Cold hyperalgesia associated with poorer prognosis in lateral epicondylalgia: a 1-year prognostic study of physical and psychological factors

Coombes, Brooke K., Bisset, Leanne and Vicenzino, Bill (2015) Cold hyperalgesia associated with poorer prognosis in lateral epicondylalgia: a 1-year prognostic study of physical and psychological factors. Clinical Journal of Pain, 31 1: 30-35. doi:10.1097/AJP.0000000000000078

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Author Coombes, Brooke K.
Bisset, Leanne
Vicenzino, Bill
Title Cold hyperalgesia associated with poorer prognosis in lateral epicondylalgia: a 1-year prognostic study of physical and psychological factors
Journal name Clinical Journal of Pain   Check publisher's open access policy
ISSN 1536-5409
0749-8047
Publication date 2015-01-14
Year available 2015
Sub-type Article (original research)
DOI 10.1097/AJP.0000000000000078
Open Access Status Other
Volume 31
Issue 1
Start page 30
End page 35
Total pages 6
Place of publication Philadelphia PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2016
Language eng
Formatted abstract
Background: Predictors of outcome in lateral epicondylalgia, which is mainly characterized as a mechanical hyperalgesia, are largely limited to sociodemographic and symptomatic factors. Quantitative sensory testing is used to study altered pain processing in various chronic pain conditions and may be of prognostic relevance.

Methods: The predictive capacity of early measures of physical and psychological impairment on pain and disability and mechanical hyperalgesia, were examined using data from 41 patients assigned to placebo in a prospective randomized controlled trial of unilateral lateral epicondylalgia. Quantitative sensory testing (pressure, cold pain thresholds), motor function (pain-free grip), and psychological factors (Tampa Scale of Kinesiophobia, Hospital Anxiety and Depression Scale) were measured at baseline. The outcome measures were the Patient-rated Tennis Elbow Evaluation (PRTEE) scale and pressure pain threshold (PPT) measured by digital algometry at the affected elbow. Backward stepwise linear regression was used to predict PRTEE and PPT scores at 2 and 12 months.

Results: Cold pain threshold was the only consistent predictor for both PRTEE (P<0.034) and PPT (P<0.048). Initial PRTEE was the strongest single predictor of PRTEE at 2 months, whereas female sex was the strongest single predictor of PPT (P<0.002). At 1 year, final models explained 9% to 52% of the variability in pain and disability and mechanical hyperalgesia, respectively.

Discussion: Early assessment of cold pain threshold could be a useful clinical tool to help identify patients at risk of poorer outcomes and might provide direction for future research into mechanism-based treatment approaches for these patients.
Keyword Tennis elbow
Lateral epicondylalgia
Prognosis
Hyperalgesia
Anxiety
Depression
Kinesiophobia
Thermal pain threshold
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Health and Rehabilitation Sciences Publications
 
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