Pressure pain thresholds in office workers with chronic neck pain: A systematic review and meta‐analysis

Abstract

Objectives The purpose of this study was to (a) compare pressure pain threshold (PPT) values between office workers with chronic neck pain and asymptomatic controls; (b) establish reference PPT values in chronic neck pain; and (c) evaluate associations between PPTs and pain intensity, and disability. Methods Seven English/Portuguese databases were searched for relevant literature. Studies investigating adult office workers (age >18 years) with chronic neck pain were included if PPTs were an outcome. The risk of bias was assessed using the Downs and Black checklist. Meta‐analysis was conducted if a cluster contained at least two studies reporting the same PPTs. Results Ten high quality, two low quality, and one poor quality studies were included. The meta‐analysis revealed decreased PPT values in the upper trapezius, extensor carpi ulnaris, and tibialis anterior in office workers with chronic neck pain when compared with healthy workers, without a statistical difference (p > 0.05). The PPT reference value in the upper trapezius was 263 kPa (95% confidence interval [CI] = 236.35 to 289.70), and 365 kPa (95% CI = 316.66 to 415.12) for the tibialis anterior in office workers with chronic neck pain. No correlations were found between the upper trapezius PPT and pain intensity and disability. Conclusion This meta‐analysis found that all the PPT measurements were not significantly reduced in office workers with chronic neck pain compared with healthy workers. These assumptions were based on a small sample of existing studies, and therefore further studies are necessary to quantify the differences in PPTs. Hypersensitivity PPT reference values are proposed for localized and extrasegmental sites in office workers with chronic neck pain.

Social inequalities in multimorbidity patterns in Europe: A multilevel latent class analysis using the European Social Survey (ESS)

“…It can be hypothesised that educational level and place of origin may have been critical factors in these differences. Like we have said, the “Back, Digestive and Headaches” pattern is a typical pattern of young/medium age people and it could be related with medium/high skilled technical work, with these pathologies being some of the most frequent in office/technique jobs ( Madeleine et al, 2013 ; Nunes et al, 2021 ), while the “Musculoskeletal” patterns are associated with manual and low skilled jobs and rural areas ( Docking et al, 2015 ; Stewart et al, 2014 ), as well as being associated with lower incomes.…”

Bedside clinical tests to assess sensitization in office workers with chronic neck pain

“…This study aimed to assess sensitization in office workers with chronic neck pain through simple bedside QST findings and by using an already published normative data set from PPT (Neziri et al 2011;Waller et al 2016) andCPM (Schliessbach et al 2019) in healthy subjects and from PPT in office workers with chronic neck pain (Nunes et al 2021).…”

“…Office workers were analyzed for pain sensitization using previously published normative data score according to the following criteria: a) PPT points were considered to be hypersensitive if values were below 155 kPa (upper trapezius) and 245 kPa (tibialis anterior) (Neziri et al 2011;Waller et al 2016;Nunes et al 2021). Since the scores from the above studies were found to be similar the lowest scores from Neziri et al (2011) were chosen as cutoff.…”

“…The current study used normative data and cut-off points for easiness of use in the clinical practice. For PPT assessment, the reference scores were established based on the ones previously reported in the literature (Neziri et al 2011;Waller et al 2016;Nunes et al 2021), which allowed us to identify the subjects with hypersensitivity PPT values in the upper trapezius and the tibialis anterior. Furthermore, the reference values from PPT hypersensitivity in the tibialis anterior identified as the non-painful region in subjects with chronic neck pain, suggest widespread pressure hyperalgesia which is a clinical sign of central sensitization (Arendt-Nielsen et al 2011;.…”

Effect of Manual Pressure Release and Scapular Stabilization Exercises on Myofascial Pain Syndrome Following Neck Dissection Surgery

“…To diagnose PPT of MPS, pressure algometry can be used [11] . Antidepressants, anticonvulsants, and muscle relaxants are among the medications used to treat MPS, while analgesic non-steroidal antiinflammatory drugs (NSAIDs) are widely recommended [5,12] .…”