Does Sensorimotor Incongruence Trigger Pain and Sensory Disturbances in People With Chronic Low Back Pain? A Randomized Cross-Over Experiment

Chronic low back pain (CLBP) has major public health implications, and underlying mechanisms are still unclear. Sensorimotor incongruence (SMI)-an ongoing mismatch between top-down motor output and predicted sensory feedback-may play a role in the course of chronic nonspecific low back pain. The hypothesis of this study was that the induction of SMI causes sensory disturbances and/or pain in people with CLBP and healthy volunteers. A sample of 66 people (33 people with CLBP and 33 healthy volunteers) participated in a visual feedback experiment involving real-time images of their own lower backs-either during movement or in a static position-provided via a live video feed. Experimental SMI was induced via distorting visual feedback of the lower back during movement. There were no significant differences in sensory disturbances or pain intensity between experimental SMI and the other movement conditions in people with CLBP and healthy volunteers (P > .05). Static visual feedback had a significant effect on the intensity of sensory disturbances in people with CLBP (P = .038) and healthy volunteers (P < .001). In conclusion, experimental SMI did not affect sensory disturbances or pain in either group. Therefore, the research hypothesis was not supported. Perspective: The results of this study show that sensorimotor incongruence does not cause additional symptoms and pain in people with chronic low back pain. The conceptual premise that sensorimotor incongruence is an underlying contributor in the course of pain in this population is not supported. (C) 2018 by the American Pain Society