Association between widespread pressure pain hypersensitivity, health history, and trigger points in subjects with neck pain

Association between widespread pressure pain hypersensitivity, health history, and trigger points... 168Scientific presentations at the 2017 Annual Meeting / Scandinavian Journal of Pain 16 (2017) 165–188the upper trapezius, and collection of neck disability and neck painintensity. The examination was performed by an assessor blindedto subjects’ condition.Results: A significant positive association between pain and disability (P < 0.003), pain and PPT in the upper trapezius (P < 0.041),pain and PPT in tibialis anterior (P < 0.038), disability and PPT inupper trapezius (P = 0.006) was found in both groups. Subjects withMNP showed significantly negative association between disability and PPT in the tibialis anterior (P = 0.003). Subjects with activeTrPs in the upper trapezius exhibited significantly higher neck painintensity and neck disability and lower PPTs (all, P < 0.015), thanthose with latent TrPs in both groups.Conclusions: Our results suggest that the association betweenpain, disability, and PPTs is similar in subjects with neck pain andnot influenced by the origin of neck pain. The presence of activeTrPs in upper trapezius in neck pain patients was related to higherpain intensity, related-disability and lower PPTs, compared to neckpain patients with latent TrPs in upper trapezius. Future studies areneeded to determine the clinical role of these associations.http://dx.doi.org/10.1016/j.sjpain.2017.04.012Association between widespread pressure painhypersensitivity, health history, and triggerpoints in subjects with neck painMatteo Castaldo a,b,c,∗ , Antonella Catena a , César˜ b,d , Lars Arendt-Nielsen bFernández-de-las-PenasaPoliambulatorio FisioCenter, Collecchio, Parma,Italyb SMI® , Department of Health Science andTechnology, Faculty of Medicine, Aalborg University,Aalborg, Denmarkc University of Siena, Siena, Italyd Department of Physical Therapy, OccupationalTherapy, Physical Medicine and Rehabilitation,Universidad Rey Juan Carlos, Alcorcón, SpainE-mail address: matteo.castaldo@poliambulatoriofisiocenter.com(M. Castaldo).Aims: Health history (medical conditions, comorbid musculoskeletal pain, surgical operation, long term intake of medications)may contribute to central sensitization. The duration and the number of the peripheral nociceptive input seem to play a crucial rolein the development and maintenance of sensitization. No study haspreviously investigated these relationships. Our aim was to investigate the association between pressure pain thresholds (PPTs) andhealth history in patients with neck pain, and the role of activetrigger points (TrPs) on PPTs.Methods: Thirty-four subjects with mechanical neck pain and34 with whiplash-associated neck pain participated. They underwent an assessment of PPTs over upper trapezius, extensor carpiradialis longus, and tibialis anterior muscles, and were screenedfor the presence of active TrPs in upper trapezius muscle. Further,patients fulfilled a questionnaire investigating health history outcomes number and duration.Results: Significant negative correlations between all PPTs andthe duration of health history outcomes were found in both groups(all, P < 0.02), with no correlations between PPTs and the number ofhealth history outcomes (all, P > 0.15). Significant lower PPTs overupper trapezius, extensor carpi radialis longus, and tibialis anterior(all, P < 0.01) muscles were found in subjects with active TrPs ascompared to those with latent TrPs.Conclusions: Widespread pressure pain hypersensitivity wasassociated with the duration, but not the number, of health historyoutcomes suggesting that long-lasting health complains may act astriggering factor driving sensitization in individuals with neck painregardless the origin of neck pain. Patients with active TrPs in theupper trapezius muscle showed higher widespread pressure sensitivity than those with latent TrPs. These data should be includedin the assessment of neck pain subjects, as they may be useful forplanning the management of their symptoms.http://dx.doi.org/10.1016/j.sjpain.2017.04.013Neuromas in patients with peripheral nerveinjury and amputation - An ongoing studyN.S. Buch a,b,∗ , E. Qerama c , N.B. Finnerup b , L.Nikolajsen a,baDepartment of Anesthesiology and Intensive Care,Aarhus University Hospital, Denmarkb Danish Pain Research Center, Aarhus UniversityHospital, Denmarkc Department of Neurophysiology, Aarhus UniversityHospital, DenmarkE-mail address: nina.buch@clin.au.dk (N.S. Buch).Background and aims: Injury to peripheral nerves associatedwith trauma, amputation, or surgery may lead to the formationof neuromas that can cause severe pain. Unfortunately, neuromasare frequently refractory to medical and surgical treatment. Thisongoing study examines whether neuromas are more frequent inpatients experiencing pain after peripheral nerve injury or amputation than in patients without pain.Methods: In this observational cohort study, 80 patients withperipheral nerve injury or amputation will be recruited. Patientswill answer pain questionnaires and undergo a clinical examination with quantitative sensory testing performed within the area ofspontaneous pain, including areas of brush-evoked allodynia andpinprick hyperalgesia. Neuromas are identified using ultrasound.Results: Patient inclusion is ongoing. At present, fourteenamputees have participated in the study: nine males and fourfemales, aged 38–77 years. Six patients had no neuromas. Stumppain in this group ranged from 0 to 8 and phantom pain from 0 to10 on a numerical rating scale, 0–10. Eight patients had neuromas.Stump pain in this group ranged from 0 to 7 and phantom pain from0 to 8. Further results will be presented at the congress.Conclusions: Because of a limited number of patients included,it is not yet possible to conclude if neuromas are more frequent inpatients with pain.Hopefully, this study will increase our understanding of the roleof neuromas in patients with pain after peripheral nerve injury andamputation.http://dx.doi.org/10.1016/j.sjpain.2017.04.014 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

Association between widespread pressure pain hypersensitivity, health history, and trigger points in subjects with neck pain

