scholarly journals Mechanisms of “Cough-Trick” for Pain Relief during Venipuncture: An Experimental Crossover Investigation in Healthy Volunteers

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Taras I. Usichenko ◽  
Henriette Janner ◽  
Maria Gagarine ◽  
Dragan Pavlovic ◽  
Eric Lang ◽  
...  
Keyword(s):  
Pressure Pain Threshold ◽  
Underlying Mechanism ◽  
Mean Difference ◽  
Opioid Antagonist ◽  
Pressure Pain ◽  
Naloxone Administration ◽  
Paired Samples ◽  
Pressure Pain Thresholds ◽  
Before And After ◽  
Scale Data

Objectives. The easily performed “cough-trick” (CT) reduces pain during venipuncture (VP), although the underlying mechanism remains unclear. The aim was to investigate the pain-reducing effect of CT during VP in comparison with two distraction methods, as well as under the influence of naloxone. Methods. 54 healthy male volunteers participated in 3 investigations. Pain during standardized VP with CT was compared to a “weak” distraction (squeezing a rubber ball; investigation 1; n=20) and to a “strong” distraction (inflating a tourniquet to a given pressure; investigation 2; n=21). In investigation 3 (n=13), pain at a VP without intervention was compared to pain at VP with CT under naloxone; pressure pain thresholds before and after naloxone administration were also measured. Pain was assessed using a 100 mm visual analogue scale. Data were compared within each sample using Student’s t-test for paired samples. Results. Pain intensity at VP with CT was lower than under “weak” distraction (mean difference 5 mm; 95% CI: 0.5 to 9.6; P=0.03). Pain levels under CT and “strong” distraction were comparable. There was no difference between pain under CT after naloxone infusion and pain without intervention. Pressure pain threshold decreased (mean difference 1 mm; 95% CI: 0.1 to 1.0 mm; P=0.02) after naloxone administration. Conclusion. Pain-reducing effect of CT during VP is superior to that of simple motor distraction and equivalent to a complex distraction method. This might be due to the activation of segmental pain inhibitory pathways during coughing indicated through the lack of pain reduction due to CT under opioid antagonist blockage.

scholarly journals Effects of Compressive Stockings and Standard Stockings in Skin Temperature and Pressure Pain Threshold in Runners with Functional Ankle Equinus Condition

2018 ◽  
Vol 7 (11) ◽  
pp. 454 ◽  
Author(s):  
David Rodríguez-Sanz ◽  
Ricardo Becerro-de-Bengoa-Vallejo ◽  
Marta Losa-Iglesias ◽  
Eva Martínez-Jiménez ◽  
Daniel Muñoz-García ◽  
...  
Keyword(s):  
Skin Temperature ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Pressure Pain ◽  
Clinical Assessments ◽  
Pressure Pain Thresholds ◽  
Before And After ◽  
Temperature And Pressure ◽  
Skin Temperatures ◽  
Control Study

Objective: To assess clinical differences in the Achilles tendons of runners with ankle equinus wearing either compressive or standard stockings. Design: Case–control study. Methods: In this study, we conducted clinical examinations of 98 sportsmen (runners) with equinus, before and after 30 min of running on a treadmill; 49 runners wore compressive stockings and 49 wore standard stockings. Clinical assessments of the runners’ Achilles tendons were based on the pressure pain threshold (PPT) and skin temperature analysis. Results: Achilles tendon evaluations identified significant differences in skin temperature modification and PPT between the compressive and standard stocking groups. Conclusions: Based on our findings, we propose that higher skin temperatures are associated with lower pressure pain thresholds in the Achilles tendons of runners with ankle equinus.

Pressure Pain Threshold and Pain Tolerance in Episodic Tension-Type Headache Do Not Depend on the Presence of Headache

Cephalalgia ◽  
1999 ◽  
Vol 19 (3) ◽  
pp. 174-178 ◽  
Author(s):  
GM Bove ◽  
N Nilsson
Keyword(s):  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Underlying Mechanism ◽  
Tension Type Headache ◽  
Pain Tolerance ◽  
Mechanical Stimuli ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Tension Type Headaches

Pressure pain thresholds and responses to painful mechanical stimuli were obtained from 20 subjects with episodic tension-type headaches (TTH). Tender points in the temporalis and trapezius muscles were studied, along with two nontender points, one in the temporalis and one on the Achilles tendon. Two examinations were performed, one during and one without a headache, and results were compared. No significant differences were found in either variable for any tested points. The data demonstrate that the sensitivity level of these points does not differ based on the presence or absence of TTH. This suggests that the muscle sensitivity in TTH is constant. The observation that the sensitivity levels of both tender and nontender points did not vary suggests that the underlying mechanism or effect of TTH is not restricted to tender muscles.

