scholarly journals Associations of pain sensitisation with tender and painful joint counts in people with hand osteoarthritis: results from the Nor-Hand study

RMD Open ◽  
2022 ◽  
Vol 8 (1) ◽  
pp. e001774
Author(s):  
Marthe Gløersen ◽  
Pernille Steen Pettersen ◽  
Tuhina Neogi ◽  
Barbara Slatkowsky-Christensen ◽  
Tore K Kvien ◽  
...  
Keyword(s):  
Tibialis Anterior ◽  
Finger Joint ◽  
Hand Osteoarthritis ◽  
Widespread Pain ◽  
Central Sensitisation ◽  
Painful Joint ◽  
Pressure Pain Thresholds ◽  
Total Body ◽  
Body Joint ◽  
Pain Sensitisation

ObjectiveTo examine associations of pain sensitisation with tender and painful joint counts and presence of widespread pain in people with hand osteoarthritis (OA).MethodsPressure pain thresholds (PPT) at a painful finger joint and the tibialis anterior muscle, and temporal summation (TS) were measured in 291 persons with hand OA. We examined whether sex-standardised PPT and TS values were associated with assessor-reported tender hand joint count, self-reported painful hand and total body joint counts and presence of widespread pain using linear and logistic regression analyses adjusted for age, sex, body mass index, education and OA severity.ResultsPeople with lower PPTs at the painful finger joint (measure of peripheral and/or central sensitisation) had more tender and painful hand joints than people with higher PPTs. PPT at tibialis anterior (measure of central sensitisation) was associated with painful total body joint count (beta=−0.82, 95% CI −1.28 to –0.35) and presence of widespread pain (OR=0.57, 95% CI 0.43 to 0.77). The associations between TS (measure of central sensitisation) and joint counts in the hands and the total body were statistically non-significant.ConclusionThis cross-sectional study suggested that pain sensitisation (ie, lower PPTs) was associated with joint counts and widespread pain in hand OA. This knowledge may be used for improved pain phenotyping of people with hand OA, which may contribute to better pain management through more personalised medicine. Further studies are needed to assess whether a reduction of pain sensitisation leads to a decrease in tender and painful joint counts.

scholarly journals Increased postural stiffness in patients with knee osteoarthritis who are highly sensitized

2017 ◽  
Vol 16 (1) ◽  
pp. 173-174
Author(s):  
R.P. Hirata ◽  
S.T. Skou ◽  
O. Simonsen ◽  
S. Rasmussen ◽  
T. Graven-Nielsen
Keyword(s):  
Knee Osteoarthritis ◽  
Postural Stability ◽  
Tibialis Anterior ◽  
High Sensitivity ◽  
Force Platform ◽  
Widespread Pain ◽  
Pressure Pain Thresholds ◽  
Pressure Algometer ◽  
Low Sensitivity ◽  
Extensor Carpi Radialis

AbstractAimsTo evaluate the effect of widespread pain sensitization on postural stability during quiet standing tasks in patients with knee osteoarthritis.MethodsPatients (56) stood quietly on a force platform for 1 min in 4 conditions (each repeated 3 times): (i) firm surface (FS) with open eyes (OE), (ii) FS with closed eyes (CE), (iii) soft foam surface (SS) with OE, and (iv) SS with CE. Postural stability was quantified by Center of Pressure (CoP) variables extracted from the force platform. Pressure pain thresholds (PPTs), were assessed bilaterally with a handheld pressure algometer (1 cm2 probe) at: (i) four sites in the knee region (3 cm medial to the midpoint of the medial edge of the patella; 2 cm proximal to the superior edge of the patella; 3 cm lateral to the mid-point of the lateral edge of the patella; and centre of the patella), (ii) tibialis anterior muscle, and (iii) extensor carpi radialis longus muscle. The PPT values from tibialis anterior and extensor carpi radialis longus muscles were used to divide the patients in high and low sensitization groups (two-steps clustering).ResultsPPT values at bilateral knees sites were lower in the high sensitivity [median (range) of all sites: 423 (153, 1129) kPa] compared with low sensitivity group [822 (305, 2051) kPa] (P < 0.05). CoP range in the anterior–posterior direction was reduced in high sensitivity group (41±16 mm) compared with the low sensitivity group (51±16 mm) during the SS with CE (P < 0.05) condition.ConclusionsThe lower CoP Range suggests stiffer postural strategy in patients with higher widespread pain sensitivity compared with low sensitivity patients during sensory restrictions. The lack of mobility found in high sensitivity patients under such restrictions might be related to the impaired integration of sensory information due to the parallel processing of the nociceptive information.

