AAPT Diagnostic Criteria for Chronic Low Back Pain

John D. Markman, Katarzyna Czerniecka-Foxx, Partap S. Khalsa, Salim Michel Hayek, Anthony L. Asher, John D. Loeser, Roger Chou

Research output: Contribution to journalArticle

Abstract

Chronic low back pain (CLBP) conditions are highly prevalent and constitute the leading cause of disability worldwide. The Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks (ACTTION) public-private partnership with the US Food and Drug Administration and the American Pain Society (APS), have combined to create the ACTTION-APS Pain Taxonomy (AAPT). The AAPT initiative convened a working group to develop diagnostic criteria for CLBP. The working group identified 3 distinct low back pain conditions which result in a vast public health burden across the lifespan. This article focuses on: 1) the axial predominant syndrome of chronic musculoskeletal low back pain, 2) the lateralized, distally-radiating syndrome of chronic lumbosacral radicular pain 3) and neurogenic claudication associated with lumbar spinal stenosis. This classification of CLBP is organized according to the AAPT multidimensional framework, specifically 1) core diagnostic criteria; 2) common features; 3) common medical and psychiatric comorbidities; 4) neurobiological, psychosocial, and functional consequences; and 5) putative neurobiological and psychosocial mechanisms, risk factors, and protective factors. Perspective: An evidence-based classification of CLBP conditions was constructed for the AAPT initiative. This multidimensional diagnostic framework includes: 1) core diagnostic criteria; 2) common features; 3) medical and psychiatric comorbidities; 4) neurobiological, psychosocial, and functional consequences; and 5) putative neurobiological and psychosocial mechanisms, risk factors, and protective factors.

Original languageEnglish (US)
JournalJournal of Pain
DOIs
StateAccepted/In press - 2020

Keywords

  • Chronic low back pain
  • diagnostic criteria
  • lumbar spinal stenosis
  • neurogenic claudication
  • radicular back pain
  • sciatica

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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  • Cite this

    Markman, J. D., Czerniecka-Foxx, K., Khalsa, P. S., Hayek, S. M., Asher, A. L., Loeser, J. D., & Chou, R. (Accepted/In press). AAPT Diagnostic Criteria for Chronic Low Back Pain. Journal of Pain. https://doi.org/10.1016/j.jpain.2020.01.008