Pressure pain thresholds in office workers with chronic neck pain. A systematic review and meta‐analysis

Pain Practice ◽  
2021 ◽  
Author(s):  
Alexandre Maurício Passos Nunes ◽  
João Paulo Azinheira Martins Moita ◽  
Maria Margarida Marques Rebelo Espanha ◽  
Kristian Kjær Petersen ◽  
Lars Arendt‐Nielsen
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Meta Analysis ◽  
Chronic Neck Pain ◽  
Office Workers ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds

Effects of Deep Cervical Flexor Training on Pressure Pain Thresholds Over Myofascial Trigger Points in Patients With Chronic Neck Pain

2013 ◽  
Vol 36 (9) ◽  
pp. 604-611 ◽  
Author(s):  
Enrique Lluch ◽  
Maria Dolores Arguisuelas ◽  
Pablo S. Coloma ◽  
Francisco Palma ◽  
Alejandro Rey ◽  
...  
Keyword(s):  
Neck Pain ◽  
Chronic Neck Pain ◽  
Trigger Points ◽  
Myofascial Trigger Points ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds

Widespread Pressure Pain Hypersensitivity, Health History, and Trigger Points in Patients with Chronic Neck Pain: A Preliminary Study

Pain Medicine ◽  
2019 ◽  
Vol 20 (12) ◽  
pp. 2516-2527 ◽  
Author(s):  
Matteo Castaldo ◽  
Antonella Catena ◽  
César Fernández-de-las-Peñas ◽  
Lars Arendt-Nielsen
Keyword(s):  
Neck Pain ◽  
Chronic Neck Pain ◽  
Trigger Points ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pain Hypersensitivity ◽  
Health History ◽  
Upper Trapezius ◽  
Pressure Pain Thresholds ◽  
Pain Patients

Abstract Background Pain sensitivity in chronic neck pain patients may be influenced by health conditions related to higher levels of widespread pressure pain hypersensitivity (sensitization). Trigger points have also been reported to play a role in the sensitization process. Objectives To investigate the association between pressure pain thresholds, trigger points, and health conditions in patients with chronic neck pain. Design Original research, preliminary study. Setting A private clinic. Subjects Thirty-four chronic mechanical neck pain patients and 34 chronic whiplash-associated neck pain patients, giving a final sample of 68 chronic neck pain patients. Methods Patients underwent an assessment of pressure pain thresholds over the upper trapezius, extensor carpi radialis longus, and tibialis anterior muscles and were screened for the presence of trigger points in the upper trapezius muscle. Further, information about health history conditions was obtained and collected in a form. Results Significantly negative correlations between all pressure pain thresholds and duration of health history conditions were found (all P < 0.02). Significantly lower pressure pain thresholds (all P < 0.01) were found in patients with active trigger points as compared with those with latent trigger points. Conclusion Widespread pressure pain hypersensitivity was associated with duration of health history conditions, suggesting that long-lasting health complaints may act as a triggering/perpetuating factor, driving sensitization in individuals with chronic neck pain. Active trigger points may be associated with higher widespread pressure hypersensitivity.

scholarly journals Exploring the pain in patellofemoral pain: A systematic review and meta-analysis examining signs of central sensitization

2020 ◽  
Author(s):  
Kemery J. Sigmund ◽  
Marie K. Hoeger Bement ◽  
Jennifer E. Earl-Boehm
Keyword(s):  
Systematic Review ◽  
Central Sensitization ◽  
Temporal Summation ◽  
Meta Analysis ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Pain Mapping

