Association between quantitative sensory testing, treatment choice, and subsequent pain reduction in vulvar vestibulitis syndrome

Granot, Michal; Zimmer, Etan Z.; Friedman, Michael; Löwenstein, Lior; Yarnitsky, David

doi:10.1016/j.jpain.2004.03.005

Cited by 64 publications

(39 citation statements)

References 41 publications

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“…Whether such findings will extend to patients with OA and other forms of musculoskeletal pain remains to be determined. Given the potential clinical utility of multimodal QST and the stability of these subgroups in the literature, future clinical trials should be cognizant of these pain phenotypes in assessing treatment responses as well as probing underlying mechanisms (5,7,24,27,46,58). …”

Section: Discussionmentioning

confidence: 99%

Experimental pain phenotyping in community-dwelling individuals with knee osteoarthritis

Cardoso

Riley

Glover

et al. 2016

Pain

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Pain among individuals with knee osteoarthritis (OA) is associated with significant disability in older adults, and recent evidence demonstrates enhanced experimental pain sensitivity. Although previous research showed considerable heterogeneity in the OA clinical pain presentation, less is known regarding the variability in responses to experimental pain. The present study included individuals with knee OA (n = 292) who participated in the Understanding Pain and Limitations in Osteoarthritic Disease study and completed demographic and psychological questionnaires followed by a multimodal quantitative sensory testing (QST) session. Quantitative sensory testing measures were subjected to variable reduction procedures to derive pain sensitivity index scores, which in turn were entered into a cluster analysis. Five clusters were significantly different across all pain sensitivity index variables (P < 0.001) and were characterized by: (1) low pain sensitivity to pressure pain (N = 39); (2) average pain sensitivity across most modalities (N = 88); (3) high temporal summation of punctate pain (N = 38); (4) high cold pain sensitivity (N = 80); and (5) high sensitivity to heat pain and temporal summation of heat pain (N = 41). Clusters differed significantly by race, gender, somatic reactivity, and catastrophizing (P < 0.05). Our findings support the notion that there are distinct subgroups or phenotypes based on experimental pain sensitivity in community-dwelling older adults with knee OA, expanding previous findings of similar cluster characterizations in healthy adults. Future research is needed to further understand the pathophysiological mechanisms underlying pain within these subgroups, which may be of added value in tailoring effective treatments for people with OA.

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Section: Discussionmentioning

confidence: 99%

Experimental pain phenotyping in community-dwelling individuals with knee osteoarthritis

Cardoso

Riley

Glover

et al. 2016

Pain

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“…This pain sensitivity may be attributed to either the chronicity of pain (central sensitization) 6, 90 or alternatively can be viewed as a reflection of an intrinsic defect in mechanisms of pain regulation 91, 92 . As PVD1 patients exhibit greater sensitivity to thermal pain in comparison to women with PVD2, it was suggested that subgroups of PVD patients are different with regard to extragenital pain thresholds, implying differences in underlying pathophysiological mechanisms 93 .…”

Section: Central Pain Mechanismsmentioning

confidence: 99%

Recent advances in understanding provoked vestibulodynia

Lev‐Sagie

2016

F1000Res

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Vulvodynia refers to pain in the vulva of at least 3 months’ duration in the absence of a recognized underlying cause. Provoked, localized vestibulodynia is the term used to describe superficial pain confined to the vulvar vestibule, provoked by touch. This review will focus on provoked vestibulodynia with regard to its suggested causative factors and will discuss the role of inflammation, vulvovaginal infections, mucosal nerve fiber proliferation, hormonal associations, central pain mechanisms, pelvic floor muscle dysfunction, and genetic factors. Clinical observations, epidemiological studies, and data from basic research emphasize the heterogeneity of vulvar pain syndromes. There is a critical need to perform prospective, longitudinal studies that will allow better diagnostic criteria and subgrouping of patients that would lead to improvements in our understanding of provoked vestibulodynia and its treatment.

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“…There is a growing awareness of the correlation between experimental pain sensitivity and postoperative pain2,3 and the risk of chronic pain 4,5. Furthermore, chronic pain patients who have higher experimental pain sensitivity respond less favorably to treatment, compared to chronic pain patients who have lower pain sensitivity 6–8…”

Section: Introductionmentioning

confidence: 99%

Validation of the Norwegian Pain Sensitivity Questionnaire

Valeberg¹,

Pedersen²,

Girotto³

et al. 2017

JPR

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Background and purposeThere is a large variation in people’s reactions to painful stimuli. Although some conditions are more painful, the variation between people is larger than the reaction to pain across conditions. Induced experimental pain is one way to assess some aspects of these differences in pain perception. Experimental nociceptive testing is time consuming and not always feasible in a clinical setting. In order to overcome the obstacles of assessing pain sensitivity using experimental stimulation, the Pain Sensitivity Questionnaire (PSQ) was developed. The purpose of this study is to validate the Norwegian version of the PSQ.MethodsConstruct validity was examined through an exploratory principal component factor analysis with varimax rotation. Internal consistency was measured by Cronbach’s alpha reliability for subscales and the total PSQ. As confounding variables such as age and gender may contribute to the experience of pain, a regression analysis was performed with demographic variables and PSQ scores as independent variables and the experimental measures of pain as the dependent variable.ResultsThe factor analysis yielded at two factor solution, with an eigenvalue greater than one, explain 58% of the variance. Cronbach’s alpha for the PSQ was 0.92. In the regression analysis, only PSQ scores contributed to explain the experimental pain intensity and tolerance. Gender only influenced the experimental pain threshold, as men had statistically significant higher heat pain threshold than women.ConclusionThis study shows that PSQ is a valid and reliable questionnaire and might be a promising instrument for assessing pain sensitivity in Norwegian clinical settings. Further studies are needed to examine whether the PSQ can be used in clinical settings to predict postoperative pain and the development of chronic pain.

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Association between quantitative sensory testing, treatment choice, and subsequent pain reduction in vulvar vestibulitis syndrome

Cited by 64 publications

References 41 publications

Experimental pain phenotyping in community-dwelling individuals with knee osteoarthritis

Experimental pain phenotyping in community-dwelling individuals with knee osteoarthritis

Recent advances in understanding provoked vestibulodynia

Validation of the Norwegian Pain Sensitivity Questionnaire

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