The interleukin-1α gene C>T polymorphism rs1800587 is associated with increased pain intensity and decreased pressure pain thresholds in patients with lumbar radicular pain

2014 ◽  
Vol 5 (3) ◽  
pp. 212-212
Author(s):  
Elina Iordanova Schistad ◽  
Line Melå Jacobsen ◽  
Cecilie Røe ◽  
Johannes Gjerstad
Keyword(s):  
Pain Intensity ◽  
Disc Herniation ◽  
Pressure Pain Threshold ◽  
Radicular Pain ◽  
University Hospital ◽  
Repeated Measure ◽  
Taqman Assay ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Lumbar Radicular Pain

Abstract Aims Previous studies have suggested that many inflammatory cytokines, including interleukin (IL)-1α, may be associated with lumbar radicular pain after disc herniation. In the present study, we examined how variability of the IL-1α gene affects pain intensity and the pressure pain threshold (PPT) in patients with symptomatic disc herniation. Methods A total of 121 patients with lumbar radicular pain due to disc herniation were recruited from Oslo University Hospital, Norway, and followed up at 6 weeks and 12 months. The primary outcome measures were pain intensity scores for the lower back and legs using a visual analog pain scale (VAS) and PPT for the gluteal muscles. Genotyping was carried out using a predesigned TaqMan assay for IL-1α rs1800587. The effect of the IL-1α genotype on the VAS and PPT was analyzed by repeated measure analyses of variance. Results The IL-1α gene C>T polymorphism rs1800587 affected VAS and PPT scores in patients with symptomatic disc herniation. Patients with the CT/TT genotype reported a higher VAS leg pain intensity (p = 0.002) and also a lower PPT in the gluteal muscles (left p = 0.016; right p = 0.016) compared to patients with the CC genotype during 1 year of follow-up. Conclusions The present data show that the IL-1α CT/TT genotype rs1800587 may be associated with increased pain intensity, and corresponding reduced PPT during the first year after disc herniation.

scholarly journals Serum Levels of Proinflammatory Cytokines in Painful Knee Osteoarthritis and Sensitization

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Marta Imamura ◽  
Fernando Ezquerro ◽  
Fábio Marcon Alfieri ◽  
Lucy Vilas Boas ◽  
Tania Regina Tozetto-Mendoza ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Capacity ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Serum Levels ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
The World ◽  
Joint Disorder ◽  
Painful Knee

Osteoarthritis (OA) is the most common joint disorder in the world. Among the mechanisms involved in osteoarthritis, biomarkers (cytokines profile) may be related to pain and pain intensity, functional capacity, and pressure pain thresholds (PPT). Thus, the study of these relationships may offer useful information about pathophysiology and associated mechanisms involved in osteoarthritis. Therefore, the objective of this study was to investigate the seric concentration of pro (IL-6, IL-8, and TNF-α) and anti-inflammatory (IL-10) cytokines in patients with painful knee osteoarthritis and to correlate the levels of these biomarkers with the patients’ functional capacity and pressure pain threshold (PPT) values.

scholarly journals The Relationship between Fibromyalgia and Pressure Pain Threshold in Patients with Dyspareunia

2015 ◽  
Vol 20 (3) ◽  
pp. 137-140 ◽  
Author(s):  
Hasan Terzi ◽  
Rabia Terzi ◽  
Ahmet Kale
Keyword(s):  
Beck Depression Inventory ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Control Group ◽  
Tender Points ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Pressure Algometer ◽  
Significant Difference

