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Low Back PainNCT06412484

State vs. Trait Alterations in Low Back Pain

An observational study of Low Back Pain, run by Schweinhardt Petra at 1 site in Switzerland.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary goal of this study is to investigate whether different alterations observed in patients with non-specific episodic low back pain (compared to healthy volunteers), detected using several assessments: psychophysical and neurophysiological testing, imaging, and blood sampling, are dependent or independent of… Read more about this study

Who is it for?
Ages 18 to 70 yearsHealthy volunteers can take part
Conditions the study is for
Low Back Pain
What is being tested?
Pain Free Session, Low Back Pain Session (= clinically relevant pain) and Experimental Pain Session (= clinically irrelevant pain)
How many people
105 participants
Where
1 siteSwitzerland
Study dates
1 Oct 2023to 12 Feb 2026
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: The study population consists of people that suffer from non-specific low back pain, meaning that their pain cannot reliably be attributed to a specific pathology and radiographic abnormalities correlate poorly with patients' symptoms. Participants should suffer from chronic episodic low back pain, meaning that they have had back pain pain for at least more than 3 months, with recurrent fluctuating pain episodes.

Who may be able to join

  • German or English proficiency
  • Informed consent
  • Low back pain for more than 3 months
  • Low back pain clinically not attributable to "red flags" (e.g. infection, fractures, inflammation)
  • Fluctuating course of pain (with on and off pain periods).

Who cannot join

  • Inability to give informed consent / follow study instructions (e.g. due to language problems)
  • Major medical or psychiatric condition. E.g. severe heart disease, diabetes, autoimmune disorders, rheumatic disorders, major depressive disorder, etc.
  • Symptomatic radiculopathy, manifested through motor and/or sensory deficits / or signs of nerve root involvement on lumbar MRI.
  • Back operation
  • BMI > 30
  • Pregnancy

Trial locations and contacts

1 site in 1 country.

Switzerland1 site
  • Balgrist Campus

    Zurich, 8008

Other trials in Switzerland

About this study

Official title: Low Back Pain - Disentangling Trait-Like and State-Like Alterations

The primary goal of this study is to investigate whether different alterations observed in patients with non-specific episodic low back pain (compared to healthy volunteers), detected using several assessments: psychophysical and neurophysiological testing, imaging, and blood sampling, are dependent or independent of the presence and type of pain experienced at the time of investigation.

Read the detailed description

The study consists of three visits (healthy volunteers will only have one pain-free visit), in which patients will be tested in a different "pain state" at each visit:

  1. Pain-free visit: will be carried out when the patients have no or little (Numerical Pain Rating Scale (NPRS) </= 2/10) clinical pain.
  2. Clinically relevant Low Back Pain visit: will be carried out with patients experiencing a low back pain episode with an intensity of 3/10 or more on the NPRS.
  3. Experimental pain / Clinically irrelevant pain visit: will be carried out with the application of a high concentration (8%) Qutenza® capsaicin patch at the arm.

Each of the visits will consist of psychophysical testing, neurophysiological assessement of sweat activity in response to pain, brain resting state magnetic resonance imaging and magnetic resonance spectroscopy. Additionally, and depending on the type of session, a lumbar spine magnetic resonance image (only pain-free session, as characterization) and a blood sample (only pain free and low back pain visit) will be performed.

Conditions
Low Back Pain
Being tested
Pain Free Session, Low Back Pain Session (= clinically relevant pain), Experimental Pain Session (= clinically irrelevant pain)
Keywords
Trait vs. State Alterations
Medical subject headings
Low Back Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Pain Free SessionBehavioural

    On a day in which participants don't have any pain or a pain ranging from 0-2 (on a numerical rating scale of 0-10), they will undergo all the study measures (see primary outcome measures for detail): clinical exam, QST, SSRs, CPM, rsMRI, lumbar MRI, MRS, and blood sample.

  • Low Back Pain Session (= clinically relevant pain)Behavioural

    On a day in which patients have an ongoing typical low back pain episode of an intensity of 3 or more (on a numerical rating scale of 0-10), they will undergo all the study measures (see primary outcome measures for detail), except the lumbar MRI: clinical exam, QST, SSRs, CPM, rsMRI, MRS, and blood sample.

  • Experimental Pain Session (= clinically irrelevant pain)Behavioural

    On a day in which participants don't have any pain or a pain ranging from 0-2 (on a numerical rating scale of 0-10), an experimental pain state will be induced using a high concentration (8%) Qutenza patch, containing capsaicin. All the study measures will be performed (see primary outcome measures for detail), except the lumbar MRI and blood sample: clinical exam, QST, SSRs, CPM, rsMRI, MRS.

