Pain Pressure Threshold in Cluster Headache Patients

Cephalalgia ◽  
1996 ◽  
Vol 16 (1) ◽  
pp. 62-66 ◽  
Author(s):  
G Bono ◽  
F Antonaci ◽  
G Sandrini ◽  
E Pucci ◽  
G Nappi ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Pain Perception ◽  
Perception Threshold ◽  
Temporal Muscle ◽  
Mean Values ◽  
Pressure Threshold ◽  
Pain Pressure Threshold ◽  
Pressure Algometer ◽  
Symmetrical Points ◽  
Symptomatic Side

Pain perception threshold (PFT) in the head was assessed with a pressure algometer in 58 cluster headache (CH) patients (52M, 6F; 41 episodic and 17 chronic). Fourteen patients in cluster period were retested in remission. Thresholds were assessed at 10 symmetrical points on each side of the head and at the deltoid. Compared with controls ( n = 80), CH patients had lower PPT in the head and in the deltoid. PPT was lower on the symptomatic side than on the non-symptomatic side in patients with episodic CH during a cluster period ( p<0.001) and in patients with chronic CH ( p<0.05). This pattern was more evident during a cluster period than during remission ( p<0.05). A reduced PPT did not correlate with illness duration and pain side. The lowest PPT mean values were found at the anterior and intermediate levels of the temporal muscle on the symptomatic side. These results imply a central mechanism underlying the pathogenesis of CH.

Asymmetrical Reduction of the Nociceptive Flexion Reflex Threshold in Cluster Headache

Cephalalgia ◽  
2000 ◽  
Vol 20 (7) ◽  
pp. 647-652 ◽  
Author(s):  
G Sandrini ◽  
F Antonaci ◽  
S Lanfranchi ◽  
I Milanov ◽  
A Danilov ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Inverse Correlation ◽  
Lower Limbs ◽  
Pain Mechanisms ◽  
Flexion Reflex ◽  
Nociceptive Flexion Reflex ◽  
Pressure Threshold ◽  
Pain Pressure Threshold ◽  
Reflex Threshold ◽  
Symptomatic Side

The nociceptive flexion reflex (NFR) of the lower limbs (RIII reflex) was examined bilaterally in 54 cluster headache (CH) patients suffering from episodic CH (ECH) and chronic CH (CCH). Fifteen ECH patients were examined in both remission and active phases. The RIII reflex threshold (Tr) and the threshold of pain sensation (Tp) were significantly reduced on the symptomatic side in patients with episodic CH during the bout. During the active phase of episodic CH an inverse correlation was found between the severity of CH (ratio: number of cluster periods/years of illness duration) and the Tp, which may suggest a role for secondary central sensitization in pain pathways. The lower Tr and Tp on the symptomatic side is in keeping with previous observations exploring pain mechanisms using different methods (i.e. corneal reflex, pain pressure threshold). On the whole, these data tie in with the view of an impairment of the pain control system, which parallels the periodicity of the disorder in the episodic form.

scholarly journals The Effect of Hamstring Relaxation Program on Headache, Pressure Pain Threshold, and Range of Motion in Patients with Tension Headache: A Randomized Controlled Trial

2021 ◽  
Vol 18 (19) ◽  
pp. 10137
Author(s):  
Soon-Hyun Kwon ◽  
Eun-Jung Chung ◽  
Jin Lee ◽  
Sang-Woo Kim ◽  
Byoung-Hee Lee
Keyword(s):  
Range Of Motion ◽  
Controlled Trial ◽  
Pressure Pain Threshold ◽  
Tension Headache ◽  
Control Group ◽  
Positive Effects ◽  
Pressure Threshold ◽  
Digital Pressure ◽  
Pain Pressure Threshold ◽  
Pressure Algometer