OBJECTIVE: To evaluate the number of tender points, pressure pain threshold and presence of fibromyalgia among women with or without dyspareunia.METHODS: The present cross-sectional study included 40 patients with dyspareunia and 30 healthy controls. The participants were asked if they had engaged in sexual intercourse during the previous four weeks, and dyspareunia was rated from 0 to 3 based on the Marinoff Dyspareunia Scale. A pressure algometer (dolorimeter) was used to measure the pressure pain threshold. Fibromyalgia was diagnosed based on the 1990 American College of Rheumatology criteria. The depression status of the participants was assessed using the Beck Depression Inventory.RESULTS: No statistically significant difference was found with regard to age, body mass index, habits (alcohol use and smoking), educational status and occupational status between the two groups. Total myalgic score, total control score and tender point mean pain threshold were significantly lower in the group with dyspareunia. The number of tender points was significantly higher in patients with dyspareunia. The mean Beck Depression Inventory score was 14.7 ±8.4 in the dyspareunia group compared with 11.2 ±7.1 in the control group. Five (12.5%) of the patients with dyspareunia were diagnosed with fibromyalgia, whereas no patients in the control group were diagnosed with fibromyalgia. There was no significant difference between the two groups with regard to the presence of fibromyalgia.CONCLUSION: The finding of lower pressure pain thresholds and a higher number of tender points among patients with dyspareunia suggests that these patients may have increased generalized pain thresholds. Additional studies involving a larger number of patients are required to investigate the presence of central mechanisms in the pathogenesis of dyspareunia.

scholarly journals “Big girls don’t cry”: the effect of the experimenter’s sex and pain catastrophising on pain

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Lechi Vo ◽  
Peter D. Drummond
Keyword(s):  
Pressure Pain Threshold ◽  
Potential Interaction ◽  
Lower Pressure ◽  
Experimental Conditions ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pain Catastrophising ◽  
Pressure Pain Thresholds ◽  
Males And Females ◽  
Pain Reports

Abstract Objectives The expression of pain in males and females involves complex socio-psychological mechanisms. Males may report lower pain to a female experimenter to appear strong, whereas females may report higher pain to a male experimenter to appear weak and to seek protection. However, evidence to support these stereotypes is inconclusive. Individuals who catastrophise about pain rate higher pain than those who do not. How pain catastrophising interacts with the effect of the experimenter’s sex on pain reports is yet to be explored. Thus, the aim of this study was to determine whether pain catastrophising moderated the effect of the experimenter’s sex on pain reports in healthy males and females. Methods Participants (n=60, 30 males) were assigned to one of four experimental conditions: males tested by male experimenters, males tested by female experimenters, females tested by male experimenters, and females tested by female experimenters. Participants completed the Pain Catastrophising Scale, and then sensitivity to heat and to blunt (pressure-pain threshold) and sharp stimuli was assessed on both forearms, and to high frequency electrical stimulation (HFS) administered to one forearm. Results Females reported lower pressure-pain thresholds than males irrespective of the experimenters’ sex. Females reported lower sharpness ratings to male than female experimenters only when the test stimuli were moderately or intensely sharp. Higher pain catastrophising scores were associated with higher sharpness ratings in females but not males. Additionally, higher pain catastrophising scores were associated with greater temporal summation of pain to HFS, and with lower pressure-pain thresholds in females who were tested by male experimenters. Conclusions These findings indicate that the experimenters’ sex and the participant’s pain catastrophising score influence pain reports, particularly in females. Awareness of these psychosocial factors is important in order to interpret pain responses in a meaningful way, especially when females are tested by male experimenters. A greater awareness of sex/gender role biases and their potential interaction with pain catastrophising may help researchers and clinicians to interpret pain reports in meaningful ways. In turn, this may help to improve delivery of treatments for patients with chronic pain.

scholarly journals Strength Exercise Has Different Effects on Pressure Pain Thresholds in Women with Endometriosis-Related Symptoms and Healthy Controls: A Quasi-experimental Study

Pain Medicine ◽  
2020 ◽  
Vol 21 (10) ◽  
pp. 2280-2287
Author(s):  
Omero Benedicto Poli-Neto ◽  
Arthur Marques Zecchin Oliveira ◽  
Mariana Cecchi Salata ◽  
Julio Cesar Rosa-e-Silva ◽  
Dalmo Roberto Lopes Machado ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Experimental Study ◽  
Pressure Pain Threshold ◽  
Strength Exercise ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Healthy Women ◽  
Pressure Pain Thresholds ◽  
Quasi Experimental

