Evaluation of Pericranial Myofascial Nociception by Pressure Algometry. Reproducibility and Factors of Variation

Cephalalgia ◽  
1992 ◽  
Vol 12 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Karin Lottrup Petersen ◽  
Jannick Brennum ◽  
Jes Olesen
Keyword(s):  
Detection Threshold ◽  
Pressure Pain Threshold ◽  
Pain Tolerance ◽  
Individual Subject ◽  
Temporal Muscle ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Pain Detection ◽  
The Individual

Pressure pain detection threshold and pressure pain tolerance threshold were measured in the temples and on the fingers in 40 healthy volunteers, equally distributed as to sex and handedness. Lower pressure pain thresholds were found over the temporal muscle than in a neighbouring temporal location without interposed myofascial tissue ( p < 0.001), indicating that nociception from myofascial tissue contributes to the pressure pain threshold. Pressure pain tolerance was more reproducible within the individual subject but differed more between subjects than pressure pain detection. Pressure pain thresholds were higher on the fingers than in the temples ( p < 10-5) and, in general, thresholds were higher in males than in females ( p = 0.02 – 0.09). Finally, pressure pain thresholds were lateralized in dextrals but not in sinistrals. The information that can be obtained from pressure pain detection and tolerance thresholds is discussed and examination of both threshold types is recommended in future studies.

scholarly journals High concurrent validity between digital and analogue algometers to measure pressure pain thresholds in healthy participants and people with migraine: a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
René F. Castien ◽  
Michel W. Coppieters ◽  
Tom S. C. Durge ◽  
Gwendolyne G. M. Scholten-Peeters
Keyword(s):  
Concurrent Validity ◽  
Tibialis Anterior Muscle ◽  
Intraclass Correlation ◽  
Cephalic Region ◽  
Limits Of Agreement ◽  
Temporal Muscle ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Healthy Participants

Abstract Background Pressure pain thresholds (PPTs) are commonly assessed to quantify mechanical sensitivity in various conditions, including migraine. Digital and analogue algometers are used, but the concurrent validity between these algometers is unknown. Therefore, we assessed the concurrent validity between a digital and analogue algometer to determine PPTs in healthy participants and people with migraine. Methods Twenty-six healthy participants and twenty-nine people with migraine participated in the study. PPTs were measured interictally and bilaterally at the cephalic region (temporal muscle, C1 paraspinal muscles, and trapezius muscle) and extra-cephalic region (extensor carpi radialis muscle and tibialis anterior muscle). PPTs were first determined with a digital algometer, followed by an analogue algometer. Intraclass correlation coefficients (ICC3.1) and limits of agreement were calculated to quantify concurrent validity. Results The concurrent validity between algometers in both groups was moderate to excellent (ICC3.1 ranged from 0.82 to 0.99, with 95%CI: 0.65 to 0.99). Although PPTs measured with the analogue algometer were higher at most locations in both groups (p < 0.05), the mean differences between both devices were less than 18.3 kPa. The variation in methods, such as a hand-held switch (digital algometer) versus verbal commands (analogue algometer) to indicate when the threshold was reached, may explain these differences in scores. The limits of agreement varied per location and between healthy participants and people with migraine. Conclusion The concurrent validity between the digital and analogue algometer is excellent in healthy participants and moderate in people with migraine. Both types of algometer are well-suited for research and clinical practice but are not exchangeable within a study or patient follow-up.

Hyperalgesia and allodynia to superficial and deep-tissue mechanical stimulation within and outside of the UVB irradiated area in human skin

2014 ◽  
Vol 5 (4) ◽  
pp. 258-267 ◽  
Author(s):  
Silvia Lo Vecchio ◽  
Lars J. Petersen ◽  
Sara Finocchietti ◽  
Parisa Gazerani ◽  
Lars Arendt-Nielsen ◽  
...  
Keyword(s):  
Blood Flow ◽  
Skin Inflammation ◽  
Ultraviolet B ◽  
Skin Area ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Uvb Irradiation ◽  
Stimulus Response ◽  
Pressure Pain Thresholds ◽  
The Individual