scholarly journals Patients with symptomatic permanent atrial fibrillation show quantitative signs of pain sensitisation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Jackson ◽  
O Frobert ◽  
D Boye Larsen ◽  
L Arendt-Nielsen ◽  
A Bjorkenheim
Keyword(s):  
Atrial Fibrillation ◽  
Tibialis Anterior ◽  
Tibialis Anterior Muscle ◽  
Primary Objective ◽  
Pain Modulation ◽  
Pain Tolerance ◽  
Asymptomatic Group ◽  
Pressure Pain Thresholds ◽  
Pain Area ◽  
Pain Sensitisation

Abstract Background/Introduction Most patients with atrial fibrillation (AF) report symptoms, while around one-third are asymptomatic. We hypothesized that sensory processing, in particular pain, differs in patients with symptomatic and asymptomatic AF. Purpose To assess differences in pain sensitisation in patients with symptomatic and asymptomatic AF. Methods Thirty individuals with permanent AF (15 symptomatic, 15 asymptomatic) completed the AF6 and SF-36 questionnaires and underwent quantitative pain sensitisation testing using pressure algometry at the sternum (referred pain area) and the tibialis anterior muscle (generalized pain area). The primary objective was to assess differences in pressure pain thresholds (PPT), temporal summation of pain (TSP), and conditioned pain modulation (CPM) in the two groups. The secondary objective was to determine association of demographic and clinical parameters to quantitative measures of pain sensitisation. Results The symptomatic group had lower PPTs at both tibialis (p=0.004) and sternum (p=0.01), as well as impaired CPM (p=0.025) and facilitated TSP (p=0.008) at the tibialis but not sternum, compared to the asymptomatic group. The AF6 sum score was negatively correlated to PPT on both tibialis (r=−0.50, p=0.005) and sternum (r=−0.42, p=0.02) and positively correlated to TSP of both tibialis (r=0.57, p=0.001) and sternum (r=0.45, p=0.01), but not to CPM. The physical component summary score was positively correlated to the PPT on both tibialis (r=0.52, p=0.003) and sternum (r=0.40, p=0.03) and negatively to TSP on the tibialis (r=−0.53, p=0.003) but not sternum. Conclusions Patients with symptomatic AF exhibit lower pain tolerance than patients with asymptomatic AF, as well as impaired pain inhibitory control and facilitated summation of pain, indicating that pain sensitisation may be of importance in symptomatic AF. FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Department of Cardiology, Örebro University, Sweden PPTs tibialis anterior muscle PPTs sternum

scholarly journals FRI0659 Investigation of self-reported painful joint count as outcome measure in hand osteoarthritis

2018 ◽  
Author(s):  
F. Kroon ◽  
J. van der Plas ◽  
S. van Beest ◽  
W. Damman ◽  
M. Kloppenburg
Keyword(s):  
Outcome Measure ◽  
Hand Osteoarthritis ◽  
Painful Joint

scholarly journals Self-reported painful joint count and assessor-reported tender joint count as instruments to assess pain in hand osteoarthritis

Rheumatology ◽  
2019 ◽  
Vol 59 (5) ◽  
pp. 1094-1098
Author(s):  
Féline P B Kroon ◽  
Wendy Damman ◽  
Johan L van der Plas ◽  
Sjoerd van Beest ◽  
Frits R Rosendaal ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Visual Analogue Scale Pain ◽  
Tender Joint Count ◽  
Hand Osteoarthritis ◽  
Joint Activity ◽  
Tender Joint ◽  
Painful Joint ◽  
Bone Marrow Lesions ◽  
Joint Level ◽  
Absolute Agreement

Abstract Objectives To evaluate self-reported and assessor-reported joint counts for pain and their value in measuring pain and joint activity in hand OA patients. Methods A total of 524 patients marked painful joints on hand diagrams. Nurses assessed tenderness upon palpation. Pain was measured with a visual analogue scale pain and the Australian/Canadian hand OA index subscale pain. Synovitis and bone marrow lesions in right hand distal/proximal interphalangeal joints on MRI served as measure of joint activity. Agreement was assessed on the patient (intraclass correlation coefficient, Bland–Altman plot) and joint level (percentage absolute agreement). Correlations with measures of pain and joint activity were analysed, and joint level associations with synovitis/bone marrow lesions were calculated. Results Self-reported painful joint count (median 8, interquartile range 4–13) was consistently higher than assessor-reported tender joint count (3, 1–7). Agreement between patients and nurses on overall scores was low. Percentage absolute agreement on the joint level was 61–89%. Joint counts correlated similarly but weakly with measures of pain and joint activity (r = 0.14–0.38). On the joint level, assessor-reported tenderness was more strongly associated with synovitis/bone marrow lesions than self-reported pain. Conclusion In hand OA, self- and assessor-reported joint counts cannot be used interchangeably, and measure other pain aspects than questionnaires. Assessor-reported tenderness was most closely related to MRI-defined joint activity.

