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.

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 Tests for central sensitization in general practice: a Delphi study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Carine den Boer ◽  
Berend Terluin ◽  
Johannes C. van der Wouden ◽  
Annette H. Blankenstein ◽  
Henriëtte E. van der Horst
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
General Practice ◽  
Delphi Study ◽  
Central Sensitization ◽  
Added Value ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Central Sensitization Inventory

Abstract Introduction Central sensitization (CS) may explain the persistence of symptoms in patients with chronic pain and persistent physical symptoms (PPS). There is a need for assessing CS in the consultation room. In a recently published systematic review, we made an inventory of tests for CS. In this study we aimed to assess which tests might have added value, might be feasible and thus be suitable for use in general practice. Methods We conducted a Delphi study consisting of two e-mail rounds to reach consensus among experts in chronic pain and PPS. We invited 40 national and international experts on chronic pain and PPS, 27 agreed to participate. We selected 12 tests from our systematic review and additional searches; panellists added three more tests in the first round. We asked the panellists, both clinicians and researchers, to rate these 15 tests on technical feasibility for use in general practice, added value and to provide an overall judgement for suitability in general practice. Results In two rounds the panellists reached consensus on 14 of the 15 tests: three were included, eleven excluded. Included were the Central Sensitization Inventory (CSI), pressure pain thresholds (PPTs) and monofilaments. No consensus was reached on the Sensory Hypersensitivity Scale. Conclusion In a Delphi study among an international panel of experts, three tests for measuring CS were considered to be suitable for use in general practice: the Central Sensitization Inventory (CSI), pressure pain thresholds (PPTs) and monofilaments.

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.

scholarly journals Pressure pain thresholds in individuals with knee pain: a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Charlotte Sylwander ◽  
Ingrid Larsson ◽  
Emma Haglund ◽  
Stefan Bergman ◽  
Maria L.E. Andersson
Keyword(s):  
Knee Pain ◽  
Body Fat ◽  
Pain Sensitivity ◽  
Body Fat Percentage ◽  
Tender Points ◽  
Fat Percentage ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Pressure Algometer

Abstract Background Knee osteoarthritis (KOA), chronic widespread pain (CWP) and overweight/obesity are public health problems that often coincide, and there is a multifactorial and unclear relationship between them. The study aimed to (1) investigate pain sensitivity, assessed by pressure pain thresholds (PPTs), among women and men with knee pain and (2) associations with, respectively, radiographic KOA (rKOA), CWP, and overweight/obesity. Methods Baseline data from an ongoing longitudinal study involving 280 individuals with knee pain in the 30–60 age group. Pain sensitivity was assessed by PPTs on eight different tender points using a pressure algometer. The participants’ knees were x-rayed. Self-reported CWP and number of pain sites were assessed with a pain figure, and overweight/obesity was measured using body mass index (BMI), visceral fat area (VFA), and body fat percentage, assessed with a bioimpedance. Associations were analysed using regression analyses. Results Women reported lower PPTs than men (p < 0.001), but no PPTs differences were found between those with and without rKOA. Low PPTs was associated with female sex, more pain sites, CWP, and a higher VFA and body fat percentage. The tender points second rib and the knees were most affected. The prevalence of CWP was 38 %. Conclusions The modifiable factors, increased VFA, and body fat could be associated with increased pain sensitivity among individuals with knee pain. Longitudinal studies are needed to further investigate the associations.

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.

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.

A118G polymorphism in the μ-opioid receptor gene and levels of β-endorphin are associated with provoked vestibulodynia and pressure pain sensitivity

2014 ◽  
Vol 5 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Ulrika Heddini ◽  
Ulrika Johannesson ◽  
Alfhild Grönbladh ◽  
Fred Nyberg ◽  
Kent W. Nilsson ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Sensitivity ◽  
Provoked Vestibulodynia ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pain Hypersensitivity ◽  
Pressure Pain Thresholds ◽  
118G Allele ◽  
Μ Opioid Receptor ◽  
A118g Polymorphism

AbstractBackground and aimsProvoked vestibulodynia (PVD) is the most common cause of dyspareunia among young women. The aetiology is largely unknown and treatment is often extensive and longstanding with varying outcomes. Patients display general pain hypersensitivity and there are correlations with other chronic pain syndromes such as fibromyalgia later in life. The A118G polymorphism in the μ-opioid receptor (OPRM1) gene influences endogenous pain regulation and pain sensitivity, but has not been studied in this patient group before. We aimed to investigate a possible association between A118G polymorphism and PVD, with correlation to plasma levels of β-endorphin, and to explore relationships between this polymorphism and pain sensitivity among women with PVD and healthy controls.MethodsThis case-control study included 98 women with PVD and 103 controls. Participants filled out study-specific questionnaires and underwent quantitative sensory testing of pressure pain thresholds on the arm, leg and in the vestibular area. Levels of β-endorphin were analyzed by radioimmunoassay using the EURIA-beta-endorphin kit, and the A118G single-nucleotide polymorphism (SNP; rs1799971) in the OPRM1 gene was analyzed using the TaqMan SNP genotyping assay.ResultsThe 118G allele was more common in controls (44%) than in patients (30%) (p = 0.042). The odds ratio of having PVD was 1.8 in participants carrying the 118A allele compared to participants hetero- or homozygous for the 118G allele (OR = 1.846, CI: 1.03-3.31, p = 0.039). Pressure pain thresholds on the leg were higher for participants carrying the 118G allele (mean 480 kPa, SD 167.5) than for those carrying the 118A allele (mean 419, SD 150.4, p = 0.008). Levels of β-endorphin were higher in patients (mean 17.9 fmol/ml, SD 4.71) than in controls (mean 15.8 fmol/ml, SD 4.03) (p < 0.001).ConclusionWe found an association between the A118G polymorphism in the OPRM1 gene and an increased risk of PVD and increased pain sensitivity among participants carrying the 118A allele. PVD patients were more sensitive to pressure pain and had higher levels of plasma β-endorphin than controls. The results indicate that differences in endogenous pain modulation involving the opioid system could contribute to the pathophysiology of PVD and the general pain hypersensitivity seen in these women.ImplicationsThe data support the conceptualization of PVD as part of a general pain disorder with a possible genetic predisposition. The age of onset of PVD is usually between 18 and 25 years and already at this age general pain hypersensitivity is present but rarely causing disability. We believe that early recognition and treatment, with the risk of further development of chronic pain taken into consideration, might prevent future aggravated pain problems in this patient group.

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