scholarly journals Pain Sensitisation in Women with Active Rheumatoid Arthritis: A Comparative Cross-Sectional Study

Arthritis ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Nora Vladimirova ◽  
Anders Jespersen ◽  
Else Marie Bartels ◽  
Anton W. Christensen ◽  
Henning Bliddal ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Temporal Summation ◽  
Pain Threshold ◽  
Cuff Pressure ◽  
Pressure Pain Threshold ◽  
Pain Tolerance ◽  
Leg Pain ◽  
Central Pain ◽  
Pressure Pain ◽  
Pain Sensitisation

Objectives. In some rheumatoid arthritis (RA) patients, joint pain persists without signs of inflammation. This indicates that central pain sensitisation may play a role in the generation of chronic pain in a subgroup of RA. Our aim was to assess the degree of peripheral and central pain sensitisation in women with active RA compared to healthy controls (HC). Methods. 38 women with active RA (DAS28>2.6) and 38 female HC were included in, and completed, the study. Exclusion criteria were polyneuropathy, pregnancy, and no Danish language. Cuff Pressure Algometry measurements were carried out on the dominant lower leg. Pain threshold, pain tolerance, and pain sensitivity during tonic painful stimulation were recorded. Results. Women with active RA had significantly lower pain threshold (p<0.01) and pain tolerance (p<0.01) than HC. The mean temporal summation- (TS-) index in RA patients was 0.98 (SEM: 0.09) and 0.71 (SEM: 0.04) in HC (p<0.01). Conclusion. Patients with active RA showed decreased pressure-pain threshold compared to HC. In addition, temporal summation of pressure-pain was increased, indicating central pain sensitization, at least in some patients. Defining this subgroup of patients may be of importance when considering treatment strategies.

Design and Evaluation of a Computer-Controlled Pressure Algometer

2011 ◽  
Vol 5 (3) ◽  
Author(s):  
Michael M. Zimkowski ◽  
Emily M. Lindley ◽  
Vikas V. Patel ◽  
Mark E. Rentschler
Keyword(s):  
Blood Pressure ◽  
Real Time ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Pain Tolerance ◽  
Large Variability ◽  
Pressure Pain ◽  
New Device ◽  
Pressure Algometer ◽  
Computer Controlled

A challenge is always presented when attempting to measure the pain an individual patient experiences. Unfortunately, present technologies rely nearly exclusively on subjective techniques. Using these current techniques, a physician may use a manually operated algometer and a series of questionnaires to gauge an individual patient’s pain scale. Unfortunately these devices and test methods have been suggested to introduce error due to variability and inconsistent testing methods. Some studies have shown large variability, while others have shown minimal variability, both between patients and within the same patient during multiple testing sessions. Recent studies have also shown a lack of correlation between pain threshold and pain tolerance in pain sensitivity tests. Hand-held algometer devices can be difficult to maintain consistent application rates over multiple test periods, possibly adding to widespread variability. Furthermore, there are limited test results that correlate pain ratings with biological measures in real time. The computer-controlled pressure algometer described is not hand-held or dependent on significant examiner input. This new device is capable of recording electrocardiograph (ECG), blood pressure (BP), pressure pain threshold (PPT), and pressure pain tolerance (PPTol) in real time. One major goal is the capability of correlating pain stimuli with algometer pressure, heart rate, and blood pressure. If a predictable correlation between vital signs and pain could be established, significant gains in the understanding of pain could result. Better understanding of pain will ultimately lead to improvements in treatment and diagnosis of pain conditions, helping patients and physicians alike.

scholarly journals Within-session test-retest reliability of pressure pain threshold and mechanical temporal summation in healthy subjects

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245278
Author(s):  
Catherine Mailloux ◽  
Louis-David Beaulieu ◽  
Timothy H. Wideman ◽  
Hugo Massé-Alarie
Keyword(s):  
Measurement Error ◽  
Temporal Summation ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Low Back ◽  
Measurement Variability ◽  
Retest Reliability ◽  
Pressure Pain ◽  
Relative Reliability ◽  
Test Retest Reliability