Study groups in NCT06412484
Study groupRoleWhat they receive
Low Back Pain (LBP) PatientsLBP patients will undergo three study visits, at moments at which their pain status is different: a) "pain-free", b) low back pain (clinically relevant), c) experimental pain (clinically irrelevant). Measures will be repeated in each visit, to understand the influence / relationship of pain state on possible mechanistic alterations observed in LBP compared to HCs.
Receives: Behavioral: Pain Free Session; Behavioral: Low Back Pain Session (= clinically relevant pain); Behavioral: Experimental Pain Session (= clinically irrelevant pain)
Healthy Controls (HCs)HCs will undergo one single visit, equivalent to patients' "pain-free" visit.
Receives: Behavioral: Pain Free Session

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mechanical Detection Threshold (MDT)

    A reduced psychophysical QST battery will be performed in 3 body areas: most painful (MP), adjacent to MP, and a control area.

    MDT will be assessed with Von Frey filaments applied to the skin (mN). Subject reports when tactile input is detected.

    Measured: 1 - 6 months

  2. Mechanical Pain Threshold (MPT)

    A reduced psychophysical QST battery will be performed in 3 body areas: most painful (MP), adjacent to MP, and a control area.

    MPT will be assessed with pin-pricks (mN) applied to the skin. Subject reports when the stimulus feels sharp or blunt.

    Measured: 1 - 6 months

  3. Mechanical Pain Sensitivity (MPS)

    A reduced psychophysical QST battery will be performed in 3 body areas: most painful (MP), adjacent to MP, and a control area.

    MPS will be assessed with pin-pricks and Q-tip, cotton swab, and brush applied to the skin. Subjects rate stimuli on scale of 0-100. In our protocol only 3 blocks.

    Measured: 1 - 6 months

  4. Wind-Up Ratio (WUR)

    A reduced psychophysical QST battery will be performed in 3 body areas: most painful (MP), adjacent to MP, and a control area.

    WUR will be assessed with a pin-prick, which is applied 10 times in 10 seconds. Subjects rate the series on scale of 0-100. In our protocol, only 3 series.

    Measured: 1 - 6 months

  5. Vibration Detection Threshold (VDT)

    A reduced psychophysical QST battery will be performed in 3 body areas: most painful (MP), adjacent to MP, and a control area.

    VDT will be assessed with a tuning fork applied to a bony prominence. Subject reports when the vibration can't be felt anymore.

    Measured: 1 - 6 months

  6. Pressure Pain Threshold (PPT):

    A reduced psychophysical QST battery will be performed in 3 body areas: most painful (MP), adjacent to MP, and a control area.

    PPT will be assessed with an algometer (kg), applied to a muscle. Subject reports when pressure becomes painful.

    Measured: 1 - 6 months

  7. Sympathetic Skin Responses (SSRs)

    Neurophysiological assessement of sweat activity in response to pain will be recorded with cap electrodes located at the hand. Painful heat stimulation will be applied with a thermode of the Pathway Medoc System. A train of 15 heat stimuli, with an inter-stimulus interval of 13-17 seconds, will be applied. The thermode baseline temperature will be 42ºC and during the stimulation the temperature will quickly ramp up to 52 ºC. Subjects are asked to rate the perception of the stimulus using a pain scale of 0-100. This procedure will be done two times: one at the most painful area of the patients, and the corresponding body area in the matched healthy volunteer, and at the volar forearm as a control pain-free area. This readout is a proxy for sympathetic nervous system activity.

    Measured: 1 - 6 months

  8. Conditioned Pain Modulation (CPM)

    CPM measures the modulation of a noxious test stimulus by another noxious conditioning stimulus applied at a remote body region. In this study, test stimuli of different modalities (pressure, superficial mechanical, heat or electrical stimuli) will be applied at different body regions before and after or before, during and after a cold water bath or neutral water bath (hand immersion) as conditioning stimulus. Changes in test stimuli read-outs (during-before or after-before) will serve as CPM measure. Negative changes represent inhibitory, positive changes facilitatory CPM effects. For all test stimuli read-outs, CPM effects will be expressed as percentage changes. Test stimuli read-outs include: pain ratings on a scale of 0: no pain, to 100: most intense pain; perception thresholds and pain thresholds (in kg for pressure).

    Measured: 1 - 6 months

  9. Brain resting state Magnetic Resonance Imaging (rsMRI)

    Measure of the brain's spontaneous activity acquired during resting state using a 7T Siemens scanner.

    Measured: 1 - 6 months

  10. Lumbar Magnetic Resonance Imaging

    Structural resonance image of lumbar spine section acquired using a 3T Siemens scanner.

    Measured: 1 - 6 months

  11. Brain Magnetic Resonance Spectroscopy (MRS)

    Imaging method that allows the detection of concentration of certain metabolites in the brain. This data will be acquired using a 3T Phillips scanner.

    Measured: 1 - 6 months

  12. Blood Sample

    Blood sample of approximately 14 ml will be drawn, in a total of 3 tubes: PAXGene blood RNA tube, Serum tube, and K2 EDTA tube. This will allow analysis of inflammatory molecules (i.e. cytokines) and cell concentrations (i.e. immune cells).

