THE EFFECT OF KINESIOTAPING USED IN PHYSIOTHERAPY IN DIFFERENT TENSION ON PRESSURE PAIN THRESHOLD AND PAIN TOLERANCE

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.

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

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738120953165 ◽

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.

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Pressure Pain Threshold and Pain Tolerance in Episodic Tension-Type Headache Do Not Depend on the Presence of Headache

Cephalalgia ◽

10.1046/j.1468-2982.1999.1903174.x ◽

1999 ◽

Vol 19 (3) ◽

pp. 174-178 ◽

Cited By ~ 8

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.

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

The Open Pain Journal ◽

10.2174/1876386301811010041 ◽

2018 ◽

Vol 11 (1) ◽

pp. 41-51 ◽

Cited By ~ 1

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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Experimental pressure-pain assessments: Test-retest reliability, convergence and dimensionality

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2011.10.003 ◽

2012 ◽

Vol 3 (1) ◽

pp. 31-37 ◽

Cited By ~ 32

Author(s):

Tamara E. Lacourt ◽

Jan H. Houtveen ◽

Lorenz J.P. van Doornen

Keyword(s):

Convergent Validity ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Experimental Pain ◽

Threshold Value ◽

Pain Tolerance ◽

Pressure Pain ◽

Pain Ratings ◽

Left And Right ◽

Body Point

AbstractIntroductionExperimental pain studies can provide unique insight into the dimensions of pain and into individual differences in pain responsiveness by controlling different aspects of pain-eliciting stimuli and pain measures. In experimental pain studies, pain responsiveness can be assessed as pain threshold, pain tolerance or pain ratings. The test-theoretical qualities of these different measures, however, have not yet been completely documented. In the current study, several of these qualities were investigated in a pain experiment applying different algometric techniques. The objective of the study was to investigate the reliability (test–retest) and the convergent validity (correspondence) of the different methods found in the literature of measuring pressure-pain threshold, and the interrelationship between pressure-pain threshold, pressure-pain tolerance, and pressure-pain ratings.MethodsSixty-six healthy female subjects were enrolled in the study. All pressure stimuli were applied by a trained investigator, using a digital algometer with a 1 cm2 rubber tip. Pressure-pain thresholds were assessed repeatedly on six different body points (i.e. left and right calf one third of total calf muscle length below the popliteal space), the lower back (5 cm left and right from the L3), and left and right forearm (thickest part of brachioradialis muscle). Next, pressure-pain tolerance was measured on the thumbnail of the non-dominant hand, followed by rating affective and sensory components (on visual analogue scales) of a stimulus at tolerance level. Last, affective and sensory ratings were obtained for two pressure intensities.ResultsWith intraclass correlations above .75 for pain responses per body point, test–retest reliability was found to be good. However, values obtained from all first measurements were significantly higher as compared with the two succeeding ones. Convergent validity of pain thresholds across different body points was found to be high for all combinations assessed (Cronbach’s alpha values >.80), but the highest for bilateral similar body parts (>.89). Finally, principal components analysis including measures of threshold, tolerance and pain ratings yielded a three-factor solution that explained 81.9% of the variance: Moderate-level stimulus appraisal & pain tolerance; Pain threshold; Tolerance-level stimulus appraisal.Conclusion and implicationsFindings of the current study were used to formulate recommendations for future algometric pain studies. Concerning pressure-pain threshold, it is recommended to exclude first measurements for every body point from further analyses, as these measurements were found to be consistently higher compared with the following measurements. Further, no more than two consecutive measurements (after the first measurement) are needed for a reliable mean threshold value per body point. When combining threshold values of several body points into one mean-aggregated threshold value, we suggest to combine bilateral similar points, as convergent validity values were highest for these combinations. The three-factor solution that was found with principal components analyses indicates that pressure-pain threshold, subjective ratings of moderate intensity stimuli, and subjective ratings of the maximum (tolerance) intensity are distinct aspects of pain responsiveness. It is therefore recommended to include a measure of each of these three dimensions of pain when assessing pressure pain responsiveness. Some limitations of our study are discussed.

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

Arthritis ◽

10.1155/2015/434109 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 19

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.

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Analysis of age and gender related differences in pressure pain threshold and pressure pain tolerance levels

The Pain Clinic ◽

10.1163/15685690260494843 ◽

2002 ◽

Vol 14 (4) ◽

pp. 309-314 ◽

Cited By ~ 5

Author(s):

Nilgün Bek ◽

Fatma Uygur ◽

Banu Bayar ◽

Kadriye Armutlu

Keyword(s):

Pain Threshold ◽

Pressure Pain Threshold ◽

Pain Tolerance ◽

Age And Gender ◽

Pressure Pain ◽

And Gender

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Predicting Postoperative Pain by Preoperative Pressure Pain Assessment

Anesthesiology ◽

10.1097/00000542-200509000-00026 ◽

2005 ◽

Vol 103 (3) ◽

pp. 613-618 ◽

Cited By ~ 97

Author(s):

Yung-Wei Hsu ◽

Jacques Somma ◽

Yu-Chun Hung ◽

Pei-Shan Tsai ◽

Chen-Hsien Yang ◽

...

Keyword(s):

Postoperative Pain ◽

Pain Score ◽

Pain Threshold ◽

Pressure Pain Threshold ◽

Pain Tolerance ◽

Morphine Consumption ◽

Gynecologic Surgery ◽

Postanesthesia Care Unit ◽

Pressure Pain ◽

Pressure Algometer

Background The goal of this study was to evaluate whether preoperative pressure pain sensitivity testing is predictive of postoperative surgical pain. Methods Female subjects undergoing lower abdominal gynecologic surgery were studied. A pressure algometer was used preoperatively to determine the pressure pain threshold and tolerance. A visual analog scale (VAS) was used to assess postoperative pain. A State-Trait Anxiety Inventory was used to assess patients' anxiety. Subjects received intravenous patient-controlled analgesia for postoperative pain control. The preoperative pain threshold and tolerance were compared with the postoperative VAS pain score and morphine consumption. Results Forty women were enrolled. Their preoperative pressure pain threshold and tolerance were 141 +/- 65 kPa and 223 +/- 62 kPa, respectively. The VAS pain score in the postanesthesia care unit and at 24 h postoperatively were 81 +/- 24 and 31 +/- 10, respectively. Highly anxious patients had higher VAS pain scores in the postanesthesia care unit (P < 0.05). Pressure pain tolerance was significantly correlated with the VAS at 24 h postoperatively (P < 0.001, r = -0.52). Pressure pain tolerance after fentanyl administration (mean, 272 +/- 68 kPa) correlated significantly with morphine consumption in the first 24 h postoperatively (P < 0.002, r = -0.48). Conclusions Assessment of preoperative pressure pain tolerance is significantly correlated with the level of postoperative pain. Pain tolerance assessment after fentanyl was administered and fentanyl sensitivity predicted the dose of analgesics used in the first 24 h after surgery. The algometer is thus a simple, useful tool for predicting postoperative pain and analgesic consumption.

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