BackgroundMusculoskeletal pain from the upper extremity and shoulder region is commonly reported by computer users. However, the functional status of central pain mechanisms, i.e., central sensitization and conditioned pain modulation (CPM), has not been investigated in this population. The aim was to evaluate sensitization and CPM in computer users with and without chronic musculoskeletal pain.MethodsPressure pain threshold (PPT) mapping in the neck-shoulder (15 points) and the elbow (12 points) was assessed together with PPT measurement at mid-point in the tibialis anterior (TA) muscle among 47 computer users with chronic pain in the upper extremity and/or neck-shoulder pain (pain group) and 17 pain-free computer users (control group). Induced pain intensities and profiles over time were recorded using a 0-10 cm electronic visual analogue scale (VAS) in response to different levels of pressure stimuli on the forearm with a new technique of dynamic pressure algometry. The efficiency of CPM was assessed using cuff-induced pain as conditioning pain stimulus and PPT at TA as test stimulus.ResultsThe demographics, job seniority and number of working hours/week using a computer were similar between groups. The PPTs measured at all 15 points in the neck-shoulder region were not significantly different between groups. There were no significant differences between groups neither in PPTs nor pain intensity induced by dynamic pressure algometry. No significant difference in PPT was observed in TA between groups. During CPM, a significant increase in PPT at TA was observed in both groups (P < 0.05) without significant differences between groups. For the chronic pain group, higher clinical pain intensity, lower PPT values from the neck-shoulder and higher pain intensity evoked by the roller were all correlated with less efficient descending pain modulation (P < 0.05).ConclusionsThis suggests that the excitability of the central pain system is normal in a large group of computer users with low pain intensity chronic upper extremity and/or neck-shoulder pain and that increased excitability of the pain system cannot explain the reported pain. However, computer users with higher pain intensity and lower PPTs were found to have decreased efficiency in descending pain modulation.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-412) contains supplementary material, which is available to authorized users.

BackgroundComputer users often report musculoskeletal complaints and pain in the upper extremities and the neck-shoulder region. However, recent epidemiological studies do not report a relationship between the extent of computer use and work-related musculoskeletal disorders (WMSD).The aim of this study was to conduct an explorative analysis on short and long-term pain complaints and work-related variables in a cohort of Danish computer users.MethodsA structured web-based questionnaire including questions related to musculoskeletal pain, anthropometrics, work-related variables, work ability, productivity, health-related parameters, lifestyle variables as well as physical activity during leisure time was designed. Six hundred and ninety office workers completed the questionnaire responding to an announcement posted in a union magazine. The questionnaire outcomes, i.e., pain intensity, duration and locations as well as anthropometrics, work-related variables, work ability, productivity, and level of physical activity, were stratified by gender and correlations were obtained.ResultsWomen reported higher pain intensity, longer pain duration as well as more locations with pain than men (P < 0.05). In parallel, women scored poorer work ability and ability to fulfil the requirements on productivity than men (P < 0.05). Strong positive correlations were found between pain intensity and pain duration for the forearm, elbow, neck and shoulder (P < 0.001). Moderate negative correlations were seen between pain intensity and work ability/productivity (P < 0.001).ConclusionsThe present results provide new key information on pain characteristics in office workers. The differences in pain characteristics, i.e., higher intensity, longer duration and more pain locations as well as poorer work ability reported by women workers relate to their higher risk of contracting WMSD. Overall, this investigation confirmed the complex interplay between anthropometrics, work ability, productivity, and pain perception among computer users.

The objectives of this study were to (1) investigate the modulation of the H reflex immediately after and 24 h after eccentric exercise in the presence of delayed-onset muscle soreness (DOMS) and (2) test the reproducibility of the H reflex in trapezius across days. H reflexes were recorded from the dominant middle trapezius muscle by electrical stimulation of the C3/4 cervical nerve in ten healthy subjects. DOMS was induced by eccentric exercise of the dominant shoulder. H reflexes were obtained in four sessions: "24 h before", "Pre", "Post", and "24 h after" eccentric exercise. Ratios of maximal H reflex and M wave responses (H (max)/M (max)) were compared between sessions. In addition, a between session comparison was done for the ratios of H reflex amplitudes (H (i_75)/M (max), and H (i_50)/M (max)) obtained from the stimulus intensity needed to obtain 75 and 50 % of H (max) at "24 h before". No ratio changes were found when comparing "24 h before" and "Pre" recordings. A decrease in H (i_50)/M (max) was found at "Post" (P < 0.05) and decreases in both H (i_75)/M (max) and H (i_50)/M (max) were observed at "24 h after" (P < 0.05). This study presented evidence that an acceptable day-to-day reproducibility of the H reflex could be obtained with the applied experimental setup. Furthermore, immediately after and 24 h after exercise a stronger stimulus intensity was needed to reach the same magnitude of the H reflex reflecting that the recruitment curve was shifted to the right. This modulation of the stimulus-response relationship could be caused by presynaptic inhibition of Ia afferent fibres' input to the motoneuron by group III and IV afferents.

Trapezius muscle Hoffman (H) reflexes were obtained to investigate the neural adaptations induced by a 5-wk strength training regimen, based solely on eccentric contractions of the shoulder muscles. Twenty-nine healthy subjects were randomized into an eccentric training group (n = 15) and a reference group (n = 14). The eccentric training program consisted of nine training sessions of eccentric exercise performed over a 5-wk period. H-reflex recruitment curves, the maximal M wave (Mmax), maximal voluntary contraction (MVC) force, rate of force development (RFD), and electromyographic (EMG) voluntary activity were recorded before and after training. H reflexes were recorded from the middle part of the trapezius muscle by electrical stimulation of the C3/4 cervical nerves; Mmax was measured by electrical stimulation of the accessory nerve. Eccentric strength training resulted in significant increases in the maximal trapezius muscle H reflex (Hmax) (21.4% [5.5-37.3]; P = 0.01), MVC force (26.4% [15.0-37.7]; P < 0.01), and RFD (24.6% [3.2-46.0]; P = 0.025), while no significant changes were observed in the reference group. Mmax remained unchanged in both groups. A significant positive correlation was found between the change in MVC force and the change in EMG voluntary activity in the training group (r = 0.57; P = 0.03). These results indicate that the net excitability of the trapezius muscle H-reflex pathway increased after 5 wk of eccentric training. This is the first study to investigate and document changes in the trapezius muscle H reflex following eccentric strength training.

We found ipsilateral and contralateral responses consistent with previous findings. However, we conclude that the contralateral response in trapezius is not a crossed reflex.