Relationships between pressure pain thresholds and pain ratings in patients with whiplash-associated disorders

Kamper, Steven J., Maher, Christopher G., Hush, Julia M., Pedler, Ashley and Sterling, Michele M. (2011) Relationships between pressure pain thresholds and pain ratings in patients with whiplash-associated disorders. Clinical Journal of Pain, 27 6: 495-501. doi:10.1097/AJP.0b013e31820e1185


Author Kamper, Steven J.
Maher, Christopher G.
Hush, Julia M.
Pedler, Ashley
Sterling, Michele M.
Title Relationships between pressure pain thresholds and pain ratings in patients with whiplash-associated disorders
Journal name Clinical Journal of Pain   Check publisher's open access policy
ISSN 0749-8047
Publication date 2011-07
Sub-type Article (original research)
DOI 10.1097/AJP.0b013e31820e1185
Volume 27
Issue 6
Start page 495
End page 501
Total pages 6
Place of publication United States
Publisher Lippincott Williams & Wilkins
Collection year 2012
Language eng
Formatted abstract
Objectives:
Increased sensitivity to pressure is commonly associated with painful musculoskeletal conditions, including whiplash-associated disorders (WADs). Pressure pain thresholds (PPTs) close to the site of presumed tissue damage are thought to represent the degree of peripheral nociceptive sensitization. PPTs over healthy tissue, away from the site of injury, are a marker of central nervous system hyperexcitability. There is uncertainty, however, as to what extent does the sensitization of the nociceptive system, whether peripheral or central, contribute to the ongoing, habitual pain experienced by people with WAD.

Methods:
One hundred patients with WAD were assessed within 4 weeks of their accident and followed after 3 months; 24-hour average neck pain score, PPTs at the cervical spine and tibialis anterior, demographic factors, and psychological measures were collected.

Results:

Cervical PPT and neck pain score were significantly, but weakly correlated (r=-0.20 to -0.33). There was no significant correlation between tibialis anterior PPT and pain score at any time point (r=-0.01 to -0.21). Regression analyses indicated a strong influence of generalized psychological distress and fear avoidance on the relationship between PPT and pain report.

Discussion:

The competing explanations for these findings are that either PPTs provide a poor marker of peripheral and central sensitivity or that these processes are only weakly related to the day-to-day pain experienced by patients with WAD. The latter explanation is supported by the confounding effect of psychological factors on pain score. Copyright © 2011 by Lippincott Williams & Wilkins.
Keyword Nociception
Pain
Pressure pain threshold
Whiplash
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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Created: Wed, 22 Jun 2011, 15:41:24 EST by Chesne McGrath on behalf of Medicine - Royal Brisbane and Women's Hospital