Pressure pain threshold mappings of the infraspinatus muscle in chronic unilateral shoulder pain patients do not reflect generalized hypersensitivity

Intelangelo, Leonardo; Bordachar, Diego; Mendoza, Cristian; Lassaga, Ignacio; Barbosa, Alexandre Carvalho; Manresa, José Biurrun; Mista, Christian Ariel

doi:10.1016/j.msksp.2021.102495

Cited by 3 publications

(10 citation statements)

References 43 publications

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“…In our study, lower PPT values at the sites of the affected upper limb were obtained among the chronic group as compared to the non-chronic group, whereas PPT values in the affected lower limb were not signi cantly different among the groups, thereby suggesting that hypersensitivity might still limit to the affected side in chronic shoulder pain. Furthermore, it was reported that no widespread hyperalgesia on the asymptomatic side when comparing the USP patients and healthy subjects [9]. However, the mechanism of central sensitisation in chronic musculoskeletal pain remains unclear at present.…”

Section: Discussionmentioning

confidence: 97%

“…The dimension of generalised sensitisation can be noticed by measuring pressure pain thresholds away from the primary symptomatic area. However, there was a matter of debate on generalised sensitisation in unilateral shoulder pain (USP) patients with several methodological descriptions to explain the discrepancies between previous studies: type of pain, pain duration, assessment site and inclusion criteria [9,22].…”

Section: Discussionmentioning

confidence: 99%

“…Quantitative sensory testing (QST) is a way to detect the extent of central sensitisation, pressure pain threshold (PPT) is the most frequently used QST parameter to re ect sensitivity to pain [8]. People with chronic shoulder pain often show lower PPT on the affected side as compared to the asymptomatic side [9], with de cit somatosensory function.…”

Section: Introductionmentioning

confidence: 99%

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The effect of joint position sense therapy on chronic shoulder pain with central sensitisation

Chen

Zha

Xuan

et al. 2023

Preprint

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Objectives Chronic shoulder pain is one of the common musculoskeletal problems involved with unreleased pain and functional dysfunction, and it can even evolve into central sensitisation. Some manual therapy aggravated pain and central sensitisation. Joint position sense therapy (JPST) is moderate joint proprioception training compared with vigorous exercises or aggressive hands-on therapy. This study will explore the expression of central sensitisation in chronic shoulder pain and the effect of JPST on shoulder functional dysfunction and pain. Methods Pressure pain threshold (PPT) was assessed together with four sites at the deltoid, upper trapezius, brachioradialis and tibialis anterior muscles among 30 chronic shoulder pain and 30 non-chronic pain patients. A total of 30 patients with chronic shoulder pain were randomly divided into the JPST group and a control group. The JPST group underwent additional shoulder joint position sense training. The efficiency outcomes were the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), Visual Analog Scale (VAS) and PPT evaluated at baseline and after the intervention. Results Significant differences were observed in PPT values at brachioradialis (P < 0.05), deltoid (P < 0.01) and trapezius (P < 0.001) among non-chronic and chronic groups, but not in tibialis anterior muscle (P > 0.05). Although both control and JPST intervention were effective in improving DASH, pain intensity and PPT values in the upper limb, outcomes in the JPST group showed significant differences from the control group. Conclusions A generalised hyperalgesia changes limited to the upper limb were noticed in chronic shoulder pain. Joint position sense therapy had a beneficial effect on pain control and functional dysfunction in chronic shoulder pain patients.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effect of joint position sense therapy on chronic shoulder pain with central sensitisation