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de Gruyter
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© 2017 Scandinavian Association for the Study of Pain
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1877-8860
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1877-8879
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10.1016/j.sjpain.2017.04.013
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Abstract

168Scientific presentations at the 2017 Annual Meeting / Scandinavian Journal of Pain 16 (2017) 165–188the upper trapezius, and collection of neck disability and neck painintensity. The examination was performed by an assessor blindedto subjects’ condition.Results: A significant positive association between pain and disability (P < 0.003), pain and PPT in the upper trapezius (P < 0.041),pain and PPT in tibialis anterior (P < 0.038), disability and PPT inupper trapezius (P = 0.006) was found in both groups. Subjects withMNP showed significantly negative association between disability and PPT in the tibialis anterior (P = 0.003). Subjects with activeTrPs in the upper trapezius exhibited significantly higher neck painintensity and neck disability and lower PPTs (all, P < 0.015), thanthose with latent TrPs in both groups.Conclusions: Our results suggest that the association betweenpain, disability, and PPTs is similar in subjects with neck pain andnot influenced by the origin of neck pain. The presence of activeTrPs in upper trapezius in neck pain patients was related to higherpain intensity, related-disability and lower PPTs, compared to neckpain patients with latent TrPs in upper trapezius. Future studies areneeded to determine the clinical role of these associations.http://dx.doi.org/10.1016/j.sjpain.2017.04.012Association between widespread pressure painhypersensitivity, health history, and triggerpoints in subjects with neck painMatteo Castaldo a,b,c,∗ , Antonella Catena a , César˜ b,d , Lars Arendt-Nielsen bFernández-de-las-PenasaPoliambulatorio FisioCenter, Collecchio, Parma,Italyb SMI® , Department of Health Science andTechnology, Faculty of Medicine, Aalborg University,Aalborg, Denmarkc University of Siena, Siena, Italyd Department of Physical Therapy, OccupationalTherapy, Physical Medicine and Rehabilitation,Universidad Rey Juan Carlos, Alcorcón, SpainE-mail address: matteo.castaldo@poliambulatoriofisiocenter.com(M. Castaldo).Aims: Health history (medical conditions, comorbid musculoskeletal pain, surgical operation, long term intake of medications)may contribute to central sensitization. The duration and the number of the peripheral nociceptive input seem to play a crucial rolein the development and maintenance of sensitization. No study haspreviously investigated these relationships. Our aim was to investigate the association between pressure pain thresholds (PPTs) andhealth history in patients with neck pain, and the role of activetrigger points (TrPs) on PPTs.Methods: Thirty-four subjects with mechanical neck pain and34 with whiplash-associated neck pain participated. They underwent an assessment of PPTs over upper trapezius, extensor carpiradialis longus, and tibialis anterior muscles, and were screenedfor the presence of active TrPs in upper trapezius muscle. Further,patients fulfilled a questionnaire investigating health history outcomes number and duration.Results: Significant negative correlations between all PPTs andthe duration of health history outcomes were found in both groups(all, P < 0.02), with no correlations between PPTs and the number ofhealth history outcomes (all, P > 0.15). Significant lower PPTs overupper trapezius, extensor carpi radialis longus, and tibialis anterior(all, P < 0.01) muscles were found in subjects with active TrPs ascompared to those with latent TrPs.Conclusions: Widespread pressure pain hypersensitivity wasassociated with the duration, but not the number, of health historyoutcomes suggesting that long-lasting health complains may act astriggering factor driving sensitization in individuals with neck painregardless the origin of neck pain. Patients with active TrPs in theupper trapezius muscle showed higher widespread pressure sensitivity than those with latent TrPs. These data should be includedin the assessment of neck pain subjects, as they may be useful forplanning the management of their symptoms.http://dx.doi.org/10.1016/j.sjpain.2017.04.013Neuromas in patients with peripheral nerveinjury and amputation - An ongoing studyN.S. Buch a,b,∗ , E. Qerama c , N.B. Finnerup b , L.Nikolajsen a,baDepartment of Anesthesiology and Intensive Care,Aarhus University Hospital, Denmarkb Danish Pain Research Center, Aarhus UniversityHospital, Denmarkc Department of Neurophysiology, Aarhus UniversityHospital, DenmarkE-mail address: nina.buch@clin.au.dk (N.S. Buch).Background and aims: Injury to peripheral nerves associatedwith trauma, amputation, or surgery may lead to the formationof neuromas that can cause severe pain. Unfortunately, neuromasare frequently refractory to medical and surgical treatment. Thisongoing study examines whether neuromas are more frequent inpatients experiencing pain after peripheral nerve injury or amputation than in patients without pain.Methods: In this observational cohort study, 80 patients withperipheral nerve injury or amputation will be recruited. Patientswill answer pain questionnaires and undergo a clinical examination with quantitative sensory testing performed within the area ofspontaneous pain, including areas of brush-evoked allodynia andpinprick hyperalgesia. Neuromas are identified using ultrasound.Results: Patient inclusion is ongoing. At present, fourteenamputees have participated in the study: nine males and fourfemales, aged 38–77 years. Six patients had no neuromas. Stumppain in this group ranged from 0 to 8 and phantom pain from 0 to10 on a numerical rating scale, 0–10. Eight patients had neuromas.Stump pain in this group ranged from 0 to 7 and phantom pain from0 to 8. Further results will be presented at the congress.Conclusions: Because of a limited number of patients included,it is not yet possible to conclude if neuromas are more frequent inpatients with pain.Hopefully, this study will increase our understanding of the roleof neuromas in patients with pain after peripheral nerve injury andamputation.http://dx.doi.org/10.1016/j.sjpain.2017.04.014

Journal

Scandinavian Journal of Painde Gruyter

Published: Jul 1, 2017

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