Dynamic, but not static, pain sensitivity predicts exercise-induced muscle pain: Covariation of temporal sensory summation and pain intensity

Abstract

Cross-section studies suggest that measures of pain sensitivity, derived from quantitative sensory testing (QST), are elevated in persons with chronic pain conditions. However, little is known about whether development of chronic pain is preceded by elevated pain sensitivity or pain sensitivity increases as a result of prolonged experience of pain. Here we used QST to test static (single suprathreshold stimuli) and dynamic (temporal sensory summation) pain processing of thermal stimuli. Muscle pain was induced using high-intensity exercise (DOMS). Multi-level modeling approaches determined the daily covariation among static and dynamic QST measures and pain intensity. Variation in responses to static pain sensitivity was not associated with pain intensity from DOMS while, in contrast, variation in dynamic pain sensitivity was positively associated with variation in pain intensity from DOMS. This finding supports the use of TSS as a marker of the central pain state and potentially as an appropriate measure for treatment monitoring.

Alterations in Temporal Summation of Pain and Conditioned Pain Modulation Across an Episode of Experimental Exercise-Induced Low Back Pain

“…Further, prolonged experimental pain models, such as delayed-onset muscle soreness (DOMS) following unaccustomed eccentric exercise, can induce soreness lasting for several days, mimicking the deep, movement-evoked pain and functional impairment seen in mild non-specific LBP patients 6 . Prior experimental work has demonstrated that DOMS increases TSP magnitude over painful muscles 22,47 and in nearby regions 5 . However, changes in TSP over distant testing sites outside the painful region (which may better indicate central pain processing changes) as is assessed and often altered in clinical populations 65,66 , as well as changes in CPM, have not been investigated in this LBP-model.…”

“…For instance, TSP and CPM, assessed pre-operatively in painfree patients undergoing thoracotomy, demonstrated predictive value in determining postoperative pain intensity 70,75 . TSP and CPM magnitude in people with pain conditions can also relate to the intensity of pain experienced 5,49,65 , suggesting fluctuations in TSP and CPM may be consequential to pain 2,15 . In line with this suggestion, clinical studies have demonstrated improvements in CPM and pain sensitivity following replacement of painful osteoarthritic joints 18,30 , and experimental studies have shown impaired CPM following painful saline injection 2 .…”

“…Two-way RM-ANOVA of PPTs for Site (5) and Time (3) showed a Time*Site interaction ( Fig. 3; Assessment-number (F 2,46 = 42.56, P<0.001, η 2 = 0.65); with cPTT greater at Day-7 than Day-0 (P<0.009) and Day-2 (P<0.001), and the second (P<0.001) and third (P<0.001) assessment greater than first.…”

Pain following cancer treatment: Guidelines for the clinical classification of predominant neuropathic, nociceptive and central sensitization pain

“…The required equipment is available in many specialized pain centers. Many QST protocols are available [36][37][38][39], however they require further study, but its wider use may be hampered by its costs, complexity and time-consuming nature.…”

Movement restriction does not modulate sensory and perceptual effects of exercise-induced arm pain

“…In healthy volunteers, exercise-induced muscle soreness of the lower back was associated with higher heat-evoked pain ratings over lumbar dermatomes (Bishop et al 2012). Interestingly, dynamic pain processing, i.e.…”