The purpose of this study was to determine if the severity of headache is reduced by decreasing hamstring tension in patients with tension headache. Thirty patients participated in this study. The participants were randomly allocated to two groups: hamstring relaxation program (HR) group (n = 15) and control group (n = 15). The participants in the HR group participated in a HR program for 25 min per day, three times per week, for a period of 4 weeks, and the control group participated in an electrotherapy for 25 min per day, three times per week, for a period of 4 weeks. Both groups participated in a self-myofacial release for 5 min per day, three times per week, for a period of 4 weeks. Headache was evaluated using the headache impact test (HIT-6) and visual analog scale (VAS). The pain pressure threshold (PPT) was evaluated using a digital pressure algometer. The range of motion (ROM) was evaluated using a goniometer and two special tests: straight leg raise test (SLRT) and popliteal angle test (PAT). The two groups showed no significant differences in terms of age, sex, height, and weight. The VAS and HIT-6 scores (p < 0.05) and neck and hamstring PPT showed significant improvements (p < 0.05). Neck flexion ROM and SLRT and PAT scores showed significant improvements (p < 0.05) in both groups, and the HR group showed significantly more improvements than the control group. This study confirmed that the HR program has positive effects on tension headache and is a good intervention for alleviating headaches in patients with tension headache.

scholarly journals Effect of Manual Therapy and Splint Therapy in People with Temporomandibular Disorders: A Preliminary Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2411 ◽  
Author(s):  
Gemma Victoria Espí-López ◽  
Anna Arnal-Gómez ◽  
Alba Cuerda del Pino ◽  
José Benavent-Corai ◽  
Pilar Serra-Añó ◽  
...  
Keyword(s):  
Manual Therapy ◽  
Temporomandibular Disorders ◽  
Pain Perception ◽  
Control Group ◽  
Positive Perception ◽  
Positive Effects ◽  
Splint Therapy ◽  
Pressure Threshold ◽  
Pain Pressure Threshold

Background: Isolated manual therapy techniques (MT) have shown beneficial effects in patients with temporomandibular disorders (TMD) but the effect of the combination of such techniques, together with the well-stablished splint therapy (ST) remains to be elucidated. Objective: This study was conducted to ascertain whether a combined program of MT techniques, including intraoral treatment, plus traditional ST improves pain and clinical dysfunction in subjects with TMD. Methods: A preliminary trial was conducted. 16 participants were assigned to either the MT plus ST-Experimental Group (EG, n = 8) or the ST alone—Control Group (CG, n = 8). Forty-five minute sessions of combined MT techniques were performed, once a week for four weeks. Three evaluations were conducted: baseline, post-treatment, and one-month follow-up. Outcome measures were pain perception, pain pressure threshold (PPT), TMD dysfunction, and perception of change after treatment. Results: EG showed significant reduction on pain, higher PPT, significant improvement of dysfunction and significantly positive perception of change after treatment (p < 0.05 all). Additionally, such positive effects were maintained at follow-up with a high treatment effect (R2 explaining 26.6–33.2% of all variables). Conclusion: MT plus ST showed reduction on perceived pain (3 points decrease), higher PPT (of at least 1.0 kg/cm2), improvement of disability caused by pain (4.4 points decrease), and positive perception of change (EG: 50% felt “much improvement”), compared to ST alone.

scholarly journals Pain pressure thresholds for evaluating myofascial pain in the equine brachiocephalicus muscle

2019 ◽  
Vol 02 (02) ◽  
pp. 114-114
Author(s):  
Calatayud-Bonilla M. ◽  
Resano-Zuazu M. ◽  
Segura-Ortí E.
Keyword(s):  
Myofascial Pain ◽  
Intraclass Correlation ◽  
Trigger Points ◽  
Myofascial Trigger Points ◽  
Minimum Detectable Change ◽  
Pressure Threshold ◽  
Pain Pressure Threshold ◽  
Pressure Algometer ◽  
Manual Palpation ◽  
Distal Aspect

