Associations between pressure pain threshold in the neck and postural control in patients with dizziness or neck pain – a cross-sectional study

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.

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The Relationship between Fibromyalgia and Pressure Pain Threshold in Patients with Dyspareunia

Pain Research and Management ◽

10.1155/2015/302404 ◽

2015 ◽

Vol 20 (3) ◽

pp. 137-140 ◽

Cited By ~ 7

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.

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Effects of Global Postural Reeducation versus Specific Therapeutic Neck Exercises on Pain, Disability, Postural Control, and Neuromuscular Efficiency in Women with Chronic Nonspecific Neck Pain: Study Protocol for a Randomized, Parallel, Clinical Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182010704 ◽

2021 ◽

Vol 18 (20) ◽

pp. 10704

Author(s):

Tânia Mendes-Fernandes ◽

Ana Silvia Puente-González ◽

Manuel Antonio Márquez-Vera ◽

Carolina Vila-Chã ◽

Roberto Méndez-Sánchez

Keyword(s):

Clinical Trial ◽

Neck Pain ◽

Postural Control ◽

Pain Threshold ◽

Pain Catastrophizing ◽

Pressure Pain Threshold ◽

Home Exercise ◽

Pressure Pain ◽

Pain Disability ◽

Therapeutic Exercises

Background: Chronic nonspecific neck pain is the most frequent form of neck pain. It is more prevalent in women, and a costly public health issue. It is commonly associated with biomechanical, functional, proprioceptive, and postural impairments. The aim of this trial is to compare the effects of global postural exercises versus specific therapeutic exercises on neck pain, disability, mobility, pressure pain threshold, kinesiophobia, pain catastrophizing, postural control, and neuromuscular efficiency in women with chronic nonspecific neck pain. Methods and analysis: This study is a randomized, parallel-group and single blinded clinical trial. Sixty-two women with nonspecific chronic neck pain were recruited from the community of Guarda, Portugal, and randomly assigned to one of two intervention groups: (1) global postural reeducation (GPR group), (2) specific therapeutic exercises (STE group). The intervention was carried out over 4 weeks, with two sessions per week (eight sessions), and applied by a physiotherapist and paired with a daily individual at-home-exercise program. Primary outcomes are neck pain intensity and disability (Numerical Pain Rating Scale, Neck Disability Index). Secondary outcomes are cervical mobility and pressure pain threshold (CROM, algometry), attitude to pain (kinesiophobia, pain catastrophizing), standing postural control (Center of Pressure (COP) displacements), and neuromuscular efficiency (electromyography). There are four points of evaluation where the outcomes were assessed twice before the intervention, 1 week apart, and the two post-intervention assessments will be carried out after four and eight sessions. The objective was to increase scientific knowledge of different exercise modalities, such as global postural reeducation, in musculoskeletal disorders. Trial registration: ClínicalTrials.gov (NCT04402463), prospectively registered (data 22 May 2020).

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Response to the Letter to the Editor on “Effects of Myofascial Release on Pressure Pain Thresholds in Patients With Neck Pain

American Journal of Physical Medicine & Rehabilitation ◽

10.1097/phm.0000000000000986 ◽

2019 ◽

Vol 98 (1) ◽

pp. e4-e5

Author(s):

Manuel Rodríguez-Huguet ◽

Rafael Lomas-Vega

Keyword(s):

Neck Pain ◽

Pain Thresholds ◽

Pressure Pain ◽

Myofascial Release ◽

Letter To The Editor ◽

Pressure Pain Thresholds

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Immediate Effects of Posteroanterior Cervical Mobilization on Pressure Pain Threshold and Gait Parameters in Patients with Chronic Neck Pain: A Pilot Study

Journal of international academy of physical therapy research ◽

10.20540/jiaptr.2019.10.4.1914 ◽

2019 ◽

Vol 10 (4) ◽

pp. 1914-1920

Author(s):

Taeseok Choi ◽

Okkon Moon ◽

Wansuk Choi ◽

Seoyoon Heo ◽

Sangbin Lee

Keyword(s):

Pilot Study ◽

Neck Pain ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Chronic Neck Pain ◽

Pressure Pain ◽

Gait Parameters

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Response to the letter to the editor on “Effects of Myofascial Release on Pressure Pain Thresholds in Patients with Neck Pain. A Single-Blind Randomized Controlled Trial”

American Journal of Physical Medicine & Rehabilitation ◽

10.1097/00002060-900000000-98470 ◽

2018 ◽

pp. 1

Author(s):

Manuel Rodríguez-Huget ◽

Rafael Lomas-Vega

Keyword(s):

Randomized Controlled Trial ◽

Neck Pain ◽

Controlled Trial ◽

Pain Thresholds ◽

Pressure Pain ◽

Myofascial Release ◽

Randomized Controlled ◽

Letter To The Editor ◽

Pressure Pain Thresholds ◽

Single Blind

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Serum Levels of Proinflammatory Cytokines in Painful Knee Osteoarthritis and Sensitization

International Journal of Inflammation ◽

10.1155/2015/329792 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 32

Author(s):

Marta Imamura ◽

Fernando Ezquerro ◽

Fábio Marcon Alfieri ◽

Lucy Vilas Boas ◽

Tania Regina Tozetto-Mendoza ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Functional Capacity ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Serum Levels ◽

Pressure Pain ◽

Pressure Pain Thresholds ◽

The World ◽

Joint Disorder ◽

Painful Knee

Osteoarthritis (OA) is the most common joint disorder in the world. Among the mechanisms involved in osteoarthritis, biomarkers (cytokines profile) may be related to pain and pain intensity, functional capacity, and pressure pain thresholds (PPT). Thus, the study of these relationships may offer useful information about pathophysiology and associated mechanisms involved in osteoarthritis. Therefore, the objective of this study was to investigate the seric concentration of pro (IL-6, IL-8, and TNF-α) and anti-inflammatory (IL-10) cytokines in patients with painful knee osteoarthritis and to correlate the levels of these biomarkers with the patients’ functional capacity and pressure pain threshold (PPT) values.

