Abnormalities of somatosensory perception in patients with painful osteoarthritis normalize following successful treatment

Abstract

To investigate the effect of chronic nociceptive pain on somatosensory perception, quantitative sensibility testing was performed in the most painful area and the homologous contralateral side in 14 patients with painful osteoarthritis of the hip. Twelve patients were reassessed in a painfree state 6-14 months following surgery. Von Frey filaments were used to test low-threshold mechanoreceptive function. Pressure pain sensitivity was assessed with a pressure algometer and thermal sensitivity with a Thermotest. Sex- and age-matched controls were examined in the corresponding areas at similar time intervals. There was no statistically significant difference between groups in the sensitivity to light touch and innocuous cold in either session. Compared to controls, patients had increased sensitivity to pressure pain in the most painful area (p < 0.002), bilaterally increased sensitivity to innocuous warmth (p < 0.03), cold pain (p< 0.05) and a tendency toward bilaterally increased sensitivity to heat pain (p = 0.054) before surgery. In the painful area, patients' sensitivity to pressure pain decreased (p < 0.04) and, remaining within normal limits, sensitivity to light touch increased (p < 0.006) compared to values prior to surgery. No statistically significant differences between the groups were seen following surgery, indicating that the sensibility changes had been maintained by chronic nociceptive pain.

Widespread Pressure Pain Hypersensitivity in Elderly Subjects with Unilateral Thumb Carpometacarpal Osteoarthritis

“…Therefore, future research investigating the effects of conservative treatments should focus on the effects on both peripheral and central sensitization mechanisms. Additionally, it would be interesting to evaluate whether surgery is effective for decreasing this widespread pressure pain hypersensitivity, also to have a better insight into the role of the peripheral input in the maintenance of central sensitization in this disorder [3,21,28].…”

Low pressure pain thresholds are associated with, but does not predispose for, low back pain

“…generalized hyperalgesia) and a range of chronic or long-lasting pain conditions, including chronic low back pain (CLBP) [5,7,14,15,22]. Such generalized hyperalgesia may be maintained by nociception and may be modulated by changes in the afferent barrage [19,26].…”

Pressure Algometry: What Does It Really Tell Us?

“…Recent data indicate that augmented central pain processing mechanisms (central hyperexcitability) is a likely feature of various musculoskeletal conditions, including WAD, 8 cervical radiculopathy, 1 and arthritis. 5 More importantly, sensory responses indicative of augmented pain processing, such as cold hyperalgesia, have demonstrated predictive capacity to identify those likely to have poor functional recovery following whiplash injury, 4,7,9 resulting in recommendations that such measures be included in the assessment of people with acute WAD. 11 Walton et al 15 provide further data to support these findings by showing that pressure pain thresholds, measured at a site distal to that of the injury (over the tibialis anterior), also demonstrate predictive capacity.…”