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

doi:10.1016/j.jpain.2020.01.008

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 journal › Article › peer-review

20 Scopus citations

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 language	English (US)
Pages (from-to)	1138-1148
Number of pages	11
Journal	Journal of Pain
Volume	21
Issue number	11-12
DOIs	https://doi.org/10.1016/j.jpain.2020.01.008
State	Published - Nov 1 2020

Funding

We thank Maria E. Frazer, BS, CCRC, for her manuscript production support. Disclosures: The views expressed in this article are those of the authors, none of whom has financial conflicts of interest relevant to the issues discussed in this manuscript. No official endorsement by the US Food and Drug Administration (FDA) should be inferred. Support was provided by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the FDA, which has received contracts, grants, and other revenue for its activities from the FDA, multiple pharmaceutical and device companies, and other sources. A complete list of current ACTTION sponsors is available at: http://www.acttion.org/partners.

Funders
U.S. Food and Drug Administration
Food and Drug Administration

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

Access to Document

10.1016/j.jpain.2020.01.008

Cite this

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title = "AAPT Diagnostic Criteria for Chronic Low Back Pain",

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.",

keywords = "Chronic low back pain, diagnostic criteria, lumbar spinal stenosis, neurogenic claudication, radicular back pain, sciatica",

author = "Markman, \{John D.\} and Katarzyna Czerniecka-Foxx and Khalsa, \{Partap S.\} and Hayek, \{Salim Michel\} and Asher, \{Anthony L.\} and Loeser, \{John D.\} and Roger Chou",

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AU - Khalsa, Partap S.

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AU - Asher, Anthony L.

AU - Loeser, John D.

AU - Chou, Roger

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AAPT Diagnostic Criteria for Chronic Low Back Pain

Abstract

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Keywords

ASJC Scopus subject areas

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