Deep tissue hyperalgesia after computer work

2012 ◽  
Vol 3 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Vegard Strøm ◽  
Cecilie Røe ◽  
Dagfinn Matre ◽  
Stein Knardahl
Keyword(s):  
Neck Pain ◽  
Time Pressure ◽  
Computer Work ◽  
Office Work ◽  
Deep Tissue ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Upper Trapezius ◽  
Shoulder And Neck Pain ◽  
Pressure Pain Thresholds

AbstractBackground and purposeA growing number of people are using computers. Shoulder and neck pain occur commonly during computer work. Peripheral and central sensitization may play a major role in establishing and maintaining several chronic pain conditions. We have previously reported that a 90 min simulated computer office-work induced substantial pain in the shoulders and neck. We hypothesized that the development of pain during the computer work may be related to sensitization. The aim of the present study was to examine if the 90 min computer work induced deep tissue muscle hyperalgesia manifested as altered pressure pain thresholds (PPTs).MethodsTwenty-two subjects with chronic shoulder and neck pain (pain group) and 26 healthy and pain free subjects (reference group) performed a standardized computer office-work task with use of a computer-mouse and with time pressure and high precision demands continuously for 90 min. The pressure pain threshold was measured with a pressure algometer in shoulder and forearm muscles (bilaterally in upper trapezius and extensor carpi radialis), and at sternum, before and 15 min and 30 min after the computer work task.ResultsThe PPTs before starting the computer work were not different between the groups at any of the five locations. In both groups, the PPTs in the active and inactive side of the upper trapezius as well as in the extensor carpi radialis of the forearm operating the computer mouse were significantly reduced after the 90 min computer work compared with the pre-work levels. In the pain group, also the PPT in the inactive resting forearm was significantly reduced. The changes seen in PPTs from pre-to post-work were not significantly different between the groups, except for the inactive resting forearm where the groups exhibited different time course.ConclusionA decrease in pressure pain thresholds of involved muscles suggests that computer office-work can induce deep tissue hyperalgesia within 90 min. The development of pain during the computer work indicates peripheral sensitization as the predominant mechanism. Decreased pressure pain thresholds also in sites distant from pain areas may indicate a contribution from central sensitization in the subjects with chronic shoulder and neck pain.ImplicationsThe lasting pain after work and the reduced PPTs both in involved and distant musculature may indicate need for frequent pauses during computer work, especially when performed with time pressure and high precision demands, in order to avoid pain to increase and sustain after work, and thus to prevent the possibility of pain to become chronic.

Widespread Pressure Pain Hypersensitivity, Health History, and Trigger Points in Patients with Chronic Neck Pain: A Preliminary Study

Pain Medicine ◽  
2019 ◽  
Vol 20 (12) ◽  
pp. 2516-2527 ◽  
Author(s):  
Matteo Castaldo ◽  
Antonella Catena ◽  
César Fernández-de-las-Peñas ◽  
Lars Arendt-Nielsen
Keyword(s):  
Neck Pain ◽  
Chronic Neck Pain ◽  
Trigger Points ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pain Hypersensitivity ◽  
Health History ◽  
Upper Trapezius ◽  
Pressure Pain Thresholds ◽  
Pain Patients

Abstract Background Pain sensitivity in chronic neck pain patients may be influenced by health conditions related to higher levels of widespread pressure pain hypersensitivity (sensitization). Trigger points have also been reported to play a role in the sensitization process. Objectives To investigate the association between pressure pain thresholds, trigger points, and health conditions in patients with chronic neck pain. Design Original research, preliminary study. Setting A private clinic. Subjects Thirty-four chronic mechanical neck pain patients and 34 chronic whiplash-associated neck pain patients, giving a final sample of 68 chronic neck pain patients. Methods Patients underwent an assessment of pressure pain thresholds over the upper trapezius, extensor carpi radialis longus, and tibialis anterior muscles and were screened for the presence of trigger points in the upper trapezius muscle. Further, information about health history conditions was obtained and collected in a form. Results Significantly negative correlations between all pressure pain thresholds and duration of health history conditions were found (all P < 0.02). Significantly lower pressure pain thresholds (all P < 0.01) were found in patients with active trigger points as compared with those with latent trigger points. Conclusion Widespread pressure pain hypersensitivity was associated with duration of health history conditions, suggesting that long-lasting health complaints may act as a triggering/perpetuating factor, driving sensitization in individuals with chronic neck pain. Active trigger points may be associated with higher widespread pressure hypersensitivity.

