BACKGROUND: Chronic pain is a significant problem for patients with lower extremity injuries. While pain hypersensitivity has been identified in many chronic pain conditions, it is not known whether patients with chronic pain following lower extremity fracture report pain hypersensitivity in the injured leg. PURPOSE: To quantify and compare peripheral somatosensory function and sensory nerve activation thresholds in persons with chronic pain following lower extremity fractures with a cohort of persons with no history of lower extremity fractures. METHOD: This was a cross-sectional study where quantitative sensory testing and current perception threshold testing were conducted on the injured and noninjured legs of cases and both legs of controls. RESULTS: A total of 14 cases and 28 controls participated in the study. Mean time since injury at the time of testing for cases was 22.3 (standard deviation = 12.1) months. The warmth detection threshold ( p = .024) and nerve activation thresholds at 2,000 Hz ( p < .001) and 250 Hz ( p = .002), respectively, were significantly higher in cases compared to controls. CONCLUSION: This study suggests that patients with chronic pain following lower extremity fractures may experience hypoesthesia in the injured leg, which contrasts with the finding of hyperesthesia previously observed in other chronic pain conditions but is in accord with patients with nerve injuries and surgeries. This is the first study to examine peripheral sensory nerve function at the site of injury in patients with chronic pain following lower extremity fractures using quantitative sensory testing and current perception threshold testing.
BACKGROUND:Chronic pain is a significant problem for patients with lower extremity injuries. While painhypersensitivity has been identified in many chronic pain conditions, it is not known whether patients with chronic pain following lower extremity fracture report painhypersensitivity in the injured leg. PURPOSE: To quantify and compare peripheral somatosensory function and sensory nerve activation thresholds in persons with chronic pain following lower extremity fractures with a cohort of persons with no history of lower extremity fractures. METHOD: This was a cross-sectional study where quantitative sensory testing and current perception threshold testing were conducted on the injured and noninjured legs of cases and both legs of controls. RESULTS: A total of 14 cases and 28 controls participated in the study. Mean time since injury at the time of testing for cases was 22.3 (standard deviation = 12.1) months. The warmth detection threshold ( p = .024) and nerve activation thresholds at 2,000 Hz ( p < .001) and 250 Hz ( p = .002), respectively, were significantly higher in cases compared to controls. CONCLUSION: This study suggests that patients with chronic pain following lower extremity fractures may experience hypoesthesia in the injured leg, which contrasts with the finding of hyperesthesia previously observed in other chronic pain conditions but is in accord with patients with nerve injuries and surgeries. This is the first study to examine peripheral sensory nerve function at the site of injury in patients with chronic pain following lower extremity fractures using quantitative sensory testing and current perception threshold testing.
Authors: Robert H Dworkin; Dennis C Turk; Dennis A Revicki; Gale Harding; Karin S Coyne; Sarah Peirce-Sandner; Dileep Bhagwat; Dennis Everton; Laurie B Burke; Penney Cowan; John T Farrar; Sharon Hertz; Mitchell B Max; Bob A Rappaport; Ronald Melzack Journal: Pain Date: 2009-04-07 Impact factor: 6.961
Authors: Owen D Williamson; Grad Dip Clin Epi; Belinda J Gabbe; B Physio; Peter A Cameron; Elton R Edwards; Martin D Richardson Journal: J Orthop Trauma Date: 2009-02 Impact factor: 2.512
Authors: Kristen R Weaver; Mari A Griffioen; N Jennifer Klinedinst; Elizabeth Galik; Ana C Duarte; Luana Colloca; Barbara Resnick; Susan G Dorsey; Cynthia L Renn Journal: Front Pain Res (Lausanne) Date: 2022-01-28