Bogus Visual Feedback Alters Onset of Movement-Evoked Pain in People With Neck Pain

Abstract

Pain is a protective perceptual response shaped by contextual, psychological, and sensory inputs that suggest danger to the body. Sensory cues suggesting that a body part is moving toward a painful position may credibly signal the threat and thereby modulate pain. In this experiment, we used virtual reality to investigate whether manipulating visual proprioceptive cues could alter movement-evoked pain in 24 people with neck pain. We hypothesized that pain would occur at a lesser degree of head rotation when visual feedback overstated true rotation and at a greater degree of rotation when visual feedback understated true rotation. Our hypothesis was clearly supported: When vision overstated the amount of rotation, pain occurred at 7% less rotation than under conditions of accurate visual feedback, and when vision understated rotation, pain occurred at 6% greater rotation than under conditions of accurate visual feedback. We concluded that visual-proprioceptive information modulated the threshold for movement-evoked pain, which suggests that stimuli that become associated with pain can themselves trigger pain.

How Real Is Unreal?

“…The results revealed that altered visual feedback might increase or decrease the pain perception based on the visual proprioceptive feedback. These results [21], [23] showed that AVF increased movement amplitudes in participants with chronic back/neck pain.…”

“…However, more recent studies using an Altered Visual Feedback strategy (AVF) suggests an alternative approach to pain management, which may be more appropriate for pain caused by physical movement [21,22,23]. …”

“…In addition, altered visual cues were also used to examine pain caused by neck movement [23]. In this study, patients with chronic neck pain were asked to rotate their heads.…”

“…However, there were some limitations in these studies [21], [23]. First, the visual feedback manipulation of both studies was small (e.g., up to 20%).…”

Defensive reflexes in people with pain – a biomarker of the need to protect? A meta-analytical systematic review

“…Indeed, a modern conceptualisation of pain (e.g. Moseley and Butler, 2015b) holds that pain is the end product of a complex evaluative process that is usually, but not necessarily, triggered by noxious stimuli (see Harvie et al (2015), Moseley (2004), and Moseley and Arntz (2007) for experimental evidence of the dissociation between nociception from pain and Madden et al (2015) for a systematic review of associative learning of pain). Thus, pain and lower reflex thresholds are more likely to reflect epiphenomena in much the same way as has been proposed for pain and motor control (Moseley, 2013).…”