scholarly journals Is Dry Needling Effective When Combined with Other Therapies for Myofascial Trigger Points Associated with Neck Pain Symptoms? A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-24
Author(s):  
César Fernández-De-Las-Peñas ◽  
Gustavo Plaza-Manzano ◽  
Jorge Sanchez-Infante ◽  
Guido F Gómez-Chiguano ◽  
Joshua A Cleland ◽  
...  
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Range Of Motion ◽  
Dry Needling ◽  
Short Term ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Cervical Range Of Motion ◽  
Pressure Pain Thresholds

Objective. To evaluate the effects of combining dry needling with other physical therapy interventions versus the application of the other interventions or dry needling alone applied over trigger points (TrPs) associated to neck pain. Databases and Data Treatment. Electronic databases were searched for randomized controlled trials where at least one group received dry needling combined with other interventions for TrPs associated with neck pain. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The risk of bias (RoB) was assessed using the Cochrane risk of bias tool, methodological quality was assessed with PEDro score, and the quality of evidence was assessed by using the GRADE approach. Between-groups mean differences (MD) and standardized mean difference (SMD) were calculated. Results. Eight trials were included. Dry needling combined with other interventions reduced pain intensity at short-term (SMD −1.46, 95% CI −2.25 to −0.67) and midterm (SMD −0.38, 95% CI −0.74 to −0.03) but not immediately after or at long-term compared with the other interventions alone. A small effect on pain-related disability was observed at short-term (SMD −0.45, 95% CI −0.87 to −0.03) but not at midterm or long-term. The inclusion of dry needling was also effective for improving pressure pain thresholds only at short-term (MD 112.02 kPa, 95% CI 27.99 to 196.06). No significant effects on cervical range of motion or pain catastrophism were observed. Conclusion. Low-to-moderate evidence suggests a positive effect to the combination of dry needling with other interventions for improving pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion in people with neck pain associated with TrPs at short-term. No midterm or long-term effects were observed.

Effects of Deep Cervical Flexor Training on Pressure Pain Thresholds Over Myofascial Trigger Points in Patients With Chronic Neck Pain

2013 ◽  
Vol 36 (9) ◽  
pp. 604-611 ◽  
Author(s):  
Enrique Lluch ◽  
Maria Dolores Arguisuelas ◽  
Pablo S. Coloma ◽  
Francisco Palma ◽  
Alejandro Rey ◽  
...  
Keyword(s):  
Neck Pain ◽  
Chronic Neck Pain ◽  
Trigger Points ◽  
Myofascial Trigger Points ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds

scholarly journals Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain – a cross-sectional study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Mari K. Knapstad ◽  
Frederik K. Goplen ◽  
Tove Ask ◽  
Jan S. Skouen ◽  
Stein Helge G. Nordahl
Keyword(s):  
Neck Pain ◽  
Postural Control ◽  
Inverse Relationship ◽  
Pain Threshold ◽  
Postural Sway ◽  
Pressure Pain Threshold ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Lower Neck

Abstract Background It is theorized that neck pain may cause reduced postural control due to the known physiological connection between the receptors in the cervical spine and the vestibular system. The purpose of this study was to examine whether the pressure pain threshold in the neck is associated with postural sway in patients with dizziness or neck pain. Methods Consecutive patients with dizziness (n = 243) and neck pain (n = 129) were recruited from an otorhinolaryngological department and an outpatient spine clinic, respectively. All subjects underwent static posturography. Pressure pain thresholds were measured at four standardized points in the neck, and generalized pain was assessed using the American College of Rheumatology tender points. The relationship between postural sway and pressure pain threshold was analyzed by linear regression, and the covariates included age, sex, and generalized pain. Results In the dizzy group, there was a small, inverse relationship between pressure pain thresholds and sway area with eyes closed, after adjusting for age, sex, and generalized pain (bare platform; lower neck, p = 0.002, R2 = 0.068; upper neck, p = 0.038, R2 = 0.047; foam rubber mat; lower neck, p = 0.014, R2 = 0.085). The same inverse relationship was found between pressure pain thresholds in the neck and the Romberg ratio on a bare platform after adjusting for age, sex and generalized pain (upper neck, p = 0.15, R2 = 0.053; lower neck, p = 0.002, R2 = 0.069). Neither of these relationships were present in the neck pain group. Conclusion Our findings indicate that the pressure pain threshold in the neck is associated with postural sway in patients suffering from dizziness after adjusting for age, sex, and generalized pain, but only with closed eyes. The association was small and should be interpreted with caution. Trial registration Trial registration: Clinicaltrial.gov NCT03531619. Retrospectively registered 22 May 2018.

