Central Hypersensitivity in Chronic Pain After Whiplash Injury

Abstract

The authors found a hypersensitivity to peripheral stimulation in whiplash patients. Hypersensitivity was observed after cutaneous and muscular stimulation, at both neck and lower limb. Because hypersensitivity was observed in healthy tissues, it resulted from alterations in the central processing of sensory stimuli (central hypersensitivity). Central hypersensitivity was not dependent on a nociceptive input arising from the painful and tender muscles.

The clinical presentation of chronic whiplash and the relationship to findings of MRI fatty infiltrates in the cervical extensor musculature: a preliminary investigation

“…It is noteworthy that PPT_remote, in tandem with CPT, held in the regression model for TUF (P = 0.1). This may align with previous work demonstrating that chronic WAD can result in findings of not just local, but rather widespread abnormal pain processing [2,10,52]. However, the direction of the association between PPT_local, TF (P = 0.09) and TUF (P = 0.1) was inverse (e.g., those with higher fat content had higher thresholds) and this is more difficult to explain.…”

“…Whilst nerve root avulsion is not likely the cause of chronic pain in whiplash, it is possible that a cause of these muscular changes in patients with chronic WAD could be the result of minor or major nerve injury. Such a condition could contribute to the development of neuropathic pain and align with the features of augmented central pain processing found in some patients with chronic WAD [10,50].…”

“…The presence of cold hyperalgesia and other alterations in the central nervous systems' ability to process pain (e.g., widespread mechanical and pressure pain thresholds (PPT)) have also been identified by others [2,29,50]. It is suggested that some of these changes are potentially irreversible [10]. It is noteworthy that PPT_remote, in tandem with CPT, held in the regression model for TUF (P = 0.1).…”

Pressure Algometry: What Does It Really Tell Us?

“…Lowered pain thresholds over uninjured body areas are considered to likely represent central phenomena. 2 In the clinical setting, it has been advocated that physical therapists consider nociceptive processing in their assessment of people with musculoskeletal pain. 6 The challenge in this regard is to clearly identify such processes in individual patients.…”

Probing the equatorial groove of the hookworm protein and vaccine candidate antigen, Na-ASP-2

“…has been reported as a selective activator of SK2 and SK3 channels (Hougaard et al, 2007), and several selective small molecule channel blockers have been developed (Chen et al, 2000;Faber & Sah, 2002). Neuron hyper-excitability is an essential component of many disorders of the central nervous system (Curatolo et al, 2001), and also plays a role in the molecular basis of addiction (Koob & Le Moal, 2001) and autoimmune disorders (Hart et al, 2002). In particular, it produces enhanced pain transmission in the spinal dorsal horn after spinal cord injury (Gwak & Hulsebosch, 2011).…”