Abstract Objective To evaluate the influence of strength exercises on remote pain sensitivity in women with endometriosis-related symptoms. Design A quasi-experimental study. Setting University Hospital, a tertiary health unit. Subjects Twenty-one women with endometriosis-related symptoms and 21 healthy women provided written informed consent. Methods The participants performed weekly exercise sessions on an extensor chair for four consecutive weeks. An electronic algometer was used to measure the pressure pain thresholds on the nondominant forearm. Heart rate and blood pressure were measured using a digital device. All measurements were taken before, immediately after, and 10 and 20 minutes after the exercise series. Results Women with endometriosis-related symptoms had lower pain thresholds. Pressure pain thresholds increased immediately after exercise in healthy women, returning to baseline level 20 minutes after exercise. Women with endometriosis-related symptoms did not present significant pressure pain threshold alterations after exercise. However, they had a higher heart rate and systolic, diastolic, and average blood pressure than healthy women at all the timepoints. There were no consistent correlations between pressure pain thresholds and heart rate or blood pressure. Conclusions The strength exercise regimen used in this study increased pain thresholds in healthy women but not in women with endometriosis-related painful symptoms. The maintenance or even worsening of pain perception after exercise in women with persistent pain, such as those with endometriosis, may limit their adherence to a physical training program, which in turn could prevent them from experiencing the long-term beneficial effects of exercise.

scholarly journals A cross-sectional analysis of persistent low back pain, using correlations between lumbar stiffness, pressure pain threshold, and heat pain threshold

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Casper Glissmann Nim ◽  
Søren O’Neill ◽  
Anne Gellert Geltoft ◽  
Line Korsholm Jensen ◽  
Berit Schiøttz-Christensen ◽  
...  
Keyword(s):  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Heat Pain ◽  
Low Back ◽  
Cross Sectional ◽  
Pressure Pain ◽  
Spinal Stiffness ◽  
Pressure Pain Thresholds ◽  
Heat Pain Threshold ◽  
Sectional Analysis

Abstract Introduction Little is known about the underlying biomechanical cause of low back pain (LBP). Recently, technological advances have made it possible to quantify biomechanical and neurophysiological measurements, potentially relevant factors in understanding LBP etiology. However, few studies have explored the relation between these factors. This study aims to quantify the correlation between biomechanical and neurophysiological outcomes in non-specific LBP and examine whether these correlations differ when considered regionally vs. segmentally. Methods This is a secondary cross-sectional analysis of 132 participants with persistent non-specific LBP. Biomechanical data included spinal stiffness (global stiffness) measured by a rolling indenter. Neurophysiological data included pain sensitivity (pressure pain threshold and heat pain threshold) measured by a pressure algometer and a thermode. Correlations were tested using Pearson’s product-moment correlation or Spearman’s rank correlation as appropriate. The association between these outcomes and the segmental level was tested using ANOVA with post-hoc Tukey corrected comparisons. Results A moderate positive correlation was found between spinal stiffness and pressure pain threshold, i.e., high degrees of stiffness were associated with high pressure pain thresholds. The correlation between spinal stiffness and heat pain threshold was poor and not statistically significant. Aside from a statistically significant minor association between the lower and the upper lumbar segments and stiffness, no other segmental relation was shown. Conclusions The moderate correlation between spinal stiffness and mechanical pain sensitivity was the opposite of expected, meaning higher degrees of stiffness was associated with higher pressure pain thresholds. No clinically relevant segmental association existed.

scholarly journals Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia

2020 ◽  
Vol 4;23 (7;4) ◽  
pp. E353-E361
Author(s):  
Elizabeth Bravo EstebanHerreros
Keyword(s):  
Pain Sensitivity ◽  
Pain Catastrophizing ◽  
Pressure Pain Threshold ◽  
Referred Pain ◽  
Pain Mechanisms ◽  
Pressure Pain ◽  
Infraspinatus Muscle ◽  
Pain Models ◽  
Pressure Pain Thresholds ◽  
And Gender