Chen

Zha

Xuan

et al. 2023

Preprint

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“…4,5 The etiology of this condition is presumably mechanical, although several studies have proposed that sensitization of shoulder muscle afferents contributes to the development of shoulder pain. [6][7][8] In particular, clinical evaluations often reveal that pain and mechanical tenderness is localized around the infraspinatus muscle in patients with unilateral shoulder pain (USP). 9 Therefore, this muscle is considered as a region of interest when assessing hypersensitivity in chronic USP.…”

mentioning

confidence: 99%

“…It constitutes the third most common musculoskeletal symptom, and about 50% of the patients report persistent pain 12 months after its appearance 4,5 . The etiology of this condition is presumably mechanical, although several studies have proposed that sensitization of shoulder muscle afferents contributes to the development of shoulder pain 6–8 . In particular, clinical evaluations often reveal that pain and mechanical tenderness is localized around the infraspinatus muscle in patients with unilateral shoulder pain (USP) 9 .…”

mentioning

confidence: 99%

No Evidence of Short-Term Changes in Muscle Activity Elicited by Dry Needling in Chronic Unilateral Shoulder Pain Patients

Intelangelo

Mendoza

Lassaga

et al. 2023

The Clinical Journal of Pain

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Objectives: The aim of the study was to assess short-term changes in shoulder muscle activity elicited by dry needling in chronic unilateral shoulder pain patients. Methods: A double-blind, placebo-controlled clinical trial was conducted, in which 30 volunteers with unilateral shoulder pain (USP) were recruited and randomly assigned to either real or sham dry needling conditions. Pain intensity scores, pressure pain threshold (PPT), glenohumeral internal rotation angles, and electromyographic activity during isotonic shoulder tasks (shoulder flexion and extension) were assessed before, immediately and 72 h after the intervention in the infraspinatus and deltoid muscles. Results: A single application of real dry needling resulted in lower pain intensity scores and a larger range in glenohumeral internal rotation 72 h after the intervention in comparison with sham dry needling. No differences in PPT or muscle activity were observed due to the intervention. Discussion: A single application of real dry needling resulted in clinically significant changes in the short-term. No differences were detected in muscle activation in the infraspinatus or deltoid muscles. Complementary interventions and longer follow-up times may be required to observe changes in muscle activity.

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The effect of joint position sense therapy on chronic shoulder pain with central sensitization

Chen,

Cha,

Xuan

et al. 2024

Medicine

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Background: Chronic shoulder pain is a common musculoskeletal problem associated with unreleased pain and functional dysfunction that can evolve into central sensitization. Some forms of manual therapy may exacerbate pain and central sensitization. This study investigated the impact of joint position sense therapy (JPST), a moderate joint proprioception training technique, on central sensitization, shoulder functional dysfunction, and pain in patients with chronic shoulder pain compared with more intense exercises or aggressive manual therapies. Methods: We assessed the pressure pain threshold (PPT) in 30 patients with and 30 patients without chronic shoulder pain. The assessment focused on 4 muscle sites: deltoid, upper trapezius, brachioradialis, and tibialis anterior. Thirty patients with chronic shoulder pain were randomly divided into the JPST and control groups. The JPST group underwent additional shoulder joint position–sense training. The efficiency outcomes were the disabilities of the arm, shoulder, and hand questionnaire, visual analog scale (VAS), and PPT, evaluated at baseline and after the intervention. Results: Significant differences were observed in the PPT values at the brachioradialis (P < .05), deltoid (P < .01), and trapezius (P < .001) among the non-chronic and chronic groups, but not in the tibialis anterior muscle (P > .05). Although both control and JPST interventions effectively improved the disabilities of the arm, shoulder, and hand questionnaire score, pain intensity, and PPT values in the upper limb, the outcomes in the JPST group were significantly different from those in the control group. Conclusions: Generalized hyperalgesia changes limited to the upper limbs were observed in patients with chronic shoulder pain. JPST has beneficial effects on pain control and functional dysfunction in patients with chronic shoulder pain.

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Pressure pain threshold mappings of the infraspinatus muscle in chronic unilateral shoulder pain patients do not reflect generalized hypersensitivity

Cited by 3 publications

References 43 publications

The effect of joint position sense therapy on chronic shoulder pain with central sensitisation

The effect of joint position sense therapy on chronic shoulder pain with central sensitisation

No Evidence of Short-Term Changes in Muscle Activity Elicited by Dry Needling in Chronic Unilateral Shoulder Pain Patients

The effect of joint position sense therapy on chronic shoulder pain with central sensitization

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