    Measured: 1 - 6 months

Secondary outcomes (11)
  1. Anxiety and Depression

    Anxiety and depression will be assessed using the Hospital Anxiety and Depression Scale (HADS). The HADS is a self-report rating scale of 14 items on a 4-point Likert scale (range 0-3), with 7 items for each subscale (anxiety and depression). The total score is the sum of the 14 items, and for each subscale the score is the sum of the respective seven items (ranging from 0-21). Higher score means more anxiety or depression.

    Measured: 1 - 6 months

  2. Pain Catastrophizing

    Pain catastrophizing will be assessed using questionnaires as for example the Pain Catastrophizing Scale (0-52; higher score meaning more catastrophizing).

    Measured: 1 - 6 months

  3. Pain Sensitivity

    Pain sensitivity will be assessed using the Pain Sensitivity Questionnaire (PSQ). It consists of 17 items, with an answer range from 0 (not at all painful) to 10 (most severe pain imaginable). The maximum score is 170, where a higher score indicates a higher pain sensitivity.

    Measured: 1 - 6 months

  4. Pain Self Efficacy

    Pain self efficacy will be assessed using the Pain Self Efficacy Questionnaire (PSEQ). It consists of 10 items, with an answer range from 0 (not at all confident) to 6 (completely confident). The maximum score is 60, where a higher score indicates a higher pain self efficacy / pain coping capacity.

    Measured: 1 - 6 months

  5. Back Awareness

    Back awareness will be assessed using the Fremantle Back Awareness Questionnaire. It consists of 9 items, with an answer range from 0 (never) to 4 (always). The maximum score is 36, where a higher score indicates a decreased back awareness.

    Measured: 1 - 6 months

  6. Central sensitization

    Central sensitization symptoms will be assessed using the Central Sensitization Inventory (CSI), which consists of two parts.

    Part A: includes 25 questions assessing typical central sensitisation symptoms. Each answer is scored on a scale of 0 (never) to 4 (always). A score of more than 40 indicates the presence of central sensitisation.

    Part B: determines if the patient has been diagnosed with certain central sensitivity disorder or related disorders, such as anxiety and depression.

    Measured: 1 - 6 months

  7. Widespread Pain Index (WPI)

    Presence of fibromyalgia symptoms will be assessed using the WPI. In the WPI, patients report body areas in which they have had pain in the past week. Each marked area adds one point, to reach a total score of 19.

    A patient would meet the criteria for fibromyalgia if:

    • WPI score (Part 1) is 7 or higher and SSS score (see below) (Part 2a \& b) is 5 or higher OR
    • WPI score (Part 1) is from 3 to 6 AND the SSS score (Part 2a \& b) is 9 or higher.

    Measured: 1 - 6 months

  8. Symptom Severity Scale (SSS)

    Presence of fibromyalgia symptoms will be assessed using the SSS. SSS consists of two parts. In part A patients report the severity of fatigue, waking unrefreshed, and cognitive symptoms. Each question can be answered from 0-3, for a total of 9. The higher the score, the higher the severity of these symptoms. In part B, patients report other somatic symptoms that they have experienced in the past week, reaching a total score of 3. Parts A and B, have a total score of 12 put together.

    A patient would meet the criteria for fibromyalgia if:

    • WPI score (see above) (Part 1) is 7 or higher and SSS score (Part 2a \& b) is 5 or higher OR
    • WPI score (Part 1) is from 3 to 6 AND the SSS score (Part 2a \& b) is 9 or higher.

    Measured: 1 - 6 months

  9. Neuropathic Pain

    Neuropathic pain components will be assessed using PainDETECT, which consists of 9 items: 7 weighted sensory descriptor items (never to very strongly) and 2 items relating to spatial and temporal pain characteristics. A score of 19 or more (out of 38) indicates likely neuropathic pain.

    Measured: 1 - 6 months

  10. Disability

    Patients' functional disability will be measured using the Oswestry Disability Index (ODI), which consists of 10 items addressing different aspects of life (i.e. walking, social life, hygiene, etc.). Each item, has a possible 5 point answer. A higher score indicates higher functional disability.

    Measured: 1 - 6 months

  11. Pain Extent

    Low back pain patients will be asked to complete pain drawings indicating painful body regions. The painful body area will be calculated as percentage of the whole body area. Higher percentages represent more widespread pain.

    Measured: 1 - 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 May 2024
  2. Study start1 Oct 2023
  3. Primary completion12 Feb 2026
  4. Study completion12 Feb 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Cross-sectional
Enrolment
105 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06412484
Sponsor's protocol ID
CRPP Renewal
Status last verified
May 2024
First submitted
22 Jan 2024
Last updated
30 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

An observational study of Low Back Pain, run by Schweinhardt Petra at 1 site in Switzerland.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 30 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Switzerland. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mechanical Detection Threshold (MDT) (time frame: 1 - 6 months). The study lists 12 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Jun 2026.

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