(480) Conditioned pain modulation and treatment response in patients with knee osteoarthritis

Abstract Objectives To assess the immediate and three days postintervention effect of one dry needling session compared to one sham needling session on pain, central pain processing, muscle co-contraction and spatiotemporal parameters during gait in knee osteoarthritis patients. Methods A double-blind randomized controlled trial was conducted. Sixty-one knee osteoarthritis patients were randomly assigned to the dry needling or sham needling group. Primary outcomes were pain and central pain processing. Secondary outcomes included muscle co-contraction and spatiotemporal parameters during gait. Patients were assessed at baseline and 15 min after the intervention, and pain also three days after the intervention. Linear mixed models were used to examine between- and within-group differences. Results No significant between-group differences for pain were found, but within-group scores showed a significant decrease 15 min after sham needling and three days after dry needling. The mean conditioned pain modulation effect measured at the m. Trapezius worsened significantly 15 min after sham needling compared to after dry needling (between-group difference). However, individual conditioned pain modulation percentage scores remained stable over time. Various significant within-group differences were found 15 min after sham needling: a decrease of conditioned pain modulation measured at m. Quadriceps and m. Trapezius and stride- and step-time scores, and an increase in step length and widespread pain pressure threshold. A significant decrease in muscle co-contraction index of the m. Vastus Medialis and Semitendinosus was found as within-group difference 15 min after dry needling. Conclusions Dry needling has no larger effect on pain, central pain processing, muscle co-contraction and gait pattern 15 min and three days postintervention compared to sham needling. Mean conditioned pain modulation scores worsened after sham needling compared to after dry needling. Further research remains necessary.

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(294) The association of psychological resilience and conditioned pain modulation is moderated by optimism in adults with symptomatic knee osteoarthritis

Journal of Pain ◽

10.1016/j.jpain.2017.02.187 ◽

2017 ◽

Vol 18 (4) ◽

pp. S49

Author(s):

K. Thompson ◽

H. Bulls ◽

K. Sibille ◽

E. Bartley ◽

L. Bradley ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Pain Modulation ◽

Conditioned Pain Modulation ◽

Psychological Resilience ◽

Symptomatic Knee Osteoarthritis ◽

Symptomatic Knee

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The Association of Pain Sensitization and Conditioned Pain Modulation to Pain Patterns in Knee Osteoarthritis

Arthritis Care & Research ◽

10.1002/acr.24437 ◽

2020 ◽

Author(s):

Lisa C. Carlesso ◽

Laura Frey Law ◽

Na Wang ◽

Michael Nevitt ◽

Cora E. Lewis ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Pain Modulation ◽

Conditioned Pain Modulation ◽

Pain Sensitization

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Pain perception in chronic knee osteoarthritis with varying levels of pain inhibitory control: an exploratory study

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0016 ◽

2020 ◽

Vol 20 (4) ◽

pp. 651-661

Author(s):

Paulo E. P. Teixeira ◽

Hanan I. Zehry ◽

Swapnali Chaudhari ◽

Laura Dipietro ◽

Felipe Fregni

Keyword(s):

Knee Osteoarthritis ◽

Pain Intensity ◽

Pain Perception ◽

Small Sample Size ◽

Linear Regression Analysis ◽

Small Sample ◽

Pain Modulation ◽

Clinical Variables ◽

Pain Scores ◽

Intensity Perception

AbstractBackground and aimsPain is a disabling symptom in knee osteoarthritis (KOA) and its underlying mechanism remains poorly understood. Dysfunction of descending pain modulatory pathways and reduced pain inhibition enhance pain facilitation in many chronic pain syndromes but do not fully explain pain levels in chronic musculoskeletal conditions. The objective of this study is to explore the association of clinical variables with pain intensity perception in KOA individuals with varying levels of Conditioned Pain Modulation (CPM) response.MethodsThis is a cross-sectional, exploratory analysis using baseline data of a randomized clinical trial investigating the effects of a non-invasive brain stimulation treatment on the perception of pain and functional limitations due to KOA. Sixty-three subjects with KOA were included in this study. Data on pain perception, mood perception, self-reported depression, physical function, quality of life, and quantitative sensory testing was collected. Multiple linear regression analysis was performed to explore the association between the clinical variables with pain perception for individuals with different levels of CPM response.ResultsFor KOA patients with limited CPM response, perception of limitations at work/other activities due to emotional problems and stress scores were statistically significantly associated with pain scores, F(2, 37) = 7.02, p < 0.01. R-squared = 0.275. For KOA patients with normal CPM response, general health perception scores were statistically significantly associated with pain scores, F(1, 21) = 5.60, p < 0.05. R-squared = 0.2104. Limitations of this study include methodology details, small sample size and study design characteristics.ConclusionsPain intensity perception is associated differently with clinical variables according to the individual CPM response. Mechanistic models to explain pain perception in these two subgroups of KOA subjects are discussed.

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