scholarly journals Investigation of self-reported painful joint count as an outcome measure in hand osteoarthritis

2018 ◽  
Vol 26 ◽  
pp. S213-S214 ◽  
Author(s):  
F.P. Kroon ◽  
J.L. van der Plas ◽  
S. van Beest ◽  
W. Damman ◽  
M. Kloppenburg
Keyword(s):  
Outcome Measure ◽  
Hand Osteoarthritis ◽  
Painful Joint

scholarly journals Association between Physiological and Subjective Aspects of Pain and Disability in Post-Stroke Patients with Shoulder Pain: A Cross-Sectional Study

2019 ◽  
Vol 8 (8) ◽  
pp. 1093 ◽  
Author(s):  
Martín-Martín ◽  
Membrilla-Mesa ◽  
Lozano-Lozano ◽  
Galiano-Castillo ◽  
Fernández-Lao ◽  
...  
Keyword(s):  
Shoulder Pain ◽  
Tibialis Anterior ◽  
Pain Perception ◽  
Stroke Patients ◽  
Pressure Pain ◽  
Negatively Associated ◽  
Post Stroke ◽  
Upper Trapezius ◽  
Pain Disability ◽  
Pressure Pain Thresholds

Background: Patients often experience pain as a result of a stroke. However, the mechanism of this pain remains uncertain. Our aim was to investigate the relationship between pressure pain thresholds (PPTs) and disability pain in patients with hemiplegic shoulder pain (HSP). Methods: Twenty-six post-stroke patients (age 53.35 ± 13.09 years) and healthy controls (54.35 ± 12.37 years) participated. We investigated spontaneous shoulder pain, disability pain perception through the shoulder pain and disability index (SPADI), and the PPTs over joint C5–C6, upper trapezius, deltoid, epicondyle, second metacarpal, and tibialis anterior, bilaterally. Results: The analysis of variance (ANOVA) showed significant differences in pain between groups (p < 0.001) and differences in the SPADI (p < 0.001) between groups but not between sides for PPTs over deltoid (group: p = 0.007; side: p = 0.750), epicondyle (group: p = 0.001; side: p = 0.848), and tibialis anterior (group: p < 0.001; side: p = 0.932). Pain in the affected arm was negatively associated with PPTs over the affected epicondyle (p = 0.003) and affected tibialis anterior (p = 0.009). Pain (SPADI) appeared negatively correlated with PPTs over the affected epicondyle (p = 0.047), and disability (SPADI) was negatively associated with PPTs over the affected tibialis anterior (p = 0.041). Conclusions: Post-stroke patients showed a relationship between widespread pressure pain hypersensitivity with lower PPT levels and pain disability perception, suggesting a central sensitization mediated by bilateral and symmetric pain patterns.

scholarly journals Increased deep pain sensitivity in persistent musculoskeletal pain but not in other musculoskeletal pain states

2016 ◽  
Vol 13 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Helena Eva Margareta Gunnarsson ◽  
Birgitta Grahn ◽  
Jens Agerström
Keyword(s):  
Musculoskeletal Pain ◽  
Acute Pain ◽  
Tibialis Anterior ◽  
Pain Sensitivity ◽  
Tibialis Anterior Muscle ◽  
Persistent Pain ◽  
Healthy Controls ◽  
Recurrent Pain ◽  
Pressure Pain Thresholds ◽  
Pain Duration

AbstractBackgroundPressure pain thresholds (PPTs) in a non-painful body area are known to be affected in some chronic pain states. The aim of this study is to investigate PPTs in a pain-free body part in relation to pain persistence and intensity in patients with musculoskeletal pain.MethodsPatients with musculoskeletal pain were divided into three different pain groups: acute pain (pain duration < 3 months, n = 38), regularly recurrent pain (regularly recurrent pain duration > 3 months, n = 56), persistent pain (persistent pain duration >3 months, n = 52) and a healthy control group (n = 51). PPT measures were conducted over the tibialis anterior muscle on the right leg in all groups.ResultsThe persistent pain group showed significantly lower PPTs over the tibialis anterior muscle compared to controls. No significant differences were found between the acute and regularly recurrent pain groups compared to healthy controls. Significant correlations, albeit small, were found between pain intensity and PPTs.ConclusionsIncreased deep pain sensitivity was found in patients with persistent musculoskeletal pain, but not in regularly recurrent pain or in acute pain. Yet, a limitation of the study is that it did not have sufficient power to detect small levels of increased deep pain sensitivity among the latter groups when compared to healthy controls.ImplicationsKnowledge about increased general hypersensitivity in persistent musculoskeletal pain could be important in clinical treatment.

