Specific Mechanical Pain Hypersensitivity Over Peripheral Nerve Trunks in Women With Either Unilateral Epicondylalgia or Carpal Tunnel Syndrome

Fernández‐de‐las‐Peñas, César; Ortega‐Santiago, Ricardo; Ambite-Quesada, Silvia; Jiménez-García, Rodrigo; Arroyo-Morales, Manuel; Cleland, Joshua A.

doi:10.2519/jospt.2010.3331

Cited by 40 publications

(22 citation statements)

References 70 publications

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“…Our results revealed that preoperative centrally mediated symptoms slightly correlated with BCTQ scores and moderately correlated with CTS symptom duration, consistent with previous findings showing that PPT were negatively correlated with pain intensity and duration of symptoms 24 . Although the median nerve of the affected limb might be more sensitized in individuals with CTS, vibration 25 , thermal 26 , and motor impairments 27 have been identified bilaterally in patients with unilateral CTS.…”

Section: Discussionsupporting

confidence: 92%

Influence of centrally mediated symptoms on functional outcomes after carpal tunnel release

Roh

Kim²,

Gong

et al. 2018

Sci Rep

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Patients with carpal tunnel syndrome (CTS) often show bilaterally increased pain sensitivity and widespread symptoms. We evaluated the influence of centrally mediated symptoms on functional outcomes of carpal tunnel release (CTR). A total of 120 patients with surgically treated CTS were enrolled. Centrally mediated symptoms were preoperatively measured by administering a self-reported central sensitization inventory (CSI) questionnaire and peripheral sensitization was measured by assessing patient’s pressure pain thresholds (PPT) in the forearm. Boston Carpal Tunnel Questionnaires (BCTQ) were assessed preoperatively and postoperatively at 3 and 12 months. CSI scores slightly correlated with symptom duration and moderately correlated with preoperative BCTQ scores, while PPT slightly correlated with the BCTQ scores. At 3 months, BCTQ symptom and function scores moderately correlated with lower PPTs and higher CSI scores. At 12 months, only severe electrophysiological grade was associated with BCTQ function scores. Multivariable analysis revealed that preoperative PPT, CSI, and female gender were associated with BCTQ scores at 3 months; these factors failed to be associated for 12-month outcomes. Centrally mediated symptoms measured by CSI and peripheral sensitization measured by PPTs correlated with symptom severity and duration. They were associated with poorer functional outcomes after CTR up to 3 months. However, they did not show persistent effects in the long term.

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Section: Discussionsupporting

confidence: 92%

Influence of centrally mediated symptoms on functional outcomes after carpal tunnel release

Roh

Kim²,

Gong

et al. 2018

Sci Rep

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“…This is further supported by the finding that pressure pain hypersensitivity is found over the radial nerve in patients with LE. 21 …”

Section: Discussionmentioning

confidence: 97%

Anatomical Association Between Wrist Extensor Musculature and Topographical Pain Sensitivity Maps of the Elbow Area

Prados-Frutos

Ruiz

de-la-Llave-Rincón

et al. 2012

Journal of Manipulative and Physiological Therapeutics

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“…Neuropathic pain leading to adverse neural tissue tension can be brought on by a multitude of factors including, but not limited to, trauma, joint position or malalignment, and posture [3] [8]. A continuous stimulation of the nociceptors in a peripheral nerve can result in hypersensitivity of that nerve [6]. This hypersensitivity can then lead to AIGS which may result in an altered perception of pain in the form of allodynia, or central sensitization [3] [6].…”

Section: Introductionmentioning

confidence: 99%

“…This hypersensitivity can then lead to AIGS which may result in an altered perception of pain in the form of allodynia, or central sensitization [3] [6]. Central sensitization is associated with chemical changes in the central nervous system that may lead to chronic pain [6].…”

Section: Introductionmentioning

confidence: 99%

A Combination of Manual Therapy, Movement Systems, and Biopsychosocial Approaches for the Treatment of Upper Limb Adverse Neural Tissue Tension: A Case Report

Shinost¹,

Pratt²,

Smith³

2017

OALib

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Background and Purpose: Peripheral nerve injuries can result from a multitude of causes including trauma, poor posture, and altered movement patterns. Adverse neural tension is a possible consequence to insult to the nervous system which can lead to dysfunction and fear avoidance behaviors. The purpose of this case report is to demonstrate the use of a multimodal approach in the physical therapy treatment of a patient who sustained an occupational upper extremity injury which resulted in adverse neural tissue tension of multiple peripheral nerves. Case Description: The patient was a 40-year-old female who sustained an injury to the second right metacarpophalangeal joint. Impairments included joint hypomobility, decreased muscle function, and movement system dysfunction. The patient was treated six times over a two-week period. Intervention: The physical therapy treatment administered to the patient included manual therapy, exercises focused on improving movement systems impairment, exercise focused on improving neural excursion, and patient education based on the biopsychosocial model. The treatments were focused on improving function of work-related activities to decrease disability to promote regular and full job duties. Outcomes: Outcome measures include the Numeric Pain Rating Scale (NPRS), Fear Avoidance Beliefs Questionnaire of Work and Physical Activity (FABQ-W and FABQ-PA, respectively), and the Quick Disability of the Arm, Shoulder and Hand (QuickDASH). After six visits there was an NPRS rating of 0/10 with rest and activity; the FABQ-W improved from 17/42 to 10/42; the FABQ-PA improved from 15/24 to 3/24; the QuickDASH improved from 22% symptom 2/28OALib Journal related disability to 9% and improved from 75% disability with work-related tasked to 0% disability. Discussion: Interventions of joints mobilization, neuromuscular reeducation using the movement systems approach, and concepts focused on the biopsychosocial approach were determined to be an integral combination in the patient's successful return to full work-related duties.

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Specific Mechanical Pain Hypersensitivity Over Peripheral Nerve Trunks in Women With Either Unilateral Epicondylalgia or Carpal Tunnel Syndrome

Cited by 40 publications

References 70 publications

Influence of centrally mediated symptoms on functional outcomes after carpal tunnel release

Influence of centrally mediated symptoms on functional outcomes after carpal tunnel release

Anatomical Association Between Wrist Extensor Musculature and Topographical Pain Sensitivity Maps of the Elbow Area

A Combination of Manual Therapy, Movement Systems, and Biopsychosocial Approaches for the Treatment of Upper Limb Adverse Neural Tissue Tension: A Case Report

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