The tolerance to stretch is linked with endogenous modulation of pain

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Morten Pallisgaard Støve ◽  
Rogerio Pessoto Hirata ◽  
Thorvaldur Skuli Palsson
Keyword(s):  
Range Of Motion ◽  
Pain Sensitivity ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Static Stretch ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressor Test ◽  
Pressure Pain Thresholds ◽  
Exercise Induced

Abstract Objectives The effect of stretching on joint range of motion is well documented, and although sensory perception has significance for changes in the tolerance to stretch following stretching the underlining mechanisms responsible for these changes is insufficiently understood. The aim of this study was to examine the influence of endogenous pain inhibitory mechanisms on stretch tolerance and to investigate the relationship between range of motion and changes in pain sensitivity. Methods Nineteen healthy males participated in this randomized, repeated-measures crossover study, conducted on 2 separate days. Knee extension range of motion, passive resistive torque, and pressure pain thresholds were recorded before, after, and 10 min after each of four experimental conditions; (i) Exercise-induced hypoalgesia, (ii) two bouts of static stretching, (iii) resting, and (iv) a remote, painful stimulus induced by the cold pressor test. Results Exercise-induced hypoalgesia and cold pressor test caused an increase in range of motion (p<0.034) and pressure pain thresholds (p<0.027). Moderate correlations in pressure pain thresholds were found between exercise-induced hypoalgesia and static stretch (Rho>0.507, p=0.01) and exercise-induced hypoalgesia and the cold pressor test (Rho=0.562, p=0.01). A weak correlation in pressure pain thresholds and changes in range of motion were found following the cold pressor test (Rho=0.460, p=0.047). However, a potential carryover hypoalgesic effect may have affected the results of the static stretch. Conclusions These results suggest that stretch tolerance may be linked with endogenous modulation of pain. Present results suggest, that stretch tolerance may merely be a marker for pain sensitivity which may have clinical significance given that stretching is often prescribed in the rehabilitation of different musculoskeletal pain conditions where reduced endogenous pain inhibition is frequently seen.

Pain and executive function: no association between remote exercise-induced hypoalgesia and cognitive inhibition in pain-free participants

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Hannah Gajsar ◽  
Marcel Meyer ◽  
Monika I. Hasenbring ◽  
Henrik B. Vaegter
Keyword(s):  
Pain Sensitivity ◽  
Stroop Interference ◽  
Stop Signal ◽  
Stop Signal Task ◽  
Cognitive Inhibition ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Exercise Induced ◽  
Interference Score

Abstract Objectives Cognitive inhibition, which denotes the ability to suppress predominant or automatic responses, has been associated with lower pain sensitivity and larger conditioned pain modulation in humans. Studies exploring the association between cognitive inhibition and other pain inhibitory phenomena, like exercise-induced hypoalgesia (EIH), are scarce. The primary aim was to explore the association between cognitive inhibition and EIH at exercising (local) and non-exercising (remote) muscles after isometric exercise. The secondary aim was to explore the association between cognitive inhibition and pressure pain sensitivity. Methods Sixty-six pain-free participants (28.3 ± 8.9 years old, 34 women) completed two cognitive inhibition tasks (stop-signal task and Stroop Colour-Word task), a 3-min isometric wall squat exercise, and a quiet rest control condition with pre- and post-assessments of manual pressure pain thresholds at a local (thigh) and a remote site (shoulder). In addition, cuff pressure pain thresholds, pain tolerance and temporal summation of pain were assessed at baseline. Results No association was found between remote EIH and cognitive inhibition (Stroop interference score: r=0.12, [−0.15; 0.37], p=0.405, BF01=6.70; stop-signal reaction time: r=−0.08, [−0.32; 0.17], p=0.524, BF01=8.32). Unexpectedly, individuals with worse performance on the Stroop task, as indicated by a higher Stroop interference score, showed higher local EIH (r=0.33; [0.10; 0.53], p=0.007, BF01=0.29). No associations were observed between pain sensitivity and any of the cognitive inhibition performance parameters. Conclusions The present findings do not support previous evidence on positive associations between exercise-induced hypoalgesia and cognitive inhibition, as well as baseline pain sensitivity and cognitive inhibition.

The Effects of an Acute Maximal Seated Lumbar Spine Flexion Exposure on Low Back Mechanical Pain Sensitivity

2021 ◽  
pp. 1-8
Author(s):  
Daniel Viggiani ◽  
Jack P. Callaghan
Keyword(s):  
Lumbar Spine ◽  
Pain Sensitivity ◽  
Recovery Period ◽  
Low Back ◽  
Pain Thresholds ◽  
Pressure Algometry ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Sensitivity Changes ◽  
Neural Feedback

Viscoelastic creep generated in the lumbar spine following sustained spine flexion may affect the relationship between tissue damage and perceived pain. Two processes supporting this altered relationship include altered neural feedback and inflammatory processes. Our purpose was to determine how low back mechanical pain sensitivity changes following seated lumbar spine flexion using pressure algometry in a repeated-measures, cross-sectional laboratory design. Thirty-eight participants underwent a 10-minute sustained seated maximal flexion exposure with a 40-minute standing recovery period. Pressure algometry assessed pressure pain thresholds and the perceived intensity and unpleasantness of fixed pressures. Accelerometers measured spine flexion angles, and electromyography measured muscular activity during flexion. The flexion exposure produced 4.4° (2.7°) of creep that persisted throughout the entire recovery period. The perception of low back stimulus unpleasantness was elevated immediately following the exposure, 20 minutes before a delayed increase in lumbar erector spinae muscle activity. Women reported the fixed pressures to be more intense than men. Sustained flexion had immediate consequences to the quality of mechanical stimulus perceived but did not alter pressure pain thresholds. Neural feedback and inflammation seemed unlikely mechanisms for this given the time and direction of pain sensitivity changes, leaving a postulated cortical influence.

