Central pain processing is altered in people with Achilles tendinopathy

Tompra, Nefeli, van Dieen, Jaap H. and Coppieters, Michel W. (2015) Central pain processing is altered in people with Achilles tendinopathy. British Journal of Sports Medicine, 50 16: 1004-U79. doi:10.1136/bjsports-2015-095476

Author Tompra, Nefeli
van Dieen, Jaap H.
Coppieters, Michel W.
Title Central pain processing is altered in people with Achilles tendinopathy
Journal name British Journal of Sports Medicine   Check publisher's open access policy
ISSN 1473-0480
Publication date 2015-12-23
Sub-type Article (original research)
DOI 10.1136/bjsports-2015-095476
Open Access Status Not Open Access
Volume 50
Issue 16
Start page 1004
End page U79
Total pages 6
Place of publication London, United Kingdom
Publisher BMJ Group
Language eng
Formatted abstract
Background Tendinopathy is often a chronic condition. The mechanisms behind persistent tendon pain are not yet fully understood. It is unknown whether, similar to other persistent pain states, central pain mechanisms contribute to ongoing tendon pain.

Aim We investigated the presence of altered central pain processing in Achilles tendinopathy by assessing the conditioned pain modulation (CPM) effect in people with and without Achilles tendinopathy.

Methods 20 people with Achilles tendinopathy and 23 healthy volunteers participated in this cross-sectional study. CPM was assessed by the cold pressor test. The pressure pain threshold (PPT) was recorded over the Achilles tendon before and during immersion of the participant's hand into cold water. The CPM effect was quantified as the absolute difference in PPT before and during the cold pressor test.

Results An increase in PPT was observed in the Achilles tendinopathy and control group during the cold pressor test (p<0.001). However, the CPM effect was stronger in the control group (mean difference=160.5 kPa, SD=84.9 kPa) compared to the Achilles tendinopathy group (mean difference=36.4 kPa, SD=68.1 kPa; p<0.001).

Summary We report a reduced conditioned pain modulation effect in people with Achilles tendinopathy compared to people without Achilles tendinopathy. A reduced conditioned pain modulation effect reflects altered central pain processing which is believed to contribute to the persistence of pain in other conditions. Altered central pain processing may also be an important factor in persistent tendon pain that has traditionally been regarded to be dominated by peripheral mechanisms.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes Published Online 23 December 2015

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