AbstractBackground and aimsThe ultraviolet-B (UVB) inflammatory model is a well-established model of inflammatory pain. This study investigated whether UVB-induced cutaneous inflammation would enhance pain responses from the underlying deep somatic areas.MethodsSkin inflammation was induced, in 24 healthy volunteers, by UVB irradiation (three times of the individual minimal erythema UVB dose) in square-shaped areas on the forearm and lower back. Assessments of cutaneous blood flow, pin-prick thresholds, pressure pain thresholds and tolerance, stimulus–response functions relating graded pressure stimulations and pain intensity (visual analogue scale, VAS) were performed within and outside the irradiated area.ResultsTwenty-four hours after UVB irradiation, a significant increase in superficial blood flow in the irradiated skin area was demonstrated compared with baseline (P < 0.01) indicating that inflammation was induced. Compared with baseline, UVB irradiation significantly reduced the pin-prick thresholds, pressure pain thresholds and tolerance within and outside of the irradiated area (P < 0.05). The stimulus–response function was left-shifted compared with baseline both within and outside the irradiated area (P < 0.05) with a more pronounced left-shift within the irradiated area (P < 0.01). Application of topical anaesthesia 24h after irradiation in 5 subjects, both within and outside the irradiated area, could only increase the pin-prick thresholds outside the irradiated area.ConclusionThe UVB irradiation of the skin not only provokes cutaneous primary and secondary hyper-algesia but also causes hyperalgesia to blunt pressure stimulations 24h after the UVB exposure.ImplicationsThe presented UVB model can be used as a translational model from animals into healthy subjects. This model can potentially be used to screen drug candidates with anti-inflammatory properties in early stages of drug development.

scholarly journals Central inhibition of pain is augmented in women with self-injurious behavior

2021 ◽  
Author(s):  
Maria Lalouni ◽  
Jens Fust ◽  
Johan Bjureberg ◽  
Granit Kastrati ◽  
Robin Fondberg ◽  
...  
Keyword(s):  
Temporal Summation ◽  
Pain Modulation ◽  
Pain Tolerance ◽  
Conditioned Pain Modulation ◽  
Heat Pain ◽  
Healthy Controls ◽  
Down Regulation ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds

Individuals who engage in nonsuicidal self-injury (NSSI) have demonstrated higher pain thresholds and tolerance compared with individuals without NSSI. The objective of the study was to assess which aspects of the pain regulatory system that account for this augmented pain perception. In a cross-sectional design, 81 women, aged 18-35 (mean [SD] age, 23.4 [3.9]), were included (41 with NSSI and 40 healthy controls). A quantitative sensory testing protocol, including heat pain thresholds, heat pain tolerance, pressure pain thresholds, conditioned pain modulation (assessing central down-regulation of pain), and temporal summation (assessing facilitation of pain signals) was used. Thermal pain stimuli were assessed during fMRI scanning and NSSI behaviors and clinical symptoms were self-assessed. NSSI participants demonstrated higher pain thresholds during heat and pressure pain compared to controls. During conditioned pain modulation, NSSI participants showed a more effective central down-regulation of pain for NSSI participants. Temporal summation did not differ between the groups. There were no correlations between pain outcomes and NSSI behaviors or clinical characteristics. The fMRI analyses revealed increased activity in the primary and secondary somatosensory cortex in NSSI participants, compared to healthy controls, which are brain regions implicated in sensory aspects of pain processing. The findings suggest segregated inhibitory mechanisms for pain and emotion in NSSI, as pain insensitivity was linked to enhanced inhibitory control of pain in spite of significant impairments in emotion regulation. This may represent an endophenotype associated with a greater risk for developing self-injurious behavior.

scholarly journals The Relationship between Fibromyalgia and Pressure Pain Threshold in Patients with Dyspareunia

2015 ◽  
Vol 20 (3) ◽  
pp. 137-140 ◽  
Author(s):  
Hasan Terzi ◽  
Rabia Terzi ◽  
Ahmet Kale
Keyword(s):  
Beck Depression Inventory ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Control Group ◽  
Tender Points ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Pressure Algometer ◽  
Significant Difference

OBJECTIVE: To evaluate the number of tender points, pressure pain threshold and presence of fibromyalgia among women with or without dyspareunia.METHODS: The present cross-sectional study included 40 patients with dyspareunia and 30 healthy controls. The participants were asked if they had engaged in sexual intercourse during the previous four weeks, and dyspareunia was rated from 0 to 3 based on the Marinoff Dyspareunia Scale. A pressure algometer (dolorimeter) was used to measure the pressure pain threshold. Fibromyalgia was diagnosed based on the 1990 American College of Rheumatology criteria. The depression status of the participants was assessed using the Beck Depression Inventory.RESULTS: No statistically significant difference was found with regard to age, body mass index, habits (alcohol use and smoking), educational status and occupational status between the two groups. Total myalgic score, total control score and tender point mean pain threshold were significantly lower in the group with dyspareunia. The number of tender points was significantly higher in patients with dyspareunia. The mean Beck Depression Inventory score was 14.7 ±8.4 in the dyspareunia group compared with 11.2 ±7.1 in the control group. Five (12.5%) of the patients with dyspareunia were diagnosed with fibromyalgia, whereas no patients in the control group were diagnosed with fibromyalgia. There was no significant difference between the two groups with regard to the presence of fibromyalgia.CONCLUSION: The finding of lower pressure pain thresholds and a higher number of tender points among patients with dyspareunia suggests that these patients may have increased generalized pain thresholds. Additional studies involving a larger number of patients are required to investigate the presence of central mechanisms in the pathogenesis of dyspareunia.

