Pain intensity and pressure pain thresholds after a light dynamic physical load in patients with chronic neck-shoulder pain

Abstract

Background: To investigate the development of pain intensity and pressure pain thresholds during and 24 h after a light dynamic physical load among patients with chronic neck-shoulder pain. Methods: Twenty-six patients with chronic neck-shoulder pain and 12 healthy controls were included. The participants arm-cycled on an ergometer. Effort was rated with the Borg Rating of Perceived Exertion scale (RPE), and pain intensity with an numeric rating scale (NRS). Pressure pain thresholds were measured by an algometer. Participants started a pain diary 1 week before the physical exercise and continued until 1 week after. Pain intensity was assessed before, during and the following two evenings after arm-cycling. Pressure pain thresholds were assessed before, 15 min after, 105 min after and 24 h after. Results: The chronic pain group showed increased pain intensity during, and the following two evenings after the arm cycling, and decreased pain thresholds immediately after the arm cycling involving painful regions. In the patient group there were no impact on pain thresholds in the neck the following day. Conclusions: Patients with chronic neck-shoulder pain reported increased pain intensity during and in the evenings after a light dynamic load involving painful regions. In addition, they showed decreased pain thresholds close to the exercise, indicating mechanical hyperalgesia.

Impaired exercise‐induced hypoalgesia in individuals reporting an increase in low back pain during acute exercise

“…E.g. Kuithan et al (2019) observed increases in clinical pain and impaired EIH after repeated back exercises in 21 subjects with chronic LBP, and in a recent study on 26 patients with chronic neck and shoulder pain reduced PPTs and increases in clinical pain during light aerobic arm exercises and lasting for up to 2 days were reported (Grimby-Ekman et al, 2020).…”

Current Concept of Quantitative Sensory Testing and Pressure Pain Threshold in Neck/Shoulder and Low Back Pain

“…Forty-nine studies, in which the PPT of the neck–shoulder area was measured in patients with neck/shoulder pain and/or healthy volunteers, are listed in Table 2 [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ]. The subjects of studies of healthy volunteers, workers, children, and young adults without pain were also reported in 10 articles, shown at the bottom of Table 2 [ …”

“…In addition, several papers compared the data from healthy controls with those of the patients with chronic pain in the neck or shoulder. Nine articles showed the normative value, while data values in comparative tests ranged from 151 to 337 kPa at this area [ 33 , 34 , 35 , 40 , 41 , 47 , 48 , 49 , 53 , 55 , 56 , 57 , 58 , 59 , 65 ], again revealing variability in the data.…”

“…There were 39 studies that measured PPT in the neck–shoulder area of patients with neck/shoulder pain ( Table 2 ) [ 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ]. Algometers made by Somedic AB (units in kPa) and Wagner Instruments (units in kg/cm 2 ) were mainly used for PPT measurements, but more than 10 different devices were used in the articles.…”

“…The areas of PPT examination were the deltoid, trapezius, levator scapulae, semispinalis capitis, sternocleidomastoid, supraspinatus, and infraspinatus muscles, spinal processes, suboccipital muscles, and C5–C6 zygapophyseal joints. The trapezius muscle and levator scapulae were the most commonly evaluated areas of PPT [ 33 , 34 , 41 , 53 , 55 , 56 , 57 , 64 , 66 , 70 , 73 , 74 ], but the analyzed areas differed widely in the articles. The abnormal values of PPT in the trapezius muscle of the patients with chronic neck or shoulder pain were reported to vary from 151 to 411 kPa and 1.35 to 4.14 kg/cm 2 [ 33 , 34 , 41 , 53 , 55 , 56 , 57 , 64 ], with varying data depending on the device and units used.…”