Abstract Introduction Myofascial pain is one of the most common musculoskeletal pathologies in humans, with the presence of myofascial trigger points (MTrPs). A MTrP is defined as a hyperirritable nodule in a taut band of musculoskeletal fibers. The pain pressure threshold is a tool for the assessment of pain used in humans with proven reliability, however there is no evidence of the same in the study of MTrPs in horses. Aims The aim of this study was to evaluate the reliability of the measurement of pressure pain sensitivity in horses with MTrPs in the brachiocephalicus muscle. A second aim was to calculate the minimum detectable change (MDC) for this result. Material and Methods Twenty horses were evaluated, aged between five and fifteen years old. All without pathology or previous pharmacological treatment. The cranial angle of the scapula was taken as the anatomic reference. A first evaluator, whose reliability was already confirmed, performed a manual palpation of the distal aspect of the brachiocepalicus muscle. A MTrP was located in all animals included in the study. The anatomic reference and the MTrP were marked. The pain pressure threshold of the MTrP was measured using a pressure algometer (Wagner Instruments, EE.UU., kg/cm2). The same evaluator applied the tip of the algometer parallel to the neck and transversal to the muscle fibers, gradually increasing pressure until the ‘jump sign’ or facial expressions of pain were detected by a second operator who also recorded the measurements. The measurements were repeated consecutively twice in this manner. The first operator was blind to the measurements. The intraclass correlation index (ICC) was calculated to evaluate reliability. Results The mean thresholds of pain pressure sensitivity registered for the first and second measurement were 3.29 (1.0) kg/cm2 and 3.31 (0.9) kg/cm2. The ICC was 0.86 (95% CI: 0.68 to 0.95). The MDC was 0.9 kg/cm2 (95% CI: 0.6 to 1.4). Conclusions Acceptable reliability was found for the measurement of the pain pressure threshold in horses with MTrPs in the brachiocephalicus muscle.

scholarly journals Roller massage decreases spinal excitability to the soleus

2018 ◽  
Vol 124 (4) ◽  
pp. 950-959 ◽  
Author(s):  
James D. Young ◽  
Alyssa-Joy Spence ◽  
David G. Behm
Keyword(s):  
High Intensity ◽  
Pain Perception ◽  
H Reflex ◽  
Moderate Intensity ◽  
Plantar Flexors ◽  
M Wave ◽  
Neural Modulation ◽  
Pressure Threshold ◽  
Pain Pressure Threshold ◽  
Spinal Excitability

Roller massage (RM) interventions have shown acute increases in range of motion (ROM) and pain pressure threshold (PPT). It is unclear whether the RM-induced increases can be attributed to changes in neural or muscle responses. The purpose of this study was to evaluate the effect of altered afferent input via application of RM on spinal excitability, as measured with the Hoffmann (H-) reflex. A randomized within-subjects design was used. Three 30-s bouts of RM were implemented on a rested, nonexercised, injury-free muscle with 30 s of rest between bouts. The researcher applied RM to the plantar flexors at three intensities of pain: high, moderate, and sham. Measures included normalized M-wave and H-reflex peak-to-peak amplitudes before, during, and up to 3 min postintervention. M-wave and H-reflex measures were highly reliable. RM resulted in significant decreases in soleus H-reflex amplitudes. High-intensity, moderate-intensity, and sham conditions decreased soleus H-reflex amplitudes by 58%, 43%, and 19%, respectively. H-reflexes induced with high-intensity rolling discomfort or pain were significantly lower than moderate and sham conditions. The effects were transient in nature, with an immediate return to baseline following RM. This is the first evidence of RM-induced modulation of spinal excitability. The intensity-dependent response observed indicates that rolling pressure or pain perception may play a role in modulation of the inhibition. Roller massage-induced neural modulation of spinal excitability may explain previously reported increases in ROM and PPT. NEW & NOTEWORTHY Recent evidence indicates that the benefits of foam rolling and roller massage are primarily accrued through neural mechanisms. The present study attempts to determine the neuromuscular response to roller massage interventions. We provide strong evidence of roller massage-induced neural modulation of spinal excitability to the soleus. It is plausible that reflex inhibition may explain subsequent increases in pain pressure threshold.

