Experimental Forearm Immobilization in Humans Induces Cold and Mechanical Hyperalgesia

Background Complex regional pain syndrome is a painful condition of unknown etiology. Clinical and experimental observations suggest that limb immobilization may induce symptoms and signs characteristic of complex regional pain syndrome. This study examined the effect of forearm immobilization on regional sensory and autonomic functions in healthy subjects. Methods Thermal and mechanical sensitivity, skin temperature, and vasoconstrictor responses were measured in 30 healthy subjects before and 0, 3, and 28 days after scaphoid cast immobilization. Fifteen subjects served as nonimmobilized controls. Results At cast removal, 27 subjects experienced pain at joint movement. Cast immobilization induced cold hyperalgesia in glabrous and hairy skin on the immobilized hand and induced significant skin temperature differences between the control and the immobilized hand at cast removal and after 3 days. Immobilization also reduced pain threshold at skin fold testing at all time points after cast removal. All measures except pain threshold at skin fold testing were normalized after 28 days. Immobilization did not affect thermal detection, heat pain, and pressure pain thresholds; resting skin perfusion; or vasoconstrictor responses induced by mental stress or deep inspirations. Conclusions Four weeks of forearm immobilization caused transient changes in skin temperature, mechanosensitivity, and thermosensitivity, without alteration in the sympathetically mediated vascular tone.

Download Full-text

Brain Neuroplastic Changes Accompany Anxiety and Memory Deficits in a Model of Complex Regional Pain Syndrome

Anesthesiology ◽

10.1097/aln.0000000000000403 ◽

2014 ◽

Vol 121 (4) ◽

pp. 852-865 ◽

Cited By ~ 48

Author(s):

Maral Tajerian ◽

David Leu ◽

Yani Zou ◽

Peyman Sahbaie ◽

Wenwu Li ◽

...

Keyword(s):

Working Memory ◽

Mouse Model ◽

Complex Regional Pain Syndrome ◽

Structural Changes ◽

Brain Plasticity ◽

Pain Syndrome ◽

The United States ◽

Cast Immobilization ◽

Cognitive Changes ◽

Painful Condition

Abstract Background: Complex regional pain syndrome (CRPS) is a painful condition with approximately 50,000 annual new cases in the United States. It is a major cause of work-related disability, chronic pain after limb fractures, and persistent pain after extremity surgery. Additionally, CRPS patients often experience cognitive changes, anxiety, and depression. The supraspinal mechanisms linked to these CRPS-related comorbidities remain poorly understood. Methods: The authors used a previously characterized mouse model of tibia fracture/cast immobilization showing the principal stigmata of CRPS (n = 8 to 20 per group) observed in humans. The central hypothesis was that fracture/cast mice manifest changes in measures of thigmotaxis (indicative of anxiety) and working memory reflected in neuroplastic changes in amygdala, perirhinal cortex, and hippocampus. Results: The authors demonstrate that nociceptive sensitization in these mice is accompanied by altered thigmotactic behaviors in the zero maze but not open field assay, and working memory dysfunction in novel object recognition and social memory but not in novel location recognition. Furthermore, the authors found evidence of structural changes and synaptic plasticity including changes in dendritic architecture and decreased levels of synaptophysin and brain-derived neurotrophic factor in specific brain regions. Conclusions: The study findings provide novel observations regarding behavioral changes and brain plasticity in a mouse model of CRPS. In addition to elucidating some of the supraspinal correlates of the syndrome, this work supports the potential use of therapeutic interventions that not only directly target sensory input and other peripheral mechanisms, but also attempt to ameliorate the broader pain experience by modifying its associated cognitive and emotional comorbidities.

Download Full-text

Effectiveness between Dry Needling and Ischemic Compression in the Triceps Surae Latent Myofascial Trigger Points of Triathletes on Pressure Pain Threshold and Thermography: A Single Blinded Randomized Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm8101632 ◽

2019 ◽

Vol 8 (10) ◽

pp. 1632 ◽

Cited By ~ 6

Author(s):

Benito-de-Pedro ◽

Becerro-de-Bengoa-Vallejo ◽

Losa-Iglesias ◽

Rodríguez-Sanz ◽

López-López ◽

...

