Quantitative sensory testing somatosensory profiles in patients with cervical radiculopathy are distinct from those in patients with nonspecific neck–arm pain

Tampin, Brigitte; Slater, Helen; Hall, Toby; Lee, Gabriel; Briffa, N. Kathryn

doi:10.1016/j.pain.2012.08.007

Cited by 76 publications

(113 citation statements)

References 84 publications

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“…Although bidirectional sensory abnormalities were also evident in individuals with cervical radiculopathy, it was notable that 35% of the cervical radiculopathy group presented with no sensory abnormality when assessed using QST. The presence of bidirectional sensory abnormalities in both groups in this study is consistent with data from a similar cohort of people with neck and arm pain, 34 as well as other cohorts with neuropathies and complex regional pain syndrome. 5,6 This further supports the argument for the assessment of sensory phenotypes in patient populations on the basis that heterogeneity with respect to sensory phenotypes exists within patient cohorts; hence, people with the same condition could warrant different approaches to assessment and treatment.…”

Section: Sensory Phenotypes In Nsap and Cervical Radiculopathysupporting

confidence: 91%

Divergent Sensory Phenotypes in Nonspecific Arm Pain: Comparisons With Cervical Radiculopathy

Moloney¹,

Hall²,

Doody³

2015

Archives of Physical Medicine and Rehabilitation

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Section: Sensory Phenotypes In Nsap and Cervical Radiculopathysupporting

confidence: 91%

Divergent Sensory Phenotypes in Nonspecific Arm Pain: Comparisons With Cervical Radiculopathy

Moloney¹,

Hall²,

Doody³

2015

Archives of Physical Medicine and Rehabilitation

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“…Our results are also consistent with a recent study that indicated distinct somatosensory profiles (QST sensory profile evaluation) in patients with nonspecific neck-arm pain versus cervical radiculopathy, despite having common pain characteristics. 63 The optimal CPT protocols for patients with MND were not determined by this study, and defining clear criteria can be difficult, because the nature of the sensory symptoms reported in cervical pathology can be diffuse. We found that the 250-Hz test (which has the capacity to assess thin myelinated Aδ-fiber/pain fiber) for the middle-finger assessment (which targets the C7 nerve root and dermatome) was the strongest predictor of MND III.…”

Section: Discussionmentioning

confidence: 87%

The Current Perception Threshold Test Differentiates Categories of Mechanical Neck Disorder

Uddin

MacDermid²,

Galea³

et al. 2014

J Orthop Sports Phys Ther

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“…In previous studies, systematic TT increases in cervical dermatomes of patients with chronic cervicobrachialgia were reported (Voerman et al, 2000), and sensory disturbances in the hands were found to be associated with neck pain (Reading et al, 2003). However, in the study by Tampin et al (2012), patients with non-specific neck-arm pain associated with heightened nerve mechanosensitivity did not show such sensory disorders. In our study, TT values and within-hand variability differed between the three subgroups and were highest in NNP with unilateral pain.…”

Section: Discussionmentioning

confidence: 87%

“…Systematic TT elevations have previously been demonstrated in patients with chronic cervicobrachialgia (Voerman et al, 2000). However, patients with non-specific neckarm pain associated with heightened nerve mechanosensitivity did not show the sensory alterations in the maximal pain area and dermatome that were shown by those with cervical radiculopathy (Tampin et al, 2012). Several techniques exist to assess abnormalities in small nerve fiber function.…”

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confidence: 96%

Sensory and sympathetic disorders in chronic non-specific neck pain

Zaproudina¹

2015

Functional Neurology

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SummaryThe signs of sympathetic and sensory nerve-related disorders are not widely investigated in chronic nonspecific neck pain (NNP) patients. Thus, we performed skin temperature (Tsk), evaporation and touch threshold (TT) measurements to reveal possible dysfunctions at the fingertips of NNP patients (n=60) compared with healthy controls (n=11). Neck pain intensity was the main modifier of Tsk, and age the main modifier of TT in a multivariate model. On comparisons of the subgroups of NNP patients with unilateral (n=26) and bilateral (n=34) symptoms and controls, TT differed and Tsk tended to differ, the unilateral pain patients being found to demonstrate higher TT values on both sides. Interrelations between the measured parameters were found in the controls, but not in the patients. The NNP patients exhibited signs of functional impairment of innervation reflected in changes in tactile sensitivity and vasoactive sympathetic function. These changes may be based on both central and peripheral mechanisms, which possibly differ in patients with unilateral and bilateral symptoms. KEY WORDS: chronic non-specific neck pain, skin surface evaporation, skin temperature, sympathetic nervous system function; touch thresholds IntroductionChronic neck pain is a very common problem in Western countries. In Finland, the incidence of the condition has been reported to be 15% in women and 9% in men (Kääriä et al., 2012). In a Finnish study, Sensory and sympathetic disorders in chronic non-specific neck pain pain was found to be the reason for 40% of visits to primary care physicians, and neck pain was one of the most common types of pain reported (Mäntyselkä et al., 2001). All the structures in the neck and shoulder area (i.e. bones, nerves, discs, ligaments, muscles, facet joints and dura) are capable of evoking pain when irritated (Bogduk, 1984;Borghouts et al., 1998). In the majority of cases, however, no specific cause of the pain can be detected and these patients have been classified as affected by non-specific neck pain (NNP) with a predominantly mechanical and degenerative background (Bogduk, 1984). Hence, pathological findings are only minor in neck pain. Nerve conduction studies can detect nerve lesions but they do not provide information on small nerve fiber function. Moreover, measurement methods serving to evaluate the function of sensory and sympathetic fibers are less used in patients without signs of radiculopathy. However, an association between neck pain and sensory disorders in the hands has previously been described (Reading et al., 2003), as has the presence of sensory and sympathetic disorders, consistent with a minor neuropathy, in non-specific arm pain (Greening, 2006). The use of Semmes-Weinstein monofilaments to measure touch thresholds (TTs) is an old method of assessing sensory fiber function (Semmes et al., 1960;Bell-Krotoski and Tomancik, 1987). Systematic TT elevations have previously been demonstrated in patients with chronic cervicobrachialgia (Voerman et al., 2000). However, patients with non...

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Quantitative sensory testing somatosensory profiles in patients with cervical radiculopathy are distinct from those in patients with nonspecific neck–arm pain

Cited by 76 publications

References 84 publications

Divergent Sensory Phenotypes in Nonspecific Arm Pain: Comparisons With Cervical Radiculopathy

Divergent Sensory Phenotypes in Nonspecific Arm Pain: Comparisons With Cervical Radiculopathy

The Current Perception Threshold Test Differentiates Categories of Mechanical Neck Disorder

Sensory and sympathetic disorders in chronic non-specific neck pain

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