Kelly Ickmans1, Anneleen Malfliet2, Margot De Kooning3, Lisa Goudman4, Ives Hubloue5, Tom Schmitz5, Dorien Goubert6, Maria Encarnacion Aguilar-Ferrandiz7. 1. Pain in Motion Research Group (www.paininmotion.be). 2. Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; Department of Physiotherapy, Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; "Pain in Motion" international research group, www.paininmotion.be. 3. Pain in Motion Research Group (www.paininmotion.be); Department of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium; Department of Neurology, Faculty of Medicine, University of Antwerp, Antwerp, Belgium. 4. Pain in Motion International Research Group (www.paininmotion.be); Department of Neurosurgery, University Hospital Brussels, Belgium; Department of Manual Therapy (MANU), Vrije Universiteit Brussel, Brussels, Belgium. 5. Department of Emergency Medicine, University Hospital Brussels, Brussels, Belgium. 6. Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium and Pain in Motion Research Group, www.paininmotion.be; Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium. 7. Department of Physical Therapy, University of Granada, Spain.
Abstract
BACKGROUND: Individuals with chronic whiplash associated disorders (WAD) present persistent pain in the absence of structural pathology. In these people, altered central pain processing and central sensitization are observed. The role of personal factors, such as gender and age, on pain processing mechanisms in chronic WAD, however, is still unclear. OBJECTIVES: This study investigated possible gender- and age-related differences in self-reported and experimental pain measurements in people with chronic WAD. Besides the exercise-induced response on pain measurements between gender and age subgroups was recorded. STUDY DESIGN: Case-control study. SETTING: University Hospital, Brussels. METHODS: Self-reported pain and experimental pain measurements (pressure pain thresholds [PPT], occlusion cuff pressure, temporal summation, and conditioned pain modulation) were performed in 52 individuals (26 chronic WAD patients and 26 healthy controls), before and after a submaximal cycle exercise. RESULTS: Lower PPTs and occlusion cuff pressures were shown in chronic WAD in comparison with healthy controls. No gender and age differences regarding PPTs, occlusion cuff pressures and conditioned pain modulation were found in chronic WAD. Within the chronic WAD group, men showed higher self-reported pain compared to women and younger adults showed enhanced generalized pain facilitation compared to older adults. In addition, chronic WAD patients are able to inhibit exercise-induced hyperalgesia, but no gender and age differences in pain response following exercise were found. LIMITATIONS: This study was sufficiently powered to detect differences between the chronic WAD and control group. However, a sufficient power was not reached when patients were divided in age and gender groups. Furthermore, only mechanical stimuli were included in the experimental pain measurements. Besides, psychosocial factors were not taken into account. CONCLUSION: Some alterations of altered pain processing are present in chronic WAD patients, however not in response to exercise. No gender and age differences in pain measurements were observed in people with chronic WAD.Key words: Neck pain, whiplash associated disorders, chronic pain, personal factors, age, gender, central sensitization, exercise induced hyperalgesia, pressure pain thresholds, self reported pain.
BACKGROUND: Individuals with chronic whiplash associated disorders (WAD) present persistent pain in the absence of structural pathology. In these people, altered central pain processing and central sensitization are observed. The role of personal factors, such as gender and age, on pain processing mechanisms in chronic WAD, however, is still unclear. OBJECTIVES: This study investigated possible gender- and age-related differences in self-reported and experimental pain measurements in people with chronic WAD. Besides the exercise-induced response on pain measurements between gender and age subgroups was recorded. STUDY DESIGN: Case-control study. SETTING: University Hospital, Brussels. METHODS: Self-reported pain and experimental pain measurements (pressure pain thresholds [PPT], occlusion cuff pressure, temporal summation, and conditioned pain modulation) were performed in 52 individuals (26 chronic WADpatients and 26 healthy controls), before and after a submaximal cycle exercise. RESULTS: Lower PPTs and occlusion cuff pressures were shown in chronic WAD in comparison with healthy controls. No gender and age differences regarding PPTs, occlusion cuff pressures and conditioned pain modulation were found in chronic WAD. Within the chronic WAD group, men showed higher self-reported pain compared to women and younger adults showed enhanced generalized pain facilitation compared to older adults. In addition, chronic WADpatients are able to inhibit exercise-induced hyperalgesia, but no gender and age differences in pain response following exercise were found. LIMITATIONS: This study was sufficiently powered to detect differences between the chronic WAD and control group. However, a sufficient power was not reached when patients were divided in age and gender groups. Furthermore, only mechanical stimuli were included in the experimental pain measurements. Besides, psychosocial factors were not taken into account. CONCLUSION: Some alterations of altered pain processing are present in chronic WADpatients, however not in response to exercise. No gender and age differences in pain measurements were observed in people with chronic WAD.Key words: Neck pain, whiplash associated disorders, chronic pain, personal factors, age, gender, central sensitization, exercise induced hyperalgesia, pressure pain thresholds, self reported pain.
Authors: Ernesto Anarte-Lazo; Carlos Bernal-Utrera; Mario Lopez-Amor; Eugenia Porras-Valencia; Francisco Javier Ruy-Diaz-Rojas; Deborah Falla; Cleofas Rodriguez-Blanco Journal: BMJ Open Date: 2022-09-22 Impact factor: 3.006