Keyword(s):

Skin Temperature ◽

Pain Threshold ◽

Myofascial Pain ◽

Pressure Pain Threshold ◽

Pain Syndrome ◽

Trigger Points ◽

Triceps Surae ◽

Dry Needling ◽

Myofascial Trigger Points ◽

Pressure Pain

Background: Deep dry needling (DDN) and ischemic compression technic (ICT) may be considered as interventions used for the treatment of Myofascial Pain Syndrome (MPS) in latent myofascial trigger points (MTrPs). The immediate effectiveness of both DDN and ICT on pressure pain threshold (PPT) and skin temperature of the latent MTrPs of the triceps surae has not yet been determined, especially in athletes due to their treatment requirements during training and competition. Objective: To compare the immediate efficacy between DDN and ICT in the latent MTrPs of triathletes considering PPT and thermography measurements. Method: A total sample of 34 triathletes was divided into two groups: DDN and ICT. The triathletes only received a treatment session of DDN (n = 17) or ICT (n = 17). PPT and skin temperature of the selected latent MTrPs were assessed before and after treatment. Results: Statistically significant differences between both groups were shown after treatment, showing a PPT reduction (p < 0.05) in the DDN group, while PPT values were maintained in the ICT group. There were not statistically significant differences (p > 0.05) for thermographic values before and treatment for both interventions. Conclusions: Findings of this study suggested that ICT could be more advisable than DDN regarding latent MTrPs local mechanosensitivity immediately after treatment due to the requirements of training and competition in athletes’ population. Nevertheless, further studies comparing both interventions in the long term should be carried out in this specific population due to the possible influence of delayed onset muscle soreness and muscle damage on PPT and thermography values secondary to the high level of training and competition.

Download Full-text

Manual Therapy Reduces Pain Behavior and Oxidative Stress in a Murine Model of Complex Regional Pain Syndrome Type I

Brain Sciences ◽

10.3390/brainsci9080197 ◽

2019 ◽

Vol 9 (8) ◽

pp. 197 ◽

Cited By ~ 5

Author(s):

Afonso S. I. Salgado ◽

Juliana Stramosk ◽

Daniela D. Ludtke ◽

Ana C. C. Kuci ◽

Daiana C. Salm ◽

...

Keyword(s):

Oxidative Stress ◽

Complex Regional Pain Syndrome ◽

Manual Therapy ◽

Pain Syndrome ◽

Pain Behavior ◽

Protein Carbonyls ◽

Type I ◽

Syndrome Type ◽

Painful Condition ◽

And Oxidative Stress

Complex regional pain syndrome type I (CRPS-I) is a chronic painful condition. We investigated whether manual therapy (MT), in a chronic post-ischemia pain (CPIP) model, is capable of reducing pain behavior and oxidative stress. Male Swiss mice were subjected to ischemia-reperfusion (IR) to mimic CRPS-I. Animals received ankle joint mobilization 48h after the IR procedure, and response to mechanical stimuli was evaluated. For biochemical analyses, mitochondrial function as well as oxidative stress thiobarbituric acid reactive substances (TBARS), protein carbonyls, antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) levels were determined. IR induced mechanical hyperalgesia which was subsequently reduced by acute MT treatment. The concentrations of oxidative stress parameters were increased following IR with MT treatment preventing these increases in malondialdehyde (MDA) and carbonyls protein. IR diminished the levels of SOD and CAT activity and MT treatment prevented this decrease in CAT but not in SOD activity. IR also diminished mitochondrial complex activity, and MT treatment was ineffective in preventing this decrease. In conclusion, repeated sessions of MT resulted in antihyperalgesic effects mediated, at least partially, through the prevention of an increase of MDA and protein carbonyls levels and an improvement in the antioxidant defense system.

Download Full-text

Identification of complex regional pain syndrome in the upper limb: Skin temperature asymmetry after cold pressor test

Canadian Journal of Pain ◽

10.1080/24740527.2018.1504283 ◽

2018 ◽

Vol 2 (1) ◽

pp. 248-257

Author(s):

Tara Packham ◽

Joy MacDermid ◽

James Bain ◽

Norm Buckley

Keyword(s):

Skin Temperature ◽

Complex Regional Pain Syndrome ◽

Upper Limb ◽

Cold Pressor Test ◽

Pain Syndrome ◽

Cold Pressor ◽

Pressor Test ◽

Temperature Asymmetry

Download Full-text

Comparison of muscle and joint pressure-pain thresholds in patients with complex regional pain syndrome and upper limb pain of other origin

Pain ◽

10.1016/j.pain.2013.12.014 ◽

2014 ◽

Vol 155 (3) ◽

pp. 591-597 ◽

Cited By ~ 22

Author(s):

Tina Mainka ◽

Florian S. Bischoff ◽

Ralf Baron ◽

Elena K. Krumova ◽

Volkmar Nicolas ◽

...