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Is Dry Needling Effective When Combined with Other Therapies for Myofascial Trigger Points Associated with Neck Pain Symptoms? A Systematic Review and Meta-Analysis

Pain Research and Management ◽

10.1155/2021/8836427 ◽

2021 ◽

Vol 2021 ◽

pp. 1-24

Author(s):

César Fernández-De-Las-Peñas ◽

Gustavo Plaza-Manzano ◽

Jorge Sanchez-Infante ◽

Guido F Gómez-Chiguano ◽

Joshua A Cleland ◽

...

Keyword(s):

Neck Pain ◽

Pain Intensity ◽

Range Of Motion ◽

Dry Needling ◽

Short Term ◽

Pain Thresholds ◽

Pressure Pain ◽

Cervical Range Of Motion ◽

Pressure Pain Thresholds

Objective. To evaluate the effects of combining dry needling with other physical therapy interventions versus the application of the other interventions or dry needling alone applied over trigger points (TrPs) associated to neck pain. Databases and Data Treatment. Electronic databases were searched for randomized controlled trials where at least one group received dry needling combined with other interventions for TrPs associated with neck pain. Outcomes included pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion. The risk of bias (RoB) was assessed using the Cochrane risk of bias tool, methodological quality was assessed with PEDro score, and the quality of evidence was assessed by using the GRADE approach. Between-groups mean differences (MD) and standardized mean difference (SMD) were calculated. Results. Eight trials were included. Dry needling combined with other interventions reduced pain intensity at short-term (SMD −1.46, 95% CI −2.25 to −0.67) and midterm (SMD −0.38, 95% CI −0.74 to −0.03) but not immediately after or at long-term compared with the other interventions alone. A small effect on pain-related disability was observed at short-term (SMD −0.45, 95% CI −0.87 to −0.03) but not at midterm or long-term. The inclusion of dry needling was also effective for improving pressure pain thresholds only at short-term (MD 112.02 kPa, 95% CI 27.99 to 196.06). No significant effects on cervical range of motion or pain catastrophism were observed. Conclusion. Low-to-moderate evidence suggests a positive effect to the combination of dry needling with other interventions for improving pain intensity, pain-related disability, pressure pain thresholds, and cervical range of motion in people with neck pain associated with TrPs at short-term. No midterm or long-term effects were observed.

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Deep tissue hyperalgesia after computer work

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2011.08.005 ◽

2012 ◽

Vol 3 (1) ◽

pp. 53-60 ◽

Cited By ~ 3

Author(s):

Vegard Strøm ◽

Cecilie Røe ◽

Dagfinn Matre ◽

Stein Knardahl

Keyword(s):

Neck Pain ◽

Time Pressure ◽

Computer Work ◽

Office Work ◽

Deep Tissue ◽

Pain Thresholds ◽

Pressure Pain ◽

Upper Trapezius ◽

Shoulder And Neck Pain ◽

Pressure Pain Thresholds

AbstractBackground and purposeA growing number of people are using computers. Shoulder and neck pain occur commonly during computer work. Peripheral and central sensitization may play a major role in establishing and maintaining several chronic pain conditions. We have previously reported that a 90 min simulated computer office-work induced substantial pain in the shoulders and neck. We hypothesized that the development of pain during the computer work may be related to sensitization. The aim of the present study was to examine if the 90 min computer work induced deep tissue muscle hyperalgesia manifested as altered pressure pain thresholds (PPTs).MethodsTwenty-two subjects with chronic shoulder and neck pain (pain group) and 26 healthy and pain free subjects (reference group) performed a standardized computer office-work task with use of a computer-mouse and with time pressure and high precision demands continuously for 90 min. The pressure pain threshold was measured with a pressure algometer in shoulder and forearm muscles (bilaterally in upper trapezius and extensor carpi radialis), and at sternum, before and 15 min and 30 min after the computer work task.ResultsThe PPTs before starting the computer work were not different between the groups at any of the five locations. In both groups, the PPTs in the active and inactive side of the upper trapezius as well as in the extensor carpi radialis of the forearm operating the computer mouse were significantly reduced after the 90 min computer work compared with the pre-work levels. In the pain group, also the PPT in the inactive resting forearm was significantly reduced. The changes seen in PPTs from pre-to post-work were not significantly different between the groups, except for the inactive resting forearm where the groups exhibited different time course.ConclusionA decrease in pressure pain thresholds of involved muscles suggests that computer office-work can induce deep tissue hyperalgesia within 90 min. The development of pain during the computer work indicates peripheral sensitization as the predominant mechanism. Decreased pressure pain thresholds also in sites distant from pain areas may indicate a contribution from central sensitization in the subjects with chronic shoulder and neck pain.ImplicationsThe lasting pain after work and the reduced PPTs both in involved and distant musculature may indicate need for frequent pauses during computer work, especially when performed with time pressure and high precision demands, in order to avoid pain to increase and sustain after work, and thus to prevent the possibility of pain to become chronic.

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