The Effect of Pressure Pain Sensitivity and Patient Factors on Self-Reported Pain-Disability in Patients with Chronic Neck Pain

Abstract

The study was conducted to estimate the extent to which pressure pain sensitivity (PPS) and patient factors predict pain-related disability in patients with neck pain (NP), and to determine if PPS differs by gender. Forty-four participants with a moderate level of chronic NP were recruited for this cross sectional study. All participants were asked to complete self-reported assessments of pain, disability and comorbidity and then underwent PPS testing at 4-selected body locations. Pearson`s r w was computed to explore relationships between the PPS measures and the self-reported assessments. Regression models were built to identify predictors of pain and disability. An independent sample t-test was done to identify gender-related differences in PPS, pain-disability and comorbidity. In this study, greater PPS (threshold and tolerance) was significantly correlated to lower pain-disability (r = -.30 to -.53, p≤0.05). Age was not correlated with pain or disability but comorbidity was (r= 0.42-.43, p≤0.01). PPS at the 4-selected body locations was able to explain neck disability (R2=25-28%). Comorbidity was the strongest predictor of neck disability (R2 =30%) and pain (R2=25%). Significant mean differences for gender were found in PPS, disability and comorbidity, but not in pain intensity or rating. This study suggests that PPS may play a role in outcome measures of pain and disability but between-subject comparisons should consider gender and comorbidity issues.

Evaluation of Pressure Pain Threshold as a Measure of Perceived Stress and High Job Strain

“…It also presents several significant findings when stratifying for gender and adjusting for the highly relevant confounders of pain threshold, age, BMI as well as reported discomfort [23, 26]. However we find that the distributions of pain thresholds among stressed and non-stressed persons are strongly overlapping, causing a discriminative value too low to allow for a distinguishing of stressed from non-stressed participants.…”

“…Myocardial infarction, COPD and diabetes might result in biased associations due to confounding [23]. However, since the study population only includes individuals that gainfully employed at the time of the examination the prevalence of generalized pain disorders as myalgia and other disabling chronic disease is very low and thus confounding by comorbidity is less likely.…”

Self-reported sinus headaches are associated with neck pain and cervical musculoskeletal dysfunction: a preliminary observational case control study

“…Tests of cervical joint and muscle function were conducted. Pressure pain thresholds were also tested over the cervical spine as they have been shown to correlate to pain-disability in patients with neck pain [21]. Participants were familiarized and practiced the tests before measurements were taken.…”

Relação de flexão-relaxamento dos músculos cervicais e dor cervical crônica em trabalhadores de escritório usuários de computador

“…Ge et al (2014) avaliaram o LDP de 15 pontos na região cervical e também não encontraram diferença estatística entre os trabalhadores usuários de computador com e sem dor cervical.Neste estudo, foi determinado como ponto de avaliação o local de maior superficialização da musculatura extensora cervical(SOMMERICH et al, 2000). Não foram encontrados na literatura estudos que avaliaram o LDP do músculo esplênio da cabeça nesta mesma localização anatômica em trabalhadores usuários de computador, sendo considerado mais comumente um único ponto para avaliação dos extensores cervicais, variando entre a região adjacente ao processo espinhoso de C4 a C6(JOHNSTON et al, 2008d; CAGNIE et al, 2013;BRANDT et al, 2014;UDDIN et al, 2014). Alguns estudos evidenciaram a sensibilidade do músculo trapézio(CAGNIE et al, 2013, BRANDT et al, 2014, por ser um local de frequente queixa de dor muscular e localização de pontos-gatilho(ANDERSEN et al, 2011).…”

“…O músculo esplênio da cabeça, quando contraído unilateralmente, auxilia na flexão lateral e rotação cervical(KENDALL et al, 2007). Uma vez que trata-se de um músculo ativo em outros movimentos, que também podem ser realizados durante o uso do computador, sua ativação contínua e frequente pode levar a sobrecarga e torná-lo mais sensível à dor.Além disso, a incapacidade também exerce papel na alteração da sensibilidade muscular destes indivíduos Uddin et al (2014). relataram que tanto o limiar quando a tolerância à dor por pressão apresentam correlação negativa com o nível de incapacidade.…”