Patients with Concomitant Chronic Neck Pain and Myofascial Pain in Masticatory Muscles Have More Widespread Pain and Distal Hyperalgesia than Patients with Only Chronic Neck Pain

Muñoz-García, Daniel; López‐de‐Uralde‐Villanueva, Ibai; Beltrán-Alacreu, Héctor; Fernández‐Carnero, Josué

doi:10.1093/pm/pnw274

Cited by 30 publications

(50 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…a chemokine implicated in pain induction; Saika, Kiguchi, Kobayashi, Fukazawa, & Kishioka, 2012), consistent with data in LBP indicating higher CRP and IL‐6 to be associated with higher pain intensity (Klyne et al., 2017). In neck pain, widespread hyperalgesia has been widely reported, primarily in WAD (Stone, Vicenzino, Lim, & Sterling, 2013) but also in NTNP (Lopez‐de‐Uralde‐Villanueva, Beltran‐Alacreu, Fernandez‐Carnero, Kindelan‐Calvo, & La Touche, 2016; Munoz‐Garcia, Lopez‐de‐Uralde‐Villanueva, Beltran‐Alacreu, La Touche, & Fernandez‐Carnero, 2017). This hyperalgesia has been attributed to central sensitization due to its widespread distribution at both local (neck) and distal (upper and lower limbs) sites, and sensitivity to a range of noxious stimuli (thermal, mechanical and electrical) (Curatolo et al., 2001; Stone et al., 2013; Van Oosterwijck et al., 2013).…”

Section: Discussionmentioning

confidence: 99%

Systemic inflammatory markers in neck pain: A systematic review with meta‐analysis

Farrell

Zoete

Cabot

et al. 2020

European Journal of Pain

View full text Add to dashboard Cite

Background and Objective Mechanisms underpinning symptoms in non‐traumatic neck pain (NTNP) and whiplash‐associated disorder (WAD) are not comprehensively understood. There is emerging evidence of systemic inflammation in musculoskeletal pain conditions, including neck and back pain. The aim of this systematic review was to determine if raised blood inflammatory markers are associated with neck pain. Databases and Data Treatment MEDLINE, EMBASE, Cochrane Library, CINAHL and Web of Science databases were searched. Two independent reviewers identified studies for inclusion and extracted data. Meta‐analysis was performed by random effects model to calculate standard mean differences (SMDs). Risk of bias of individual studies was assessed using the Newcastle–Ottawa Scale. Overall quality of evidence from meta‐analysis was assessed by Grades of Recommendation, Assessment, Development and Evaluation approach. Results In total, 10 studies were included comprising 706 participants. Three studies provided data for acute WAD, two for chronic WAD, four for chronic NTNP and one for chronic mixed WAD and NTNP. Meta‐analysis indicated increased interleukin 1β (SMD: 0.84 [95% CI 0.24, 1.44], p = .01, I2 = 59%) and tumour necrosis factor α (SMD: 0.59 [0.09, 1.09], p = .02, I2 = 45%) in chronic neck pain compared to controls, but no increase in monocyte chemoattractant protein‐1. Some inflammatory markers were associated with clinical variables (including pain intensity and disability). Quality of evidence was mostly low due to small samples and high heterogeneity. Conclusions Findings imply that raised blood inflammatory markers are present in chronic neck pain, which may represent an ongoing inflammatory process in this population. Significance This systematic review advances our understanding of neck pain pathophysiology by demonstrating the presence of systemic inflammation in chronic neck pain, in the form of raised IL‐1β and TNFα. Further, numerous inflammatory markers were associated with clinical variables, including pain intensity, disability and hyperalgesia. These findings imply that systemic inflammation may contribute to mechanisms underlying neck pain.

show abstract

Section: Discussionmentioning

confidence: 99%

Systemic inflammatory markers in neck pain: A systematic review with meta‐analysis

Farrell

Zoete

Cabot

et al. 2020

European Journal of Pain

View full text Add to dashboard Cite

show abstract

“…Moreover, alterations of pain processing have been investigated in patients with neck pain, showing local and distant mechanical hyperalgesia [18]. Regarding nociceptive processing alterations, other researchers have found that some subgroups of patients with chronic neck pain present generalized and bilateral hyperalgesia in addition to local hyperalgesia in the cervical region, as well as functional alterations such as decreased range of cervical movement [19][20][21]. Even in some subgroups, we have found that generalized pain is associated with psychosocial factors such as anxiety [20].…”

Section: Introductionmentioning

confidence: 99%

“…Regarding the management of neck pain and its related alterations, attentional distraction-defined as shifting the attention away from the pain-is a commonly used strategy. In this context, virtual reality (VR) is defined as a computing system used to create an artificial world in which users have the impression of being able to navigate and manipulate objects in it [19,20]. VR treatment is based on three basic elements: simulation, interaction and immersion.…”