scholarly journals Osteoarthritis of the Distal Interphalangeal and First Carpometacarpal Joints is Associated with High Bone Mass in Women and Small Bone Size and Low Lean Mass in Men

2015 ◽  
Vol 9 (1) ◽  
pp. 399-404 ◽  
Author(s):  
Thord von Schewelov ◽  
Håkan Magnusson ◽  
Maria Cöster ◽  
Caroline Karlsson ◽  
Björn E Rosengren
Keyword(s):  
Lean Body Mass ◽  
Body Mass ◽  
Fat Mass ◽  
Lean Mass ◽  
Bone Size ◽  
Hand Osteoarthritis ◽  
Mineral Density ◽  
High Bone Mass ◽  
Carpometacarpal Joints ◽  
Total Body

Objective: To determine if primary hand osteoarthritis (OA) is associated with abnormal bone and anthropometric traits. Methods: We used DXA to measure total body bone mineral density (BMD), femoral neck width (bone size) and total body lean and fat mass in 39 subjects with hand OA (primary DIP and/or CMC I) and 164 controls. Data are presented as mean Z-scores or Odds Ratios (OR) with 95% confidence intervals. Results: Women with hand OA had (compared to controls) higher BMD (0.5(0.1,0.9)) but similar bone size (-0.3(-0.8,0.2)), lean mass (0.3(-0.3,0.9)), fat mass (-0.1(-0.6,0.5)) and BMI (0.0(-0.6,0.6)). Men with hand OA had (compared to controls) similar BMD (-0.1(-0.7,0.6)), smaller bone size (-0.5(-1.1,-0.01)), lower lean mass (-0.6(-1.1,-0.04)), and similar fat mass (-0.2(-0.7,0.4)) and BMI -0.1(-0.6,0.6). In women, each SD higher BMD was associated with an OR of 1.8 (1.03, 3.3) for having hand OA. In men each SD smaller bone size was associated with an OR of 1.8 (1.02, 3.1) and each SD lower proportion of lean body mass with an OR of 1.9 (1.1, 3.3) for having hand OA. Conclusion: Women with primary DIP finger joint and/or CMC I joint OA have a phenotype with higher BMD while men with the disease have a smaller bone size and lower lean body mass.

scholarly journals Local and Widespread Pressure Pain Hyperalgesia Is Not Side Specific in Females with Unilateral Neck Pain that Can Be Reproduced during Passive Neck Rotation

2019 ◽  
Vol 8 (8) ◽  
pp. 1246 ◽  
Author(s):  
Fernando Piña-Pozo ◽  
Alberto Marcos Heredia-Rizo ◽  
Pascal Madeleine ◽  
Isabel Escobio-Prieto ◽  
Antonio Luque-Carrasco ◽  
...  
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Tibialis Anterior ◽  
Pain Sensitivity ◽  
Specific Effect ◽  
Current Evidence ◽  
Pressure Pain ◽  
Pain Location ◽  
Pressure Pain Thresholds ◽  
Neck Rotation

Current evidence for widespread hyperalgesia in non-specific neck pain (NSNP) is unclear. It is currently recommended to group NSNP patients according to pain-provoking movements. The aim of this study was to investigate local and widespread pain sensitivity in females with unilateral NSNP that is reproducible during passive neck rotation compared with matched controls, and to compare the side specific effect of pain location on pressure pain sensitivity among females with unilateral NSNP. Thirty-six females with unilateral NSNP evoked during passive ipsilateral (n = 20) or contralateral (n = 16) rotation toward the painful side were compared with 20 controls. Participants reported their pain intensity at rest and during passive neck rotation and completed the Neck Disability Index. Pressure pain thresholds (PPTs) were assessed bilaterally over the anterior scalene; the sternocleidomastoid; the levator scapulae; lateral to the spinous process of C6; the median, ulnar, and radial nerves; and the tibialis anterior. The ANOVA revealed lower PPTs in females with unilateral NSNP compared with the controls (all at p < 0.001), but no differences were found between the sides, nor was there any Group × side interaction. Among females with NSNP, those with higher pain intensity during ipsilateral rotation toward the painful side showed lower PPTs over the anterior scalene, median nerve, ulnar nerve, and tibialis anterior (all, p < 0.05) than females with higher pain intensity during contralateral rotation toward the painful side. These findings demonstrated bilateral local and widespread pressure pain hyperalgesia in females with unilateral NSNP that was reproducible during passive neck rotation compared with controls. There was no side specific effect of pain location on PPTs among females with unilateral NSNP.

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