scholarly journals “Big girls don’t cry”: the effect of the experimenter’s sex and pain catastrophising on pain

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Lechi Vo ◽  
Peter D. Drummond
Keyword(s):  
Pressure Pain Threshold ◽  
Potential Interaction ◽  
Lower Pressure ◽  
Experimental Conditions ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pain Catastrophising ◽  
Pressure Pain Thresholds ◽  
Males And Females ◽  
Pain Reports

Abstract Objectives The expression of pain in males and females involves complex socio-psychological mechanisms. Males may report lower pain to a female experimenter to appear strong, whereas females may report higher pain to a male experimenter to appear weak and to seek protection. However, evidence to support these stereotypes is inconclusive. Individuals who catastrophise about pain rate higher pain than those who do not. How pain catastrophising interacts with the effect of the experimenter’s sex on pain reports is yet to be explored. Thus, the aim of this study was to determine whether pain catastrophising moderated the effect of the experimenter’s sex on pain reports in healthy males and females. Methods Participants (n=60, 30 males) were assigned to one of four experimental conditions: males tested by male experimenters, males tested by female experimenters, females tested by male experimenters, and females tested by female experimenters. Participants completed the Pain Catastrophising Scale, and then sensitivity to heat and to blunt (pressure-pain threshold) and sharp stimuli was assessed on both forearms, and to high frequency electrical stimulation (HFS) administered to one forearm. Results Females reported lower pressure-pain thresholds than males irrespective of the experimenters’ sex. Females reported lower sharpness ratings to male than female experimenters only when the test stimuli were moderately or intensely sharp. Higher pain catastrophising scores were associated with higher sharpness ratings in females but not males. Additionally, higher pain catastrophising scores were associated with greater temporal summation of pain to HFS, and with lower pressure-pain thresholds in females who were tested by male experimenters. Conclusions These findings indicate that the experimenters’ sex and the participant’s pain catastrophising score influence pain reports, particularly in females. Awareness of these psychosocial factors is important in order to interpret pain responses in a meaningful way, especially when females are tested by male experimenters. A greater awareness of sex/gender role biases and their potential interaction with pain catastrophising may help researchers and clinicians to interpret pain reports in meaningful ways. In turn, this may help to improve delivery of treatments for patients with chronic pain.

scholarly journals Strength Exercise Has Different Effects on Pressure Pain Thresholds in Women with Endometriosis-Related Symptoms and Healthy Controls: A Quasi-experimental Study

Pain Medicine ◽  
2020 ◽  
Vol 21 (10) ◽  
pp. 2280-2287
Author(s):  
Omero Benedicto Poli-Neto ◽  
Arthur Marques Zecchin Oliveira ◽  
Mariana Cecchi Salata ◽  
Julio Cesar Rosa-e-Silva ◽  
Dalmo Roberto Lopes Machado ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Experimental Study ◽  
Pressure Pain Threshold ◽  
Strength Exercise ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Healthy Women ◽  
Pressure Pain Thresholds ◽  
Quasi Experimental

Abstract Objective To evaluate the influence of strength exercises on remote pain sensitivity in women with endometriosis-related symptoms. Design A quasi-experimental study. Setting University Hospital, a tertiary health unit. Subjects Twenty-one women with endometriosis-related symptoms and 21 healthy women provided written informed consent. Methods The participants performed weekly exercise sessions on an extensor chair for four consecutive weeks. An electronic algometer was used to measure the pressure pain thresholds on the nondominant forearm. Heart rate and blood pressure were measured using a digital device. All measurements were taken before, immediately after, and 10 and 20 minutes after the exercise series. Results Women with endometriosis-related symptoms had lower pain thresholds. Pressure pain thresholds increased immediately after exercise in healthy women, returning to baseline level 20 minutes after exercise. Women with endometriosis-related symptoms did not present significant pressure pain threshold alterations after exercise. However, they had a higher heart rate and systolic, diastolic, and average blood pressure than healthy women at all the timepoints. There were no consistent correlations between pressure pain thresholds and heart rate or blood pressure. Conclusions The strength exercise regimen used in this study increased pain thresholds in healthy women but not in women with endometriosis-related painful symptoms. The maintenance or even worsening of pain perception after exercise in women with persistent pain, such as those with endometriosis, may limit their adherence to a physical training program, which in turn could prevent them from experiencing the long-term beneficial effects of exercise.

