Differences between traumatic and non-traumatic chronic neck pain patients: The role of central pain modulation, cognitive functioning and psychosocial characteristics

2016 ◽  
Vol 25 ◽  
pp. e71
Author(s):  
I. Coppieters ◽  
B. Cagnie ◽  
R. De Pauw ◽  
L. Danneels ◽  
K. Ickmans ◽  
...  
Keyword(s):  
Neck Pain ◽  
Cognitive Functioning ◽  
Chronic Neck Pain ◽  
Pain Modulation ◽  
Central Pain ◽  
Psychosocial Characteristics ◽  
Pain Patients

Enhanced Pronociceptive and Disrupted Antinociceptive Mechanisms in Nonspecific Chronic Neck Pain

2020 ◽  
Author(s):  
Josu Zabala Mata ◽  
Ion Lascurain-Aguirrebeña ◽  
Estíbaliz Dominguez López ◽  
Jon Jatsu Azkue
Keyword(s):  
Physical Therapy ◽  
Neck Pain ◽  
Tibialis Anterior ◽  
Chronic Neck Pain ◽  
Pain Modulation ◽  
Mean Difference ◽  
Central Pain ◽  
Nociceptive Processing ◽  
Antinociceptive Mechanisms ◽  
Second Pain

Abstract Objective Evidence suggests altered pronociceptive and antinociceptive mechanisms in many chronic pain conditions. Knowledge about these mechanisms in nonspecific chronic neck pain (NSNP) would improve understanding of the causes and the design of more effective treatments. Pressure pain threshold (PPT) is often used to assess presence of altered nociceptive processing in NSNP; however, its usefulness to detect this is yet to be established. The purpose of this study was to determine the functional status of temporal summation of second pain (TSSP) and conditioned pain modulation (CPM) in NSNP and to characterize the association of both measures with PPT and clinical features of NSNP. Methods Thirty-two participants with NSNP (mean [SD] age = 44 [11] y; 27 female) and 32 age and sex matched healthy controls were recruited. TSSP was assessed using an electrical stimulus at the dorsum of the hand, and CPM was evaluated with the Cold Pressor Test. PPT was assessed bilaterally at the neck and tibialis anterior muscles. Results Participants with NSNP showed greater TSPP (mean difference = 0.23; 95% CI = 0.46-0.01; Cohen d = 0.51) and lower CPM (mean difference = 19.44; 95% CI = 10.42-28.46; Cohen d = 1.09). Pooled data from all participants showed lower PPTs at the neck than the tibialis anterior. However, PPT measures did not differ between groups at either location. PPT measures were not correlated with CPM and TSP. Conclusion NSNP is associated with enhanced pronociceptive and impaired antinociceptive mechanisms, which may explain long-lasting pain and failure of some treatments to resolve symptoms. However, due to the observational nature of this study, a clear cause-effect relationship cannot be established. Normal PPT values in the clinic should not be interpreted as absence of altered nociceptive processing. Impact This study fills in some gaps in knowledge. Changes in central nociceptive processing may explain persistent and recurrent symptoms in NSNP and failure of treatments to obtain long-lasting relief. Further research is required to ascertain if TSSP and CPM assessment in the clinic may help predict physical therapy treatment outcome. Whether symptomatic relief with physical therapy is mediated by an improvement in TSSP and CPM should also be explored. PPTs were unaltered in participants with NSNP despite evidence of impairment in the central pain modulatory systems. Normal PPTs should not be interpreted as evidence of unaltered central pain-related processing.

Examination of Regional Interdependence Theory in Chronic Neck Pain: Interpretations from Correlation of Strength Measures in Cervical and Pain-Free Regions

Pain Medicine ◽  
2019 ◽  
Author(s):  
Leila Ghamkhar ◽  
Amir Massoud Arab ◽  
Mohammad Reza Nourbakhsh ◽  
Amir Hossein Kahlaee ◽  
Reyhaneh Zolfaghari
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Neck Disability Index ◽  
Chronic Neck Pain ◽  
Pain Intensity Score ◽  
Painful Condition ◽  
Asymptomatic Volunteers ◽  
Interdependence Theory ◽  
Regional Interdependence ◽  
Pain Patients