Background: Fibromyalgia (FM) syndrome is characterized by widespread pain, fatigue, and generalized increased pain sensitivity. Appropriate and simple pain models are methods employed to assess pain mechanisms that can potentially lead to improved treatments. Pressure pain thresholds (PPTs) or mapping the referred pain area produced by pressure stimulation at suprathreshold intensities are used to assess pain mechanisms. The optimal suprathreshold stimulation intensity to elicit referred pain with minimal discomfort for patients with FM has yet to be determined. Objectives: The aim of this study was to compare the area and intensity of pressure-induced referred pain in patients with FM as elicited by systematic increases in PPTs, compared with controls. Study Design: Observational, crossed-section study. Setting: Research laboratory. Methods: Twenty-six patients with FM and 26 healthy controls, age- and gender-matched, were included. Suprathreshold stimulation was applied to the infraspinatus muscle of the dominant side at 4 different intensities (PPT +20%, +30%, +40%, and +50%), after which referred pain was evaluated by measuring the area of pain in pixels using a digital body chart and its intensity on a Visual Analog Scale. Factors related to anxiety condition, pain catastrophizing, depression, and quality of life were recorded. Results: The referred pain areas were larger in the FM group compared with healthy individuals at 120% (P = 0.024), 130% (P = 0.001), 140% (P = 0.001), and 150% (P = 0.001) PPT, however, within the FM group no differences were found between the intensity of suprathreshold stimulation and the size of the referred pain areas (P = 0.135) or pain intensity (P > 0.05). There was a positive correlation between the size of referred pain areas and pain catastrophizing in the FM group (r = 0.457, P = 0.032). Limitations: This study presents some limitations, among which is the variability found in the referred pain areas. Conclusions: These findings show that referred pain induced by applying a suprathreshold pressure of 120% PPT can be a useful biomarker to assess sensitized pain mechanisms in patients suffering from FM. Key words: Referred pain, pain sensitivity, fibromyalgia, central sensitization, suprathreshold, pressure pain threshold, biomarker, facilitated pain mechanisms

scholarly journals Stretching and relaxing the plantar fascia may change plantar fascia thickness but not pressure pain thresholds: a cross-sectional study of patients with plantar fasciopathy

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefanie Ostermann ◽  
Jens Lykkegaard Olesen ◽  
Sinéad Holden ◽  
Henrik Riel
Keyword(s):  
Frontal Plane ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Mean Difference ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Plantar Fasciopathy ◽  
Pressure Pain Thresholds

Abstract Background Despite the established relevance of ultrasonography and assessment of pressure pain thresholds in patients with plantar fasciopathy, patient and probe positioning has been mostly ignored and are not necessarily reported in research. The primary aim of this study was to compare plantar fascia thickness in stretched and relaxed positions in patients with plantar fasciopathy. The secondary aim was to compare plantar heel pressure pain thresholds in these positions. Methods In this cross-sectional study, we measured the plantar fascia thickness with ultrasonography, and localised pressure pain thresholds using pressure algometry of 20 patients with plantar fasciopathy. These were assessed bilaterally, with the plantar fascia in both a stretched and relaxed position. In the stretched position, toes were maximally dorsiflexed, while in the relaxed position participants’ feet were hanging freely over the end of the table. Results The plantar fascia of the most symptomatic foot was significantly thicker when stretched compared with the relaxed position (sagittal: mean difference 0.2 mm, 95%CI: 0.1–0.4, P = 0.013; frontal: mean difference − 0.27, 95%CI: − 0.49 to − 0.06, P = 0.014). The plantar fascia was significantly thinner in the frontal plane compared with the sagittal plane in both positions (stretched: mean difference − 0.2 mm, 95%CI: − 0.42 to − 0.03, P = 0.025; relaxed: mean difference − 0.3 mm, 95%CI:-0.49 to − 0.08, P = 0.008). There was no difference between pressure pain thresholds in stretched or relaxed positions in either foot (P > 0.4). Conclusions The plantar fascia was significantly thicker in a stretched compared with a relaxed position and in the sagittal compared with the frontal plane, but differences were smaller than the standard deviation. Pressure pain thresholds were not different between the positions. These results highlight the importance of how ultrasonography is performed and reported in research to allow for replication. Trial registration The study was pre-registered September 25th, 2017 on ClinicalTrials.gov (NCT03291665).

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