School of Physiotherapy, Curtin University of Technology, Perth, Australia.
Eur J Pain. 2011 Feb;15(2):146-52. doi: 10.1016/j.ejpain.2010.06.010. Epub 2010 Jul 6.
This investigation aimed to quantify and compare sensory responses to hypertonic saline-induced pain in the tendoachilles and the common extensor tendon of the elbow. Healthy subjects (n=14; seven males) received in randomised order, injections of sterile saline (0.5ml, 5.8% hypertonic or 0.9% isotonic saline) at each tendon bilaterally at two sessions separated by one week. Mechanical sensitivity (pressure pain threshold), muscle pain intensity (visual analogue scale; VAS area-under-curve, pain duration, peak pain) and pain distribution were assessed pre, immediately after and post saline injection. Hypertonic saline-induced pain intensity (VAS area-under-curve, duration and peak) was significantly greater compared with control injections (P<0.001) and induced significantly greater VAS area (P<0.01) and longer pain duration (P<0.001) in tendoachilles compared with the common extensor tendon. Regardless of saline type and compared with pre and post injection, mechanical sensitivity increased significantly (P<0.01) immediately after injections at all injected tendon sites. Hypertonic saline-induced referred pain was infrequent (tendoachilles: n=3 and common extensor tendon: n=4). Significant maximal force attenuation occurred immediately after hypertonic saline injections in both tendons (P<0.001) compared with control injections. The greater induced deep tissue pain and hyperalgesia demonstrated at tendoachilles compared with the common extensor tendon may relate to anatomical differences such as higher nociceptor density or increased vascular perfusion at the injection site. This translational tendon pain model may contribute to the further understanding of pain mechanisms in tendinopathic conditions.
本研究旨在定量比较和比较跟腱和肘部伸肌腱对高渗盐水诱导疼痛的感觉反应。健康受试者（n=14；男性 7 名）在两次间隔一周的会议中，以随机顺序接受双侧各肌腱的无菌盐水（0.5ml，5.8%高渗或 0.9%等渗盐水）注射。在注射前、立即和注射后评估机械敏感性（压痛阈值）、肌肉疼痛强度（视觉模拟量表；VAS 曲线下面积、疼痛持续时间、峰值疼痛）和疼痛分布。与对照注射相比，高渗盐水引起的疼痛强度（VAS 曲线下面积、持续时间和峰值）明显更大（P<0.001），并在跟腱中引起明显更大的 VAS 面积（P<0.01）和更长的疼痛持续时间（P<0.001）与常见的伸肌腱相比。无论盐水类型如何，与注射前和注射后相比，所有注射肌腱部位的机械敏感性在注射后立即显著增加（P<0.01）。高渗盐水引起的牵涉痛很少见（跟腱：n=3，常见伸肌腱：n=4）。与对照注射相比，高渗盐水注射后立即在两个肌腱中发生显著的最大力衰减（P<0.001）。与常见伸肌腱相比，跟腱中诱导的深部组织疼痛和痛觉过敏更大，可能与解剖学差异有关，例如注射部位的伤害感受器密度较高或血管灌注增加。这种翻译后的肌腱疼痛模型可能有助于进一步了解肌腱病条件下的疼痛机制。