Section: Introductionmentioning

confidence: 99%

Effects of Virtual Reality versus Exercise on Pain, Functional, Somatosensory and Psychosocial Outcomes in Patients with Non-specific Chronic Neck Pain: A Randomized Clinical Trial

Tejera

Beltrán-Alacreu

Cano‐de‐la‐Cuerda

et al. 2020

IJERPH

Self Cite

112

View full text Add to dashboard Cite

Background: Virtual reality (VR) applied to patients with neck pain is a promising intervention to produce positive effects when used alone or combined with exercise. Therefore, the objective of this manuscript is to compare the effects of VR versus exercise treatment on pain intensity, conditioned pain modulation (CPM), temporal summation (TS) and functional and somatosensory outcomes in patients with non-specific chronic neck pain (NS-CNP). Methods: A single-blinded, randomized clinical trial was carried out. A total sample of 44 patients with NS-CNP was randomized into a VR treatment group or neck exercises group. The intervention consisted of two treatment sessions per week, for four weeks and eight sessions. Four measurement moments (at baseline, immediately, 1 month, and 3 months after intervention) were considered. Pain intensity, CPM, TS, functional and somatosensory outcomes were measured. Results: Statistically significant differences were revealed for time factor (F = 16.40, p < 0.01, ηp2 = 0.28) and group*time interaction for kinesiophobia (F = 3.89, p = 0.01, ηp2 = 0.08) showing post-hoc differences in favor of the VR group at 3 months (p < 0.05, d = 0.65). Significant effects were shown for time factor (p < 0.05) but not for the group*time interaction (p > 0.05) for pain intensity, rotation range of motion (ROM), Neck Disability Index, pain catastrophizing, fear-avoidance beliefs, left side pressure pain threshold (PPT) and anxiety. Statistically significant differences were not found for time factor (p > 0.05) and neither in group*time interaction (p > 0.05) for CPM, TS, right side PPT, flexo-extension and lateral-flexion ROM. Conclusions: Kinesiophobia was the only outcome that showed differences between VR and exercise at 3 months. Nevertheless, pain intensity, CPM, TS, ROM, neck disability, pain catastrophizing, fear-avoidance beliefs, PPT and anxiety did not show differences between both interventions.

show abstract

“…Although previous research on pain expansion had also found statistically significant differences in terms of the age variable, the difference was not considered clinically relevant (Muñoz-García et al, 2016).…”

Section: Study Limitationsmentioning

confidence: 82%

Peer Review #2 of "Relationship between healthcare seeking and pain expansion in patients with nonspecific chronic low back pain (v0.2)"

Hoegh¹

2020

View full text Add to dashboard Cite

Low back pain (LBP) is the most prevalent musculoskeletal problem, which implies a high rate of chronicity. The chronicity of symptoms can lead to pain expansion. The main objective of this study was to assess whether there were differences between patients with nonspecific chronic LBP (CLBP) who sought healthcare compared to those who did not in terms of pain expansion. Methods: Ninety individuals participated in the study and were divided into 3 groups: 30 patients who sought care; 30 patients who did not seek care; and 30 asymptomatic individuals. The primary variable analyzed was pain expansion. Secondary physical and psychological variables were assessed later, and a regression analysis was performed. Results: Patients who sought help showed significant differences in pain expansion and pain intensity compared with the group who did not seek help, with a medium effect size (0.50-0.79). The regression model for the care-seeking group showed that dynamic balance with the left leg and depression were predictors of percentage pain surface area (34.6%). The combination of dynamic balance, range of movement in flexoextension and depression were predictors of widespread pain (48.5%). Conclusion: Patients whosoughtcare presented greater pain expansion than patients whodidnot. A combination of functional and psychological variables can significantly predict pain expansion in patients with nonspecific CLBP who seek help.

show abstract

Patients with Concomitant Chronic Neck Pain and Myofascial Pain in Masticatory Muscles Have More Widespread Pain and Distal Hyperalgesia than Patients with Only Chronic Neck Pain

Cited by 30 publications

References 72 publications

Systemic inflammatory markers in neck pain: A systematic review with meta‐analysis

Systemic inflammatory markers in neck pain: A systematic review with meta‐analysis

Effects of Virtual Reality versus Exercise on Pain, Functional, Somatosensory and Psychosocial Outcomes in Patients with Non-specific Chronic Neck Pain: A Randomized Clinical Trial

Peer Review #2 of "Relationship between healthcare seeking and pain expansion in patients with nonspecific chronic low back pain (v0.2)"

Contact Info

Product

Resources

About