Abstract Objective Impairments present in chronic pain conditions have been reported not to be limited to the painful region. Pain-free regions have also been proposed to be adversely affected as a cause or consequence of the painful condition. The aim of this study was to investigate the association between muscle strength in painful and pain-free regions and chronic neck pain. Design A cross-sectional study. Setting Rehabilitation hospital laboratory. Subjects One hundred twenty-two patients with chronic neck pain (87 female) and 98 asymptomatic volunteers (52 female) were included in the study. Methods Maximal isometric strength measures of the neck, scapulothoracic, shoulder, trunk, and hip muscles were assessed using a hand-held dynamometer in all participants. Pain intensity and pain-related disability were also assessed in patients through visual analog scale and Neck Disability Index scores, respectively. Results Principal component analysis revealed one component for each of the studied regions. Multivariate analysis of variance found neck (d = 0.46), scapulothoracic (d = 0.46), shoulder (d = 0.60), trunk flexor (d = 0.38), extensor (d = 0.36), and hip (d = 0.51) strength components to be lower in the neck pain patients compared with asymptomatic participants (P < 0.01). Logistic and linear regression analyses found the shoulder strength component both to be a significant predictor for neck pain occurrence (β = 0.53, P < 0.01) and to have a considerable effect on pain intensity score (β=–0.20, P = 0.02), respectively. Conclusions The results found that some pain-free regions in addition to the cervical spine to exhibit lower levels of muscular strength in neck pain patients. These findings support the regional interdependence theory, which proposes that impairments are not limited to the painful area and are possibly mediated by central mechanisms.

Altered grey matter morphology of pain processing regions in traumatic and non-traumatic chronic neck pain patients: Relations with clinical pain measures?

2016 ◽  
Vol 25 ◽  
pp. e33-e34
Author(s):  
I. Coppieters ◽  
M. Meeus ◽  
R. De Pauw ◽  
K. Caeyenberghs ◽  
L. Danneels ◽  
...  
Keyword(s):  
Neck Pain ◽  
Grey Matter ◽  
Chronic Neck Pain ◽  
Pain Processing ◽  
Clinical Pain ◽  
Pain Patients

Does muscle morphology change in chronic neck pain patients? – A systematic review

2016 ◽  
Vol 22 ◽  
pp. 42-49 ◽  
Author(s):  
R. De Pauw ◽  
I. Coppieters ◽  
J. Kregel ◽  
K. De Meulemeester ◽  
L. Danneels ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Chronic Neck Pain ◽  
Muscle Morphology ◽  
Morphology Change ◽  
Pain Patients

scholarly journals Adaptations in Evoked Pain Sensitivity and Conditioned Pain Modulation after Development of Chronic Neck Pain

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Bahar Shahidi ◽  
Katrina S. Maluf
Keyword(s):  
Neck Pain ◽  
Pain Sensitivity ◽  
Time Course ◽  
Secondary Analysis ◽  
Chronic Neck Pain ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Healthy Individuals ◽  
Cold Pain

Numerous studies demonstrate elevated pain sensitivity and impaired conditioned pain modulation (CPM) in patients with chronic musculoskeletal pain compared to healthy individuals; however, the time course of changes in pain sensitivity and CPM after the development of a chronic pain condition is unclear. Secondary analysis of data from a prospective investigation examined changes in evoked pain sensitivity and CPM before and after development of chronic neck pain (CNP). 171 healthy office workers participated in a baseline assessment, followed by monthly online questionnaires to identify those who developed CNP over the subsequent year. These individuals (N=17) and a cohort of participants (N=10) who remained pain-free during the follow-up period returned for a 12-month follow-up assessment of mechanical and thermal pain sensitivity and CPM. Pain sensitivity measures did not differ between groups at baseline; however, cold pain threshold decreased in the CNP group at follow-up (p<0.05). CPM was lower at baseline in the CNP group compared to those who reported no neck pain (p<0.02) and remained unchanged one year later. These findings indicate that CPM is reduced in healthy individuals prior to the development of chronic neck pain and the subsequent reduction of thresholds for cold but not pressure pain.

Neural Tension Technique Improves Immediate Conditioned Pain Modulation in Patients with Chronic Neck Pain: A Randomized Clinical Trial

Pain Medicine ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 1227-1235 ◽  
Author(s):  
Josué Fernández-Carnero ◽  
Eva Sierra-Silvestre ◽  
Hector Beltran-Alacreu ◽  
Alfonso Gil-Martínez ◽  
Roy La Touche
Keyword(s):  
Clinical Trial ◽  
Neck Pain ◽  
Randomized Clinical Trial ◽  
Chronic Neck Pain ◽  
Pain Modulation ◽  
Conditioned Pain Modulation
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