Effects of Interferential Therapy Parameter Combinations Upon Experimentally Induced Pain in Pain-Free Participants: A Randomized Controlled Trial

2012 ◽  
Vol 92 (7) ◽  
pp. 911-923 ◽  
Author(s):  
Myrto D. Dounavi ◽  
Linda S. Chesterton ◽  
Julius Sim
Keyword(s):  
Placebo Group ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Pressure Pain Threshold ◽  
Control Group ◽  
Pressure Threshold ◽  
Pain Pressure Threshold ◽  
Pressure Algometer ◽  
Interferential Therapy ◽  
Experimentally Induced

Background Little evidence exists regarding parameter selection for hypoalgesia using interferential therapy (IFT). Objective This study investigated segmental and extrasegmental hypoalgesic effects of different IFT parameter combinations upon experimentally induced pressure pain threshold (PPT) in pain-free volunteers. Design The participants were randomly assigned to 6 groups: control, placebo, bipolar constant amplitude modulation frequency (AMF), bipolar sweep AMF, quadripolar constant AMF, and quadripolar sweep AMF. Setting The study was conducted in a university laboratory. Participants One hundred eighty adults who were healthy and pain-free participated in the study. Intervention Interferential therapy was delivered to all groups at high, to-tolerance intensity and at high AMF. Stimulation to the dominant forearm was delivered for 30 minutes, with monitoring for a further 30 minutes. Measurements Pain pressure threshold was measured at the area of first dorsal interosseous muscle of the dominant and nondominant hands (segmental measurements) and over the tibialis anterior muscle (extrasegmental measurement) at baseline and at 10-minute intervals using a pressure algometer. Square root transformed PPT data were analyzed using repeated-measures analysis of variance. Results There was a significant change in PPT over time, but no significant between-subjects difference in segmental or extrasegmental PPT between any of the IFT groups and the placebo or control group. Thus, IFT delivered in any of these parameter combinations did not significantly affect the PPT of pain-free participants compared with the control or placebo group. Limitations Success of blinding was not evaluated. Conclusions This study showed that IFT delivered at high, to-tolerance intensity and high AMF does not produce significant segmental and extrasegmental hypoalgesic effects on PPT in participants who were healthy compared with a control or placebo group. Further research is warranted to investigate the hypoalgesic effect of different IFT parameter combinations and to explain its possible mechanism of action.

scholarly journals Pain perception in healthy volunteers: effect of repeated exposure to experimental systemic inflammation

2016 ◽  
Vol 22 (7) ◽  
pp. 546-556 ◽  
Author(s):  
Susanne Janum ◽  
Signe T Nielsen ◽  
Mads U Werner ◽  
Jesper Mehlsen ◽  
Henrik Kehlet ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Systemic Inflammation ◽  
Pain Perception ◽  
Nicotine Patch ◽  
Cytokine Release ◽  
Healthy Human ◽  
Pressure Threshold ◽  
Transdermal Nicotine ◽  
Pain Pressure Threshold ◽  
Increasing Temperature

We aimed to study the relationship between pain perception and cytokine release during systemic inflammation. We present a randomized crossover trial in healthy volunteers ( n = 17) in 37 individual trials. Systemic inflammation was induced by an i.v. bolus of Escherichia coli LPS (2 ng/kg) on two separate trial days, with or without a nicotine patch applied 10 h previously. Pain perception at baseline, and 2 and 6 h after LPS was assessed by pressure algometry and tonic heat stimulation at an increasing temperature (45–48℃) during both trials. Compared with baseline, pain pressure threshold was reduced 2 and 6 h after LPS, while heat pain perception was accentuated at all testing temperatures after 2 but not 6 h. The magnitude of changes in pain perception did not correlate to cytokine release. No effect of transdermal nicotine or training status was observed. In conclusion, LPS administration in healthy human volunteers leads to reduction in pain pressure threshold and an increase in pain perception to heat stimuli, supporting a relationship between acute systemic inflammation and pain perception.

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