Keyword(s):

Complex Regional Pain Syndrome ◽

Upper Limb ◽

Pain Syndrome ◽

Limb Pain ◽

Pain Thresholds ◽

Pressure Pain ◽

Pressure Pain Thresholds ◽

Upper Limb Pain

Download Full-text

Diurnal and Nocturnal Skin Temperature Regulation in Chronic Complex Regional Pain Syndrome

Journal of Pain ◽

10.1016/j.jpain.2014.11.012 ◽

2015 ◽

Vol 16 (3) ◽

pp. 207-213 ◽

Cited By ~ 2

Author(s):

Johanna C.M. Schilder ◽

Sjoerd P. Niehof ◽

Johan Marinus ◽

Jacobus J. van Hilten

Keyword(s):

Skin Temperature ◽

Complex Regional Pain Syndrome ◽

Temperature Regulation ◽

Pain Syndrome

Download Full-text

Increase in Cutaneous Temperature Induced by Hypnotic Suggestion of Pain

Perceptual and Motor Skills ◽

10.2466/pms.1992.74.3.737 ◽

1992 ◽

Vol 74 (3) ◽

pp. 737-738 ◽

Cited By ~ 4

Author(s):

P. Hájek ◽

B. Jakoubek ◽

K. Kýhos ◽

T. Radil

Keyword(s):

Blood Flow ◽

Skin Temperature ◽

Atopic Eczema ◽

Healthy Subjects ◽

Pain Threshold ◽

Central Mechanism ◽

Local Change ◽

Local Increase ◽

Hypnotic Suggestion ◽

Cutaneous Temperature

Eight patients with atopic eczema and six healthy subjects were given hypnotic suggestion to feel pain in the upper part of the back and in one case on the palm. An average local increase in skin temperature of 0.6° C (detected by thermovision) occurred under this condition. For some patients cutaneous pain threshold was increased before the experiment by means of repetitive hypnotic suggestion of analgesia. These subjects reported feeling no pain subjectively, but the local change in skin temperature was equal in both cases. The results suggest a central mechanism induced by measuring changes in pain threshold in the skin, which changes are independent of local changes in blood flow.

Download Full-text

Effects of Compressive Stockings and Standard Stockings in Skin Temperature and Pressure Pain Threshold in Runners with Functional Ankle Equinus Condition

Journal of Clinical Medicine ◽

10.3390/jcm7110454 ◽

2018 ◽

Vol 7 (11) ◽

pp. 454 ◽

Cited By ~ 7

Author(s):

David Rodríguez-Sanz ◽

Ricardo Becerro-de-Bengoa-Vallejo ◽

Marta Losa-Iglesias ◽

Eva Martínez-Jiménez ◽

Daniel Muñoz-García ◽

...

Keyword(s):

Skin Temperature ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Pressure Pain ◽

Clinical Assessments ◽

Pressure Pain Thresholds ◽

Before And After ◽

Temperature And Pressure ◽

Skin Temperatures ◽

Control Study

Objective: To assess clinical differences in the Achilles tendons of runners with ankle equinus wearing either compressive or standard stockings. Design: Case–control study. Methods: In this study, we conducted clinical examinations of 98 sportsmen (runners) with equinus, before and after 30 min of running on a treadmill; 49 runners wore compressive stockings and 49 wore standard stockings. Clinical assessments of the runners’ Achilles tendons were based on the pressure pain threshold (PPT) and skin temperature analysis. Results: Achilles tendon evaluations identified significant differences in skin temperature modification and PPT between the compressive and standard stocking groups. Conclusions: Based on our findings, we propose that higher skin temperatures are associated with lower pressure pain thresholds in the Achilles tendons of runners with ankle equinus.

Download Full-text