Objective To determine the absolute and relative intra-rater within-session test-retest reliability of pressure pain threshold (PPT) and mechanical temporal summation of pain (TSP) at the low back and the forearm in healthy participants and to test the influence of the number and sequence of measurements on reliability metrics. Methods In 24 participants, three PPT and TSP measures were assessed at four sites (2 at the low back, 2 at the forearm) in two blocks of measurements separated by 20 minutes. The standard error of measurement, the minimal detectable change (MDC) and the intraclass correlation coefficient (ICC) were investigated for five different sequences of measurements (e.g. measurement 1, 1–2, 1-2-3). Results The MDC for the group (MDCgr) for PPT ranged from 28.71 to 50.56 kPa across the sites tested, whereas MDCgr for TSP varied from 0.33 to 0.57 out of 10 (numeric scale). Almost all ICC showed an excellent relative reliability (between 0.80 and 0.97), except when only the first measurement was considered (moderate). Although minimal differences in absolute PPT reliability were present between the different sequences, in general, using only the first measurement increase measurement error. Three TSP measures reduced the measurement error. Discussion We established that two measurements of PPT and three of TSP reduced the measurement error and demonstrated an excellent relative reliability. Our results could be used in future pain research to confirm the presence of true hypo/hyperalgesia for paradigms such as conditioned pain modulation or exercise-induced hypoalgesia, indicated by a change exceeding the measurement variability.

scholarly journals Can Injuries Have a Lasting Effect on the Perception of Pain in Young, Healthy Women and Men?

2020 ◽  
pp. 194173812095316
Author(s):  
Agnieszka Maciejewska-Skrendo ◽  
Maciej Pawlak ◽  
Agata Leońska-Duniec ◽  
Alina Jurewicz ◽  
Mariusz Kaczmarczyk ◽  
...  
Keyword(s):  
Physical Activity ◽  
Pain Threshold ◽  
Pain Perception ◽  
Emotional Experience ◽  
Pressure Pain Threshold ◽  
Pain Tolerance ◽  
Female Group ◽  
Pressure Pain ◽  
Left Hand ◽  
Healthy Women

Background: Pain is a characteristic, unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pain is a subjective sensation, modulated by many factors such as age, sex, emotional state, national origin, or physical activity. Moreover, it is closely associated with intense physical activity, injuries, and traumas, which can significantly modulate pain tolerance. Hypothesis: We postulate that there are correlations between past injuries, physical activity, and intensity of pain perception (pain threshold and pain tolerance) in a population of healthy men and women. Study Design: Retrospective cohort study. Level of Evidence: Level 4. Methods: A total of 302 participants aged 18 to 32 years were included. The participants were divided into 2 groups (active and inactive individuals), in accordance with the scope of physical activity they had indicated. The test of pressure pain threshold and pressure pain tolerance was performed using an algometer. Results: Active women achieved significantly higher pain threshold and pain tolerance values in all measurements on the upper limb (except for the pain threshold on the left hand) compared with inactive women. In mediation analysis, the effect of injury remained significant only for the pressure pain tolerance in the dominant arm and the left hand in the female group. In the case of men, there were no significant differences in all measurements in view of the threshold and tolerance for pain between the groups of active and inactive and between men with injuries and without injuries. Conclusion: Intense, regular physical activity is a factor modulating the perception of pain. This was demonstrated as lowered sensitivity to pain stimuli in a population of healthy women. Clinical Relevance: Injuries should be treated as an important factor modulating the perception of pain. We recommend detailed monitoring of injuries during treatment and control of pain sensation.

scholarly journals Spectroscopic differences in posterior insula in patients with chronic temporomandibular pain

2018 ◽  
Vol 18 (3) ◽  
pp. 351-361 ◽  
Author(s):  
Kristin Harfeldt ◽  
Louise Alexander ◽  
Julia Lam ◽  
Sven Månsson ◽  
Hans Westergren ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Temporal Summation ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Mouth Opening ◽  
Insular Cortex ◽  
Pressure Pain ◽  
Metabolite Concentrations ◽  
Posterior Insula ◽  
New Evidence