Hyperalgesia in human skin and deep-tissues inside and outside of a UVB irradiated area

2012 ◽  
Vol 3 (3) ◽  
pp. 190-190 ◽  
Author(s):  
Silvia Lo Vecchio ◽  
Lars J. Petersen ◽  
Thomas Graven-Nielsen ◽  
Sara Finocchietti ◽  
Parisa Gazerani ◽  
...  
Keyword(s):  
Blood Flow ◽  
Human Skin ◽  
Mechanical Stimuli ◽  
Deep Tissue ◽  
Tissue Pressure ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Uvb Irradiation ◽  
Pressure Pain Thresholds ◽  
Mechanical Pain Thresholds

Abstract Background/aims The ultraviolet B (UVB) inflammatory pain model is often used to induce a steady hyperalgesic area in human skin. UVB causes a well-described erythema, developing maximal response within about 24 h. The aim of the present study was to investigate if cutaneous UVB irradiation can influence both superficial and deep-tissue mechanical pain thresholds in the site of irradiation and in the surrounding area. Methods An area of 3 cm × 4 cm, located on the low back of 16 healthy volunteers, was irradiated by UVB (Medlight, Germany; 3xMED: Minimal Erythema Dose). The degree of inflammation was detected by measuring superficial blood flow before and after irradiation, inside and outside the stimulated area. Applying quantitative sensory assessments, mechanical pain threshold changes were detected one day after irradiation, within and outside of the irradiated area. Sensitivity to cutaneous mechanical stimuli was assessed using pin prick and deep-tissue pressure pain thresholds were evaluated on 12 spots (4 within and 8 outside, 1.5 cm distant from the irradiated area) by a computer-controlled pressure algometer (Aalborg University, Denmark; 1.0 cm2 flat probe, 0.5 cm2 flat probe and a V-shaped probe with a contact surface of 0.03 cm2). Results 24 h after exposure, the irradiated skin showed clear erythema with a boundary matching the irradiated area and a statistically significant increase in cutaneous blood flow (P < 0.001) compared with baseline assessment. Cutaneous pin prick pain thresholds and deep-tissue pressure pain thresholds (all probes) were significantly decreased inside and outside the irradiated area (P < 0.05). Conclusions Cutaneous UVB irradiation reduces mechanical pain thresholds to pin-prick and pressure stimulation which may indicate allodynic responses in both the skin and in deep-tissues. Expansion of the responses to areas outside the irradiated zone confirmed the presence of secondary hyperalgesia to mechanical stimuli.

Increased neck muscle stiffness in migraine patients with ictal neck pain: A shear wave elastography study

Cephalalgia ◽  
2020 ◽  
Vol 40 (6) ◽  
pp. 565-574
Author(s):  
Jeppe Hvedstrup ◽  
Lærke Tørring Kolding ◽  
Messoud Ashina ◽  
Henrik Winther Schytz
Keyword(s):  
Neck Pain ◽  
Shear Wave ◽  
Shear Wave Elastography ◽  
Neck Muscles ◽  
Muscle Stiffness ◽  
Neck Muscle ◽  
Cross Sectional ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds

Background Ictal neck pain is a frequent symptom reported by half of migraine patients. It is unknown if neck pain is caused by peripheral or central mechanisms. Neck muscle stiffness can be investigated with ultrasound shear wave elastography. Objectives To determine if migraine patients with ictal neck pain have stiffer neck muscles interictally compared with patients without ictal neck pain and controls. Methods This was a cross-sectional study investigating neck muscle stiffness, pressure pain thresholds and neck pain symptoms in 100 migraine patients recruited from a tertiary headache center and 46 controls. Results Patients with ictal neck pain had increased mean neck muscle stiffness interictally compared to both migraine patients without ictal neck pain ( p = 0.018) and controls ( p = 0.036). Muscle stiffness was negatively correlated with pressure pain thresholds in the neck in migraine patients with ictal neck pain (r = −0.292, p = 0.042). There were no differences in mean pressure pain thresholds between migraine subgroups. Conclusions Migraine patients with ictal neck pain have stiffer neck muscles interictally compared with migraine patients without ictal neck pain and controls measured with ultrasound shear wave elastography. The increased stiffness could be due to local alterations in the neck muscles. Trial registration: clinical-trials.gov, identifier: NCT03626805

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