. |
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| Measure | Description | Time Frame |
|---|---|---|
| Central sensitization | Central sensitization will be assessed with the "Central Sensitization Scale". The total score range is between 0-100 points. As the score increases, sensitization increases and 40 points and above are considered higher sensitization. | Baseline |
| Pain severity | Pain intensity will be assessed with Vizüel Analog Scale (VAS). VAS varies between 0-10 and the higher the score, the greater the pain. | Baseline |
| Pain pressure threshold | Pressure pain threshold will be measured with an algometer in kg. High values indicate a high pain threshold. | Baseline |
| Disability levels | Disability will be measured by the Oswestry Disability Index. The total score ranges from 0-100 and the higher the score, the higher the level of disability. | Baseline |
| Body awereness | It will be measured with a body awareness survey. The total score varies between 18-126 and as the score increases, awareness increases | Baseline |
| Low back awereness | It will be measured with the Fremantle Waist Awareness Questionnaire (FBFA). The total score varies between 0-36 and the awareness decreases as the score increases | Baseline |
| Trunk muscle endurance | The Stabilizer Pressure Biofeedback Unit will be used to evaluate the multifidus muscle endurance. The time maintained at 40 mmHg pressure will be recorded. As the time increases, the endurance increases. |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with chronic non-specific low back pain will be included in this study.
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| Name | Affiliation | Role |
|---|---|---|
| Musa Güneş, PhD | Karabuk University | Study Director |
| Seher İmanur | Karabuk University | Principal Investigator |
| Elif AydoÄŸan | Karabuk University | Principal Investigator |
| Bedirhan Turan | Karabuk University | Principal Investigator |
| Aydın Sinan Apaydın, PhD | Karabuk University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Karabuk University, Physiotherapy and Rehabilitation Application and Research Center | Karabük | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20036180 | Background | Nijs J, Van Houdenhove B, Oostendorp RA. Recognition of central sensitization in patients with musculoskeletal pain: Application of pain neurophysiology in manual therapy practice. Man Ther. 2010 Apr;15(2):135-41. doi: 10.1016/j.math.2009.12.001. Epub 2009 Dec 24. | |
| 34651401 | Result | Colgan DD, Eddy A, Green K, Oken B. Adaptive body awareness predicts fewer central sensitization-related symptoms and explains relationship between central sensitization-related symptoms and pain intensity: A cross-sectional study among individuals with chronic pain. Pain Pract. 2022 Feb;22(2):222-232. doi: 10.1111/papr.13083. Epub 2021 Nov 11. |
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| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| Baseline |
| 42144681 | Derived | Gunes M, Imanur S, Aydogan E, Turan B, Apaydin AS. The relationship between central sensitization, body awareness, pain, and muscle endurance in patients with chronic nonspecific low back pain. Physiother Theory Pract. 2026 May 17:1-10. doi: 10.1080/09593985.2026.2674078. Online ahead of print. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |