Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations

Jo Nijs; Eva Kosek; Alessandro Chiarotto; Chad Cook; Lieven A. Danneels; C. sar Fernández-de-las-Peñas; Paul W. Hodges; Bart Koes; Adriaan Louw; Raymond Ostelo; Gwendolyne G. M. Scholten-Peeters; Michele Sterling; Othman Alkassabi; Hana Alsobayel; Darren Beales; Paraskevi Bilika; Jacqui R. Clark; Liesbet de Baets; Christophe Demoulin; Rutger M. J. de Zoete; Ömer Elma; Annelie Gutke; Rikard Hanafi; Sabina Hotz Boendermaker; Eva Huysmans; Eleni Kapreli; Mari Lundberg; Anneleen Malfliet; Ney Meziat Filho; Felipe J. J. Reis; Lennard Voogt; Kory Zimney; Rob Smeets; Bart Morlion; Kurt de Vlam; Steven Z. George

doi:10.1016/S2665-9913(23)00324-7

Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations

Jo Nijs^*
, Eva Kosek
, Alessandro Chiarotto
, Chad Cook
, Lieven A. Danneels
, C. sar Fernández-de-las-Peñas
, Paul W. Hodges
, Bart Koes
, Adriaan Louw
, Raymond Ostelo
, Gwendolyne G. M. Scholten-Peeters
, Michele Sterling
, Othman Alkassabi
, Hana Alsobayel
, Darren Beales
, Paraskevi Bilika
, Jacqui R. Clark
, Liesbet de Baets
, Christophe Demoulin
, Rutger M. J. de Zoete

Ömer Elma, Annelie Gutke, Rikard Hanafi, Sabina Hotz Boendermaker, Eva Huysmans, Eleni Kapreli, Mari Lundberg, Anneleen Malfliet, Ney Meziat Filho, Felipe J. J. Reis, Lennard Voogt, Kory Zimney, Rob Smeets, Bart Morlion, Kurt de Vlam, Steven Z. George

^*Corresponding author for this work

Vrije Universiteit Brussel
Sahlgrenska Academy
Karolinska Institutet
Uppsala University
Erasmus University Rotterdam
VU University Medical Hospital
Duke University
Ghent University
Universidad Rey Juan Carlos
University of Queensland
University of Southern Denmark
Evidence in Motion
Physiotrio
King Saud University
School of Public Health Curtin University, Perth, Western Australia, Australia
University of Thessaly
Pains and Brains specialist pain physiotherapy clinic
University of Liege
University of Adelaide
Bournemouth University
Sophiahemmet University
Karolinska University Hospital
Zurich University of Applied Sciences
Research Foundation Flanders
Centro Universitário Augusto Motta (UNISUAM)
Instituto Federal do Rio de Janeiro
Rotterdam University of Applied Sciences
University of South Dakota
University of Limburg
Clinics in Rehabilitation
University Hospital Gasthuisberg
KU Leuven

Research output: Contribution to journal › Review article › Academic › peer-review

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Abstract

The potential to classify low back pain as being characterised by dominant nociceptive, neuropathic, or nociplastic mechanisms is a clinically relevant issue. Preliminary evidence suggests that these low back pain phenotypes might respond differently to treatments; however, more research must be done before making specific recommendations. Accordingly, the low back pain phenotyping (BACPAP) consortium was established as a group of 36 clinicians and researchers from 13 countries (five continents) and 29 institutions, to apply a modified Nominal Group Technique methodology to develop international and multidisciplinary consensus recommendations to provide guidance for identifying the dominant pain phenotype in patients with low back pain, and potentially adapt pain management strategies. The BACPAP consortium's recommendations are also intended to provide direction for future clinical research by building on the established clinical criteria for neuropathic and nociplastic pain. The BACPAP consortium's consensus recommendations are a necessary early step in the process to determine if personalised pain medicine based on pain phenotypes is feasible for low back pain management. Therefore, these recommendations are not ready to be implemented in clinical practice until additional evidence is generated that is specific to these low back pain phenotypes.

Original language	English
Pages (from-to)	e178-e188
Journal	The Lancet Rheumatology
Volume	6
Issue number	3
DOIs	https://doi.org/10.1016/S2665-9913(23)00324-7
Publication status	Published - 1 Mar 2024

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10.1016/S2665-9913(23)00324-7

Nociceptive-neuropathic-or-nociplastic-low-back-pain-the-low-back-pain-phenotyping-bacpap-consortiums-internationa.pdfFinal published version, 347 KBLicence: Taverne

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Nijs, J., Kosek, E., Chiarotto, A., Cook, C., Danneels, L. A., Fernández-de-las-Peñas, C. S., Hodges, P. W., Koes, B., Louw, A., Ostelo, R., Scholten-Peeters, G. G. M., Sterling, M., Alkassabi, O., Alsobayel, H., Beales, D., Bilika, P., Clark, J. R., de Baets, L., Demoulin, C., ... George, S. Z. (2024). Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations. The Lancet Rheumatology, 6(3), e178-e188. https://doi.org/10.1016/S2665-9913(23)00324-7

@article{d9b3143f7f5f44918c89a407938dd337,

title = "Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations",

abstract = "The potential to classify low back pain as being characterised by dominant nociceptive, neuropathic, or nociplastic mechanisms is a clinically relevant issue. Preliminary evidence suggests that these low back pain phenotypes might respond differently to treatments; however, more research must be done before making specific recommendations. Accordingly, the low back pain phenotyping (BACPAP) consortium was established as a group of 36 clinicians and researchers from 13 countries (five continents) and 29 institutions, to apply a modified Nominal Group Technique methodology to develop international and multidisciplinary consensus recommendations to provide guidance for identifying the dominant pain phenotype in patients with low back pain, and potentially adapt pain management strategies. The BACPAP consortium's recommendations are also intended to provide direction for future clinical research by building on the established clinical criteria for neuropathic and nociplastic pain. The BACPAP consortium's consensus recommendations are a necessary early step in the process to determine if personalised pain medicine based on pain phenotypes is feasible for low back pain management. Therefore, these recommendations are not ready to be implemented in clinical practice until additional evidence is generated that is specific to these low back pain phenotypes.",

author = "Jo Nijs and Eva Kosek and Alessandro Chiarotto and Chad Cook and Danneels, \{Lieven A.\} and Fern{\'a}ndez-de-las-Pe{\~n}as, \{C. sar\} and Hodges, \{Paul W.\} and Bart Koes and Adriaan Louw and Raymond Ostelo and Scholten-Peeters, \{Gwendolyne G. M.\} and Michele Sterling and Othman Alkassabi and Hana Alsobayel and Darren Beales and Paraskevi Bilika and Clark, \{Jacqui R.\} and \{de Baets\}, Liesbet and Christophe Demoulin and \{de Zoete\}, \{Rutger M. J.\} and {\"O}mer Elma and Annelie Gutke and Rikard Hanafi and \{Hotz Boendermaker\}, Sabina and Eva Huysmans and Eleni Kapreli and Mari Lundberg and Anneleen Malfliet and \{Meziat Filho\}, Ney and Reis, \{Felipe J. J.\} and Lennard Voogt and Kory Zimney and Rob Smeets and Bart Morlion and \{de Vlam\}, Kurt and George, \{Steven Z.\}",

note = "Publisher Copyright: {\textcopyright} 2024 Elsevier Ltd",

year = "2024",

month = mar,

day = "1",

doi = "10.1016/S2665-9913(23)00324-7",

language = "English",

volume = "6",

pages = "e178--e188",

journal = "The Lancet Rheumatology",

issn = "2665-9913",

publisher = "Elsevier Ltd",

number = "3",

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Nijs, J, Kosek, E, Chiarotto, A, Cook, C, Danneels, LA, Fernández-de-las-Peñas, CS, Hodges, PW, Koes, B, Louw, A, Ostelo, R, Scholten-Peeters, GGM, Sterling, M, Alkassabi, O, Alsobayel, H, Beales, D, Bilika, P, Clark, JR, de Baets, L, Demoulin, C, de Zoete, RMJ, Elma, Ö, Gutke, A, Hanafi, R, Hotz Boendermaker, S, Huysmans, E, Kapreli, E, Lundberg, M, Malfliet, A, Meziat Filho, N, Reis, FJJ, Voogt, L, Zimney, K, Smeets, R, Morlion, B, de Vlam, K & George, SZ 2024, 'Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations', The Lancet Rheumatology, vol. 6, no. 3, pp. e178-e188. https://doi.org/10.1016/S2665-9913(23)00324-7

Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations. / Nijs, Jo; Kosek, Eva; Chiarotto, Alessandro et al.
In: The Lancet Rheumatology, Vol. 6, No. 3, 01.03.2024, p. e178-e188.

