Myrtveit S M, Skogen J C, Sivertsen B, Steingrímsdóttir Ó A, Stubhaug A, Nielsen C S
Department of Clinical Science, University of Bergen, Norway.
Division of Mental Health, Norwegian Institute of Public Health, Bergen, Norway.
Eur J Pain. 2016 Jul;20(6):949-58. doi: 10.1002/ejp.819. Epub 2015 Nov 16.
Pain is a cardinal symptom in individuals with whiplash-associated disorders (WAD). We aimed to compare pain characteristics between individuals with WAD and individuals reporting chronic pain from other causes, and to determine whether potential differences were accounted for by experimental pain tolerance.
Data from the 6th Tromsø Study (2007-2008, n = 12,981) were analysed. The number of painful locations was compared between individuals with WAD and individuals reporting chronic pain from other causes using negative binomial regression, pain frequency using multinomial logistic regression and pain intensity using multiple linear regression. Differences in experimental pain tolerance (cold pressor test) were tested using Cox regression; one model compared individuals with WAD to those with chronic pain from other causes, one compared the two groups with chronic pain to individuals without chronic pain. Subsequently, regression models investigating clinical pain characteristics were