Assessment of heart rate variability in the patients suffering with chronic pain of musculoskeletal origin

Abstract

Background: Prolonged pain of musculoskeletal origin can cause changes in autonomic outflow and thereby cardiovascular system. Various studies have been conducted showing the effect of chronic pain on heart rate variability (HRV), but the same study has not been conducted in the population of Eastern Uttar Pradesh. Aims and Objectives: This study was conducted to assess the effects of chronic pain on cardiovascular autonomic control in male cases versus male controls and female cases versus female controls. Materials and Methods: The patients were selected from the pain clinic out patient department with chronicity of >6 months duration and severity of >3 on visual analog scale. Age-sex matched controls were also selected. Electrocardiogram was recorded in the resting state and was analyzed for the HRV by using time and frequency domains. Results: In male cases, maximum RR interval, minimum RR interval, mean RR interval and in female cases, minimum RR is significantly different than male and female controls, respectively (P < 0.05). In frequency domain, low frequency/high frequency (L.F./H.F) ratio in male cases and L.F.m 2 in female cases are different than male and female controls, respectively. Conclusion: The observations reveal that there is a decrease in parasympathetic activity and an increase in the sympathetic activity in the cases as compared to their age-sex matched controls leading to the shifting of sympathovagal balance toward the sympathetic side. The pattern of changes is similar, both in male cases versus male controls and female cases versus female controls with little difference in the magnitude.

Sensor Technologies to Manage the Physiological Traits of Chronic Pain: A Review

“…The analysis reported in [22] using HRV reveals a reduction of the parasympathetic activity and an increase of the sympathetic activity in patients with chronic pain of musculoskeletal origin.…”

“…However, there is still no universal method that allows the objective evaluation of pain [22], its intensity or severity, although it may be critical in multiple conditions [28].…”

“…However, as pain is a subjective experience, its measurement is difficult [21]. Sensitivity to pain is manifold in the different individuals [22], in part due to its association with motivational and emotional factors (depression, anger, anxiety, resentment), behavioural components, the influence of life-style (marital or workplace distress, etc. ), personal skills, capacity to face pain, health beliefs, etc.…”

“…It has been conducted in the bibliography from different points of view, ranging from video signal processing [29,31,32] or the analysis of bio-physiological signals [33][34][35][36], to systems combining heterogeneous information sources [3,11,27,[37][38][39][40]. However, to date a universal method has been developed neither for the objective evaluation of pain [22], nor for the measurement of its seriousness, due to the subjective nature of pain perception by the sufferer, although it is a critical demand for multiple disorders. In the absence of objective measurement reference standards, the evaluation is carried out through subjective self-reports from patients, caregivers or medical staff.…”

Heart rate variability in adults with chronic musculoskeletal pain: A systematic review

“…Of the 20 studies, three investigated temporomandibular disorders, 25,27,28 six neck pain, [14][15][16][29][30][31] two whiplash, 32,33 one low back pain, 34 six fibromyalgia, [35][36][37][38][39][40] one fibromyalgia and temporomandibular disorders, 41 and one musculoskeletal pain. 42 Meta-analyses were not performed due to the difference in HRV protocols in terms of indexes, and positions. Most studies reported the use of electrocardiography (ECG) to obtain the RR intervals.…”