Objective: Patellofemoral pain has high recurrence rates and minimal long-term treatment success. Central sensitization refers to dysfunctional pain modulation that occurs when nociceptive neurons become hyper responsive. Research in this area in PFP has been increasingly productive in the past decade. The aim of this review is to determine whether evidence supports manifestations of central sensitization in individuals with PFP. Data sources: MeSH terms for quantitative sensory testing (QST) pressure pain thresholds, conditioned pain modulation, temporal summation, sensitization, hyperalgesia, and anterior knee pain or PFP were searched in PubMed, SportDiscus, CINAHL, Academic Search Complete, and Ebscohost. Study Selection: Peer reviewed studies written in English, published between 2005–2020 which investigated QST and/or pain mapping in a sample with PFP were included in this review. Data Extraction: The initial search yielded 140 articles. After duplicates were removed, 78 article abstracts were reviewed. Full-text review of 21 studies occurred, with 11 studies included in the meta-analysis and eight studies included in the systematic review. Data Synthesis: A random-effects meta-analysis was conducted for four QST variables (local pressure pain thresholds, remote pressure pain thresholds, conditioned pain modulation, temporal summation). Strong evidence supports lower local and remote pressure pain thresholds, impaired conditioned pain modulation, and facilitated temporal summation in individuals with PFP compared to pain-free individuals. Conflicting evidence is presented for heat and cold pain thresholds. Pain mapping demonstrated expanding pain patterns associated with long PFP symptom duration. Conclusions: Signs of central sensitization are present in individuals with PFP, indicating altered pain modulation. PFP etiological and treatment models should reflect the current body of evidence regarding central sensitization. Signs of central sensitization should be monitored clinically and treatments with central effects should be considered as part of a multi-modal plan of care. Registration Number: This review is registered with Prospero (CRD42019127548) Registration URL: https://www.crd.york.ac.uk/PROSPERO Key Points:

Altered pain processing and sensitisation is evident in adults with patellofemoral pain: a systematic review including meta-analysis and meta-regression

2019 ◽  
Vol 20 (1) ◽  
pp. 11-27 ◽  
Author(s):  
Clare Bartholomew ◽  
Simon Lack ◽  
Bradley Neal
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Symptom Duration ◽  
Pain Processing ◽  
Detection Thresholds ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Moderate Evidence ◽  
Pressure Pain Thresholds ◽  
Meta Regression

AbstractBackground and aimsPrevious systematic reviews have reported manifestations of pain sensitisation as a feature of painful knee disorders, in particular osteoarthritis, with moderate evidence for pain sensitisation in patellofemoral pain (PFP). However, despite past studies recruiting female mostly adolescent PFP patients, it is unclear if sex or age plays a role. Investigation is required to determine if altered pain processing is a key feature of PFP and if a subgroup of patients is at an increased risk to help provide targeted management. The primary aim of this systematic review was to examine evidence investigating pain processing in PFP. Secondary aims were to evaluate the relationship between pain processing and (1) sex, (2) age and (3) symptom duration.MethodsThe protocol was prospectively registered with PROSPERO (CRD42019129851). PubMed, CINAHL, Web of Science and EMBASE were systematically searched from inception to April 2019 for studies investigating pain processing in PFP patients compared to controls using quantitative sensory testing. Each included paper was assessed for methodological quality using a modified version of Downs and Black. Means and standard deviations were extracted to calculate standardised mean differences (SMD) and 95% confidence intervals (95% CI). Where possible meta-analysis and meta-regression were performed using a random effects model.ResultsEleven studies were identified, two medium and nine high quality. Meta-analysis indicates moderate evidence for decreased pressure pain thresholds (SMD −0.68, 95% CI −0.93 to −0.43), increased tactile detection thresholds (SMD 1.35, 95% CI 0.49–2.22) and increased warmth detection thresholds (SMD 0.61, 95% CI 0.30–0.92) in PFP patients compared to controls. Secondary analysis indicates moderate evidence for decreased pressure pain thresholds in female compared to male patients (SMD −0.75, 95% CI −1.34 to −0.16). Meta-regression indicates a moderate correlation between decreasing local and distal pressure pain thresholds and decreasing patient age (local R2 = 0.556, p = 0.0211; distal R2 = 0.491, p = 0.0354) but no correlation with symptom duration (p > 0.05).ConclusionsEvidence from this systematic review with meta-analysis and meta-regression appears to suggest the presence of altered pain processing and sensitisation in patients with PFP with increased sensitivity indicated in female patients and younger patients.ImplicationsWith evidence of altered pain processing and sensitisation in PFP, it may be beneficial for clinicians to consider management approaches that aim specifically at adressing neuropathic pain, for example neuroscience education, to improve patients outcomes. With female patients and younger patients indicated as experiencing greater degree of sensitivity, this may be a good demographic to start screening for sensitisation, in order to better identify and treat those most affected.