Research output: Contribution to journal › Review article › Academic › peer-review

TY - JOUR

T1 - Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations

AU - Nijs, Jo

AU - Kosek, Eva

AU - Chiarotto, Alessandro

AU - Cook, Chad

AU - Danneels, Lieven A.

AU - Fernández-de-las-Peñas, C. sar

AU - Hodges, Paul W.

AU - Koes, Bart

AU - Louw, Adriaan

AU - Ostelo, Raymond

AU - Scholten-Peeters, Gwendolyne G. M.

AU - Sterling, Michele

AU - Alkassabi, Othman

AU - Alsobayel, Hana

AU - Beales, Darren

AU - Bilika, Paraskevi

AU - Clark, Jacqui R.

AU - de Baets, Liesbet

AU - Demoulin, Christophe

AU - de Zoete, Rutger M. J.

AU - Elma, Ömer

AU - Gutke, Annelie

AU - Hanafi, Rikard

AU - Hotz Boendermaker, Sabina

AU - Huysmans, Eva

AU - Kapreli, Eleni

AU - Lundberg, Mari

AU - Malfliet, Anneleen

AU - Meziat Filho, Ney

AU - Reis, Felipe J. J.

AU - Voogt, Lennard

AU - Zimney, Kory

AU - Smeets, Rob

AU - Morlion, Bart

AU - de Vlam, Kurt

AU - George, Steven Z.

PY - 2024/3/1

Y1 - 2024/3/1

N2 - The potential to classify low back pain as being characterised by dominant nociceptive, neuropathic, or nociplastic mechanisms is a clinically relevant issue. Preliminary evidence suggests that these low back pain phenotypes might respond differently to treatments; however, more research must be done before making specific recommendations. Accordingly, the low back pain phenotyping (BACPAP) consortium was established as a group of 36 clinicians and researchers from 13 countries (five continents) and 29 institutions, to apply a modified Nominal Group Technique methodology to develop international and multidisciplinary consensus recommendations to provide guidance for identifying the dominant pain phenotype in patients with low back pain, and potentially adapt pain management strategies. The BACPAP consortium's recommendations are also intended to provide direction for future clinical research by building on the established clinical criteria for neuropathic and nociplastic pain. The BACPAP consortium's consensus recommendations are a necessary early step in the process to determine if personalised pain medicine based on pain phenotypes is feasible for low back pain management. Therefore, these recommendations are not ready to be implemented in clinical practice until additional evidence is generated that is specific to these low back pain phenotypes.

AB - The potential to classify low back pain as being characterised by dominant nociceptive, neuropathic, or nociplastic mechanisms is a clinically relevant issue. Preliminary evidence suggests that these low back pain phenotypes might respond differently to treatments; however, more research must be done before making specific recommendations. Accordingly, the low back pain phenotyping (BACPAP) consortium was established as a group of 36 clinicians and researchers from 13 countries (five continents) and 29 institutions, to apply a modified Nominal Group Technique methodology to develop international and multidisciplinary consensus recommendations to provide guidance for identifying the dominant pain phenotype in patients with low back pain, and potentially adapt pain management strategies. The BACPAP consortium's recommendations are also intended to provide direction for future clinical research by building on the established clinical criteria for neuropathic and nociplastic pain. The BACPAP consortium's consensus recommendations are a necessary early step in the process to determine if personalised pain medicine based on pain phenotypes is feasible for low back pain management. Therefore, these recommendations are not ready to be implemented in clinical practice until additional evidence is generated that is specific to these low back pain phenotypes.

UR - https://www.scopus.com/pages/publications/85184048058

U2 - 10.1016/S2665-9913(23)00324-7

DO - 10.1016/S2665-9913(23)00324-7

M3 - Review article

C2 - 38310923

SN - 2665-9913

VL - 6

SP - e178-e188

JO - The Lancet Rheumatology

JF - The Lancet Rheumatology

IS - 3

ER -

Nociceptive, neuropathic, or nociplastic low back pain? The low back pain phenotyping (BACPAP) consortium's international and multidisciplinary consensus recommendations

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