Pressure Pain Threshold and Pain Tolerance in Episodic Tension-Type Headache Do Not Depend on the Presence of Headache

Cephalalgia ◽  
1999 ◽  
Vol 19 (3) ◽  
pp. 174-178 ◽  
Author(s):  
GM Bove ◽  
N Nilsson
Keyword(s):  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Underlying Mechanism ◽  
Tension Type Headache ◽  
Pain Tolerance ◽  
Mechanical Stimuli ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Tension Type Headaches

Pressure pain thresholds and responses to painful mechanical stimuli were obtained from 20 subjects with episodic tension-type headaches (TTH). Tender points in the temporalis and trapezius muscles were studied, along with two nontender points, one in the temporalis and one on the Achilles tendon. Two examinations were performed, one during and one without a headache, and results were compared. No significant differences were found in either variable for any tested points. The data demonstrate that the sensitivity level of these points does not differ based on the presence or absence of TTH. This suggests that the muscle sensitivity in TTH is constant. The observation that the sensitivity levels of both tender and nontender points did not vary suggests that the underlying mechanism or effect of TTH is not restricted to tender muscles.

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.

scholarly journals Relationship Between Pressure Pain Threshold and Coping Strategies in Patients with Fibromyalgia

1998 ◽  
Vol 3 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Ji-Young Song ◽  
Samuel Noh ◽  
Manfred Harth ◽  
Harold Merskey
Keyword(s):  
Chronic Pain ◽  
Coping Strategies ◽  
Pressure Pain Threshold ◽  
Pain Coping ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Behavioural Activity ◽  
Pressure Pain Thresholds ◽  
Pressure Algometer ◽  
And Coping

OBJECTIVE: To explore the hypothesis that the intensity of pain, pain thresholds and coping mechanisms differ between patients with fibromyalgia and those with rheumatoid arthritis (RA) in order to determine whether pain coping strategies contribute to the understanding of how patients adjust to fibromyalgia.METHODS: Thirty-eight fibromyalgia patients were compared with 15 RA patients regarding severity of pain, pain history, pressure pain thresholds (measured with a pressure algometer) and pain coping strategies (measured with the Coping Strategies Questionnaire [CSQ]).RESULTS: Fibromyalgia patients scored significantly higher than RA patients on severity of pain and had lower pain thresholds at three pairs of nontender sites than the RA group. Fibromyalgia patients were significantly different from RA patients with respect to catastrophizing and increasing behavioural activity, but this differentiation was not maintained with respect to the three main factors of the CSQ. Overall, both the fibromyalgia and RA groups resembled previous chronic pain populations. Depression and anxiety had strong negative correlations with the combined coping scores on the seven subscales (P<0.001).CONCLUSIONS: Patients with fibromyalgia may use some distinctive coping strategies and tend to manage their pain in many of the same ways as other patients with chronic pain.

The tolerance to stretch is linked with endogenous modulation of pain

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Morten Pallisgaard Støve ◽  
Rogerio Pessoto Hirata ◽  
Thorvaldur Skuli Palsson
Keyword(s):  
Range Of Motion ◽  
Pain Sensitivity ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Static Stretch ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressor Test ◽  
Pressure Pain Thresholds ◽  
Exercise Induced

Abstract Objectives The effect of stretching on joint range of motion is well documented, and although sensory perception has significance for changes in the tolerance to stretch following stretching the underlining mechanisms responsible for these changes is insufficiently understood. The aim of this study was to examine the influence of endogenous pain inhibitory mechanisms on stretch tolerance and to investigate the relationship between range of motion and changes in pain sensitivity. Methods Nineteen healthy males participated in this randomized, repeated-measures crossover study, conducted on 2 separate days. Knee extension range of motion, passive resistive torque, and pressure pain thresholds were recorded before, after, and 10 min after each of four experimental conditions; (i) Exercise-induced hypoalgesia, (ii) two bouts of static stretching, (iii) resting, and (iv) a remote, painful stimulus induced by the cold pressor test. Results Exercise-induced hypoalgesia and cold pressor test caused an increase in range of motion (p<0.034) and pressure pain thresholds (p<0.027). Moderate correlations in pressure pain thresholds were found between exercise-induced hypoalgesia and static stretch (Rho>0.507, p=0.01) and exercise-induced hypoalgesia and the cold pressor test (Rho=0.562, p=0.01). A weak correlation in pressure pain thresholds and changes in range of motion were found following the cold pressor test (Rho=0.460, p=0.047). However, a potential carryover hypoalgesic effect may have affected the results of the static stretch. Conclusions These results suggest that stretch tolerance may be linked with endogenous modulation of pain. Present results suggest, that stretch tolerance may merely be a marker for pain sensitivity which may have clinical significance given that stretching is often prescribed in the rehabilitation of different musculoskeletal pain conditions where reduced endogenous pain inhibition is frequently seen.

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