Johnston Venerina, Jimmieson Nerina L, Jull Gwendolen, Souvlis Tina
Division of Physiotherapy, School of Health and Rehabilitation Sciences, Level 7, Therapies Building 84A, The University of Queensland, St. Lucia, Qld 4072, Australia School of Psychology, The University of Queensland, Australia.
Pain. 2008 Jul 15;137(2):257-265. doi: 10.1016/j.pain.2007.08.037. Epub 2007 Oct 25.
This study was undertaken to investigate any relationship between sensory features and neck pain in female office workers using quantitative sensory measures to better understand neck pain in this group. Office workers who used a visual display monitor for more than four hours per day with varying levels of neck pain and disability were eligible for inclusion. There were 85 participants categorized according to their scores on the neck disability index (NDI): 33 with no pain (NDI<8); 38 with mild levels of pain and disability (NDI 9-29); 14 with moderate levels of pain (NDI30). A fourth group of women without neck pain (n=22) who did not work formed the control group. Measures included: thermal pain thresholds over the posterior cervical spine; pressure pain thresholds over the posterior neck, trapezius, levator scapulae and tibialis anterior muscles, and the median nerve trunk; sensitivity to vibrotactile stimulus over areas of the hand innervated by the median, ulnar and radial nerves; sympathetic vasoconstrictor response. All tests were conducted bilaterally. ANCOVA models were used to determine group differences between the means for each sensory measure. Office workers with greater self-reported neck pain demonstrated hyperalgesia to thermal stimuli over the neck, hyperalgesia to pressure stimulation over several sites tested; hypoaesthesia to vibration stimulation but no changes in the sympathetic vasoconstrictor response. There is evidence of multiple peripheral nerve dysfunction with widespread sensitivity most likely due to altered central nociceptive processing initiated and sustained by nociceptive input from the periphery.
本研究旨在通过定量感觉测量方法,调查女性办公室职员的感觉特征与颈部疼痛之间的关系,以便更好地了解该群体的颈部疼痛情况。每天使用视觉显示监视器超过四小时且颈部疼痛和功能障碍程度各异的办公室职员符合纳入标准。根据颈部功能障碍指数(NDI)得分,将85名参与者分为三类:33名无疼痛(NDI<8);38名有轻度疼痛和功能障碍(NDI 9 - 29);14名有中度疼痛(NDI30)。第四组为未工作的无颈部疼痛女性(n = 22),作为对照组。测量指标包括:颈椎后部的热痛阈值;颈部后部、斜方肌、肩胛提肌和胫骨前肌以及正中神经干的压痛阈值;正中神经、尺神经和桡神经支配的手部区域对振动触觉刺激的敏感性;交感神经血管收缩反应。所有测试均双侧进行。采用协方差分析模型确定各感觉测量指标均值之间的组间差异。自我报告颈部疼痛较重的办公室职员在颈部对热刺激表现为痛觉过敏,在多个测试部位对压力刺激表现为痛觉过敏;对振动刺激表现为感觉减退,但交感神经血管收缩反应无变化。有证据表明存在多根周围神经功能障碍,伴有广泛的感觉敏感,这很可能是由于外周伤害性输入启动并维持了中枢伤害性处理过程的改变所致。