Assessment of conditioned pain modulation in healthy participants and patients with chronic pain: manifestations and implications for pain progression

Petersen, Kristian Kjær; McPhee, Megan; Hoegh, Morten; Graven‐Nielsen, Thomas

doi:10.1097/spc.0000000000000419

Cited by 38 publications

(36 citation statements)

References 68 publications

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“…3 The most efficacious treatment for tendinopathy to date is exercise, whose long-term analgesic effects are believed to involve activation of the descending inhibitory pain pathway(s). 31 Therefore, though currently elusive, it is possible that there is a CNS driver for tendon pain.…”

Section: Discussionmentioning

confidence: 99%

“…While these results collectively seem to suggest a more peripheral source of pain, this is at odds with clinical practice where peripheral, tissue‐based treatments are not very effective 3 . The most efficacious treatment for tendinopathy to date is exercise, whose long‐term analgesic effects are believed to involve activation of the descending inhibitory pain pathway(s) 31 . Therefore, though currently elusive, it is possible that there is a CNS driver for tendon pain.…”

Section: Discussionmentioning

confidence: 99%

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Conditioned pain modulation is not altered in recreational athletes with Achilles tendinopathy

Mkumbuzi

Mafu

September

et al. 2020

Transl. Sports. Med.

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Background: Altered central pain mechanisms is a feature of other chronic pain states and upper limb tendinopathies. It is uncertain whether the same applies to chronic Achilles tendinopathy (AT). Objective: To investigate altered central pain mechanisms in chronic AT by assessing conditioned pain modulation (CPM) in recreational athletes with and without chronic AT. Methods: Recreational athletes with chronic AT (ATN) rated their tendinopathy symptoms on the VISA-A, and short forms of the McGill Pain Questionnaire and the Brief Pain Inventory. The CPM effect was triggered in athletes with tendinopathy (ATN, n = 123) and without tendinopathy (CON, n = 100). The cold pressor test was the conditioning stimulus, and pressure pain was the test stimulus. Results: Participants with tendinopathy had lower pressure pain thresholds before (median (IQR) [ATN: 417 (364 − 516) vs CON 601 (459 − 724), P < .01] and during [ATN: 458 (358 − 550) vs CON 633 (506 − 753), P < .01] cold pressor test. No differences were observed for the CPM effect between the two groups (P = .49). Conclusion: There was no difference in the CPM effect between athletes with AT and pain-free controls. Perhaps because tendon pain is a peripheral phenomenon, there are no alterations in descending pain modulation with chronic AT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Conditioned pain modulation is not altered in recreational athletes with Achilles tendinopathy

Mkumbuzi

Mafu

September

et al. 2020

Transl. Sports. Med.

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“… 76 Under healthy and chronic pain conditions, humans and non-human animals exhibit diffuse noxious inhibitory control (DNIC) of pain (also called inhibition of pain by pain) that is modulated by sex. 77 , 78 In rats, DNIC is less efficient in females compared with males, and the brain networks engaged during DNIC differ in males and females. 77 The above discussion of sex differences in pain modulation by vlPAG/DR circuit projections to the BNST is a good example of why it is critical for the nascent alcohol-pain field to include both sexes in all studies.…”

Section: Biological Factors In Alcohol Withdrawal Hyperalgesiamentioning

confidence: 99%

Forebrain-Midbrain Circuits and Peptides Involved in Hyperalgesia After Chronic Alcohol Exposure

Gilpin

Kash

2021

ARCR

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People living with pain report drinking alcohol to relieve pain. Acute alcohol use reduces pain, and chronic alcohol use facilitates the emergence or exaggeration of pain. Recently, funding agencies and neuroscientists involved in basic research have turned their attention to understanding the neurobiological mechanisms that underlie pain-alcohol interactions, with a focus on circuit and molecular mediators of alcohol-induced changes in pain-related behavior. This review briefly discusses some examples of work being done in this area, with a focus on reciprocal projections between the midbrain and extended amygdala, as well as some neurochemical mediators of pain-related phenotypes after alcohol exposure. Finally, as more work accumulates on this topic, the authors highlight the need for the neuroscience field to carefully consider sex and age in the design and analysis of pain-alcohol interaction experiments.

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“…Depending on CPM efficacy, individuals can be positioned on a clinical spectrum between pro-nociception or anti-nociception [ 30 , 31 ]. CPM effects have been studied in several chronic pain populations [ 32 ] but not yet in individuals with FS.…”

Section: Introductionmentioning

confidence: 99%

Conditioned Pain Modulation Is Not Impaired in Individuals with Frozen Shoulder: A Case-Control Study

Aguilar‐Rodríguez

Dueñas

Balasch-Bernat

et al. 2021

IJERPH

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Frozen shoulder (FS) is a poorly understood condition resulting in substantial shoulder pain and mobility deficits. The mechanisms behind FS are not yet fully understood, but, similar to other persistent pain states, central pain mechanisms may contribute to ongoing symptoms in this population. The objective of this research was to investigate conditioned pain modulation (CPM) in people with FS compared with pain-free individuals. A total of 64 individuals with FS and 64 healthy volunteers participated in this cross-sectional study. CPM was assessed by using the pressure pain threshold (PPT) and an occlusion cuff (tourniquet test) as the test and conditioning stimulus, respectively. The absolute and percentage of change in PPT (CPM effect) as well as pain profiles (pro-nociceptive vs. anti-nociceptive) of individuals with FS and healthy controls were calculated. No significant differences in the absolute change in the PPT or CPM effect were found in people with FS compared to pain-free controls. Moreover, no between-group differences in the percentage of subjects with pro-nociceptive and anti-nociceptive pain profiles were observed. These results suggest that endogenous pain inhibition is normally functioning in people with FS. Altered central pain-processing mechanisms may thus not be a characteristic of this population.

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Assessment of conditioned pain modulation in healthy participants and patients with chronic pain: manifestations and implications for pain progression

Abstract: , T. (2019). Assessment of conditioned pain modulation in healthy participants and patients with chronic pain: manifestations and implications for pain progression.

Cited by 38 publications

References 68 publications

Conditioned pain modulation is not altered in recreational athletes with Achilles tendinopathy

Conditioned pain modulation is not altered in recreational athletes with Achilles tendinopathy

Forebrain-Midbrain Circuits and Peptides Involved in Hyperalgesia After Chronic Alcohol Exposure

Conditioned Pain Modulation Is Not Impaired in Individuals with Frozen Shoulder: A Case-Control Study

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