Abstract Background and aims Chronic pain including temporomandibular disorder (TMD) pain involves a complex interplay between peripheral and central sensitization, endogenous modulatory pathways, cortical processing and integration and numerous psychological, behavioral and social factors. The aim of this study was to compare spectroscopic patterns of N-Acetyl-aspartate (NAA), total creatine (tCr), choline (Cho), myo-inositol (MI), glutamate (Glu), and the combination of Glu and glutamine in the posterior insula in patients with chronic generalized or regional chronic TMD pain (gTMD and rTMD, respectively) compared to healthy individuals (HI) in relation to clinical findings of TMD pain. Methods Thirty-six female patients with chronic rTMD or gTMD with at least 3 months duration were included in the study. Ten healthy women were included as controls. All participants completed a questionnaire that comprised assessment of degrees of depression, anxiety, stress, catastrophizing, pain intensity, disability and locations. A clinical Diagnostic Criteria for Temporomandibular Disorders examination that comprised assessment of pain locations, headache, mouth opening capacity, pain on mandibular movement, pain on palpation and temporomandibular joint noises was performed. Pressure-pain threshold (PPT) over the masseter muscle and temporal summation to pressure stimuli were assessed with an algometer. Within a week all participants underwent non-contrast enhanced MRI on a 3T MR scanner assessing T1-w and T2-w fluid attenuation inversion recovery. A single-voxel 1H-MRS examination using point-resolved spectroscopy was performed. The metabolite concentrations of NAA, tCr, Cho, MI, Glu and Glx were analyzed with the LC model. Metabolite levels were calculated as absolute concentrations, normalized to the water signal. Metabolite concentrations were used for statistical analysis from the LC model if the Cramér–Rao bounds were less than 20%. In addition, the ratios NAA/tCr, Cho/tCr, Glu/tCr and MI/tCr were calculated. Results The results showed significantly higher tCr levels within the posterior insula in patients with rTMD or gTMD pain than in HI (p=0.029). Cho was negatively correlated to maximum mouth opening capacity with or without pain (rs=−0.42, n=28, p=0.031 and rs=−0.48, n=28, p=0.034, respectively) as well as pressure-pain threshold on the hand (rs=−0.41, n=28, p=0.031). Glu was positively correlated to temporal summation to painful mechanical stimuli (rs=0.42, n=26, p=0.034). Conclusions The present study found that increased concentrations of Cho and Glu in the posterior insular cortex is related to clinical characteristics of chronic TMD pain, including generalized pain. These findings provide new evidence about the critical involvement of the posterior insular cortex and the neurobiology underlying TMD pain in both regional and generalized manifestations. Implications The findings in this study have indirect implications for the diagnosis and management of TMD patients. That said, the findings provide new evidence about the critical involvement of the posterior insular cortex and the neurobiology underlying TMD pain in both regional and generalized manifestations. It is also a further step towards understanding and accepting chronic pain as a disorder in itself.

Differences in Pressure-Pain Threshold Between Healthy Women and Patients with Fibromyalgia Syndrome, Systemic Lupus Erythematosus, and Rheumatoid Arthritis

2009 ◽  
Vol 17 (2) ◽  
pp. 139-154 ◽  
Author(s):  
Esmeralda García-Fernández ◽  
Débora Godoy-Izquierdo ◽  
Miguel Pérez-García ◽  
Juan Jiménez-Alonso ◽  
Isabel López-Chicheri ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Fibromyalgia Syndrome ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Systemic Lupus ◽  
Pressure Pain ◽  
Healthy Women

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 An Experimental Investigation of the Effect of Age and Sex/Gender on Pain Sensitivity in Healthy Human Participants

2018 ◽  
Vol 11 (1) ◽  
pp. 41-51 ◽  
Author(s):  
Hanan El-Tumi ◽  
Mark I. Johnson ◽  
Osama A. Tashani
Keyword(s):  
Pain Sensitivity ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Heat Pain ◽  
Detection Thresholds ◽  
Pressure Pain ◽  
Heat Pain Threshold ◽  
Cold Pressor Pain

Background: Ageing is associated with alterations of the structure and function of somatosensory tissue that can impact on pain perception. The aim of this study was to investigate the relationship between age and pain sensitivity responses to noxious thermal and mechanical stimuli in healthy adults. Methods: 56 unpaid volunteers (28 women) aged between 20 and 55 years were categorised according to age into one of seven possible groups. The following measurements were taken: thermal detection thresholds, heat pain threshold and tolerance using a TSA-II NeuroSensory Analyzer; pressure pain threshold using a handheld electronic pressure algometer; and cold pressor pain threshold, tolerance, intensity and unpleasantness. Results: There was a positive correlation between heat pain tolerance and age (r = 0.228, P = 0.046), but no statistically significant differences between age groups for cold or warm detection thresholds, or heat pain threshold or tolerance. Forward regression found increasing age to be a predictor of increased pressure pain threshold (B = 0.378, P = 0.002), and sex/gender to be a predictor of cold pressor pain tolerance, with women having lower tolerance than men (B = -0.332, P = 0.006). Conclusion: The findings of this experimental study provide further evidence that pressure pain threshold increases with age and that women have lower thresholds and tolerances to innocuous and noxious thermal stimuli. Significance: The findings demonstrate that variations in pain sensitivity response to experimental stimuli in adults vary according to stimulus modality, age and sex and gender.

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