scholarly journals https://painphysicianjournal.com/current

2020 ◽  
Vol 4;23 (7;4) ◽  
pp. 335-348
Author(s):  
Nicholas Van Halm-Lutterodt
Keyword(s):  
Systematic Review ◽  
Pain Relief ◽  
Neck Pain ◽  
Functional Status ◽  
Spinal Stenosis ◽  
Local Anesthetic ◽  
Meta Analysis ◽  
Chronic Neck Pain ◽  
Epidural Injections ◽  
Significant Difference

Background: Chronic neck pain is reportedly considered the fourth leading cause of disability. Cervical interlaminar epidural injections are among the commonly administered nonsurgical interventions for managing chronic neck pain, secondary to disc herniation and radiculitis, spinal stenosis, or chronic neck pain of discogenic origin. Objectives: To systematically review the differences in the effectiveness of cervical epidural injections with local anesthetics with or without steroids for the management of chronic neck pain. Study Design: Systematic review and meta-analysis. Methods: A comprehensive search of the literature of randomized controlled trials (RCTs) that compared epidural injections with local anesthetic with or without steroids was performed, including a search of PubMed, EMBASE, and Cochrane databases for all years up to May 2019. Meta-analysis was done for pain relief based on the Numeric Rating Scale, functional status based on the Neck Disability Index, and opioid intake dosage. Results: Four studies met the inclusion criteria. A total of 370 patients were divided into 2 groups: the experimental group received cervical epidural injection with steroid and local anesthetic, and the control group received injection with local anesthetic only. Regrading pain relief, no significant difference was observed between both groups (weighted mean difference [WMD], –0.006; 95% confidence interval (CI), –0.275 to 0.263; P = 0.963; I2 = 0.0% at 12 months). There was also no significant difference in the improvement of the functional status (WMD, 0.159; 95% CI, –1.231 to 1.549; P = 0.823; I2 = 9.8% at 12 months). Similarly, there was no significant difference in opioid dosage (WMD, –0.093; 95% CI, –5.952 to 5.766; P = 0.975; I2 = 0.0% at 12 months). Limitations: Only a few studies on this premise were found in the literature. There was also a lack of heterogeneity of the included RCT studies. Conclusions: The addition of steroids to anesthetic injectates was not associated with better pain and functional score outcomes compared with anesthetic injectate alone in patients with chronic neck pain. Key words: Chronic neck pain, cervical radiculopathy, cervical disc disease, spinal stenosis, facet joint pathology, cervical epidural injections, steroid injections, local anesthetic injections, systematic review, meta-analysis, randomized control trial

scholarly journals Individuals With Chronic Neck Pain Have Lower Neck Strength Than Healthy Controls: A Systematic Review With Meta-Analysis

2019 ◽  
Vol 42 (8) ◽  
pp. 608-622
Author(s):  
Iã Ferreira Miranda ◽  
Edgar Santiago Wagner Neto ◽  
William Dhein ◽  
Guilherme A. Brodt ◽  
Jefferson F. Loss
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Meta Analysis ◽  
Chronic Neck Pain ◽  
Healthy Controls ◽  
Neck Strength ◽  
Lower Neck
Sign in / Sign up

Export Citation Format

Share Document