Minimizing the source of nociception and its concurrent effect on sensory hypersensitivity: An exploratory study in chronic whiplash patients

The cervical zygapophyseal joints may be a primary source of pain in up to 60% of individuals with chronic WAD and may be a contributing factor for peripheral and centrally mediated pain (sensory hypersensitivity). Sensory hypersensitivity has been associated with a poor prognosis.

The purpose of the study was to determine if there is a change in measures indicative of sensory hypersensitivity in patients with chronic whiplash associated disorders (WAD) grade II following a medial branch block (MBB) procedure in the cervical spine.

Methods: Measures of sensory hypersensitivity were taken via quantitative sensory testing (QST) consisting of pressure pain thresholds (PPT's) and cold pain thresholds (CPT's). In patients with chronic WAD (n = 18), the measures were taken at three sites bilaterally, pre- and post- MBB.

Reduced pain thresholds at remote sites have been considered an indicator of central hypersensitivity. A healthy age and gender matched comparison group (n=18) was measured at baseline.

An independent t-test was applied to determineif there were any significant differences between the WAD and normative comparison groups at baseline with respect to cold pain and pressure pain thresholds. A dependent t-test was used to determine whether there were any significant differences between the pre and post intervention cold pain and pressure pain thresholds in the patients with chronic WAD.

Results: At baseline, PPT's were decreased at all three sites in the WAD group (p<0.001).

Cold pain thresholds were increased in the cervical spine in the WAD group (p<0.001). Post-MBB, the WAD group showed significant increases in PPT's at all sites (p<0.05), and significant decreases in CPT's at the cervical spine (p<0.001).

Conclusions: The patients with chronic WAD showed evidence of widespread sensory hypersensitivity to mechanical and thermal stimuli.

The WAD group revealed decreased sensory hypersensitivity following a decrease in their primary source of pain stemming from the cervical zygapophyseal joints.

Author: Geoff SchneiderAshley SmithAllen HooperPaul StratfordKathryn SchneiderMichael WestawayBevan FrizzellLee Olson
Credits/Source: BMC Musculoskeletal Disorders 2010, 11:29

Published on: 2010-02-09

Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please make sure to read our disclaimer prior to contacting 7thSpace Interactive. To contact our editors, visit our online helpdesk. If you wish submit your own press release, click here.

Comments Page 0 of 0

There are currently 0 comments to display.

+ Add New Comment

Custom Search