UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, Belfield, Dublin 4, Ireland.
BMC Musculoskelet Disord. 2010 Jan 30;11:22. doi: 10.1186/1471-2474-11-22.
Work related upper limb disorders constitute 45% of all occupational diseases and are a significant public health problem. A subgroup, non specific arm pain (NSAP), remains elusive in terms of understanding its pathophysiological mechanisms with its diagnosis based on the absence of specific clinical findings. One commonly proposed theory is that a neural tissue disorder is the primary dysfunction in NSAP and findings from previous studies lend some support to this theory. However, it is not clear if changes identified are simply a consequence of ongoing pain rather than due to specific neural changes. The presence of neuropathic pain has been investigated in several other musculoskeletal conditions but currently, there is no specific diagnostic tool or gold standard which permits an unequivocal diagnosis of neuropathic pain. The purpose of this study is to further describe the somatosensory profiles in patients with NSAP and to compare these profiles to a group of patients with MRI confirmed cervical radiculopathy who have been previously classified as having neuropathic pain.
METHODS/DESIGN: Three groups of participants will be investigated: Groups 1 and 2 will be office workers with either NSAP or cervical radiculopathy and Group 3 will be a control group of non office workers without upper limb pain. Participants will undergo a clinical assessment, pain questionnaires (LANSS, Short Form McGill, DASH and TSK) and quantitative sensory testing comprising thermal detection and pain thresholds, vibration thresholds and pressure pain thresholds.
The spectrum of clinically suspected neuropathic pain ranges from more obvious conditions such as trigeminal neuralgia to those with vague signs of nerve disorder such as NSAP. A thorough description of the somatosensory profiles of NSAP patients and a comparison with a more defined group of patients with evidence of neuropathic pain will help in the understanding of underlying neurophysiology in NSAP and may influence future classification and intervention studies relating to this condition.
与工作相关的上肢疾病占所有职业病的 45%，是一个重大的公共卫生问题。其中一个亚组，非特异性手臂疼痛（NSAP），其病理生理机制难以理解，其诊断基于缺乏特定的临床发现。一种常见的理论是，神经组织障碍是 NSAP 的主要功能障碍，先前的研究结果为此理论提供了一些支持。然而，目前尚不清楚所确定的变化仅仅是持续疼痛的结果，还是由于特定的神经变化。在其他几种肌肉骨骼疾病中已经研究了神经性疼痛的存在，但目前，没有特定的诊断工具或金标准可以明确诊断神经性疼痛。本研究的目的是进一步描述 NSAP 患者的躯体感觉特征，并将这些特征与一组经 MRI 证实的患有神经根病的患者进行比较，这些患者以前被归类为患有神经性疼痛。
方法/设计：将研究三组参与者：第 1 组和第 2 组为患有 NSAP 或颈椎神经根病的办公室工作人员，第 3 组为无上肢疼痛的非办公室工作人员对照组。参与者将接受临床评估、疼痛问卷（LANSS、短表单麦吉尔、DASH 和 TSK）和定量感觉测试，包括热探测和疼痛阈值、振动阈值和压力疼痛阈值。
临床上疑似神经性疼痛的范围从更明显的疾病，如三叉神经痛，到那些有神经障碍模糊迹象的疾病，如 NSAP。对 NSAP 患者的躯体感觉特征进行全面描述，并与更明确的一组有神经性疼痛证据的患者进行比较，将有助于了解 NSAP 中的潜在神经生理学，并可能影响未来与该疾病相关的分类和干预研究。