scholarly journals Pain thresholds and suprathreshold pain after sleep restriction in migraine – A blinded crossover study

Cephalalgia ◽  
2021 ◽  
pp. 033310242110565
Author(s):  
Jan Petter Neverdahl ◽  
Martin Uglem ◽  
Dagfinn Matre ◽  
Johannes Orvin Hansen ◽  
Morten Engstrøm ◽  
...  
Keyword(s):  
Crossover Study ◽  
Pain Sensitivity ◽  
Sleep Restriction ◽  
Heat Pain ◽  
Healthy Controls ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Disturbed Sleep ◽  
Pressure Pain Thresholds ◽  
Lower Pain

Objective There is an unexplained association between disturbed sleep and migraine. In this blinded crossover study, we investigate if experimental sleep restriction has a different effect on pain thresholds and suprathreshold pain in interictal migraineurs and controls. Methods Forearm heat pain thresholds and tolerance thresholds, and trapezius pressure pain thresholds and suprathreshold pain were measured in 39 interictal migraineurs and 31 healthy controls after two consecutive nights of partial sleep restriction and after habitual sleep. Results The effect of sleep restriction was not significantly different between interictal migraineurs and controls in the primary analyses. Pressure pain thresholds tended to be lower (i.e., increased pain sensitivity) after sleep restriction in interictal migraineurs compared to controls with a 48-hour preictal-interictal cut-off (p = 0.061). We found decreased pain thresholds after sleep restriction in two of seven migraine subgroup comparisons: heat pain thresholds decreased in migraineurs with lower pain intensity during attacks (p = 0.005) and pressure pain thresholds decreased in migraineurs with higher severity of photophobia during attacks (p = 0.031). Heat pain thresholds tended to decrease after sleep restriction in sleep-related migraine (p = 0.060). Sleep restriction did not affect suprathreshold pain measurements in either group. Conclusion This study could not provide strong evidence for an increased effect of sleep restriction on pain sensitivity in migraineurs compared to healthy controls. There might be a slightly increased effect of sleep restriction in migraineurs, detectable using large samples or more pronounced in certain migraine subgroups.

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

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.

scholarly journals Validity of the cold pressor test and pain sensitivity questionnaire via online self-administration

PLoS ONE ◽  
2020 ◽  
Vol 15 (4) ◽  
pp. e0231697
Author(s):  
Matthew H. McIntyre ◽  
Achim Kless ◽  
Peter Hein ◽  
Mark Field ◽  
Joyce Y. Tung ◽  
...  
Keyword(s):  
Pain Sensitivity ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Self Administration ◽  
Pressor Test

Pain Sensitivity in Pericranial and Extracranial Regions

Cephalalgia ◽  
2003 ◽  
Vol 23 (6) ◽  
pp. 456-462 ◽  
Author(s):  
S Ashina ◽  
R Jensen ◽  
L Bendtsen
Keyword(s):  
Muscle Pain ◽  
Pain Sensitivity ◽  
Temporal Summation ◽  
Myofascial Pain ◽  
Anterior Tibial Muscle ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Anterior Tibial ◽  
Nociceptive Input

Chronic myofascial pain is very common in the general population. The pain is most frequently located in the shoulder and neck regions, and nociceptive input from these regions may play an important role for tension-type headache. The mechanisms leading to the frequent occurrence of muscle pain in the shoulder and neck regions are largely unknown. It is possible that the pain is caused by increased sensitivity of muscle nociceptors or by central sensitization induced by nociceptive input from muscle. The primary aim of the present study was to compare muscle pain sensitivity in the trapezius and anterior tibial muscles. The secondary aim was to investigate whether temporal summation, a clinical correlate of wind-up, is more pronounced in muscle than in skin and, if so, whether such a difference is more pronounced in the trapezius than in the anterior tibial region. Sixteen healthy subjects were included. Pressure-pain thresholds and electrical cutaneous and intramuscular pain thresholds were measured at standard anatomical points in the trapezius and anterior tibial regions. Temporal summation was assessed by repetitive electrical stimulation. Pressure-pain thresholds ( P = 0.005) and intramuscular electrical pain thresholds ( P = 0.006) were significantly lower in trapezius than in anterior tibial muscle. Temporal summation was present in skin and muscle of both regions ( P < 0.001). The degree of temporal summation was significantly higher in muscle than in skin in the trapezius region ( P = 0.02), but not in the anterior tibial region ( P = 0.47). In conclusion, we found that muscle pain sensitivity was higher in the trapezius than in the anterior tibial muscle. We also demonstrated that temporal summation could be induced in both muscle and skin and, importantly, that temporal summation was significantly more pronounced in muscle than in skin in the trapezius but not in the anterior tibial region. These data may help to explain why chronic muscle pain most frequently is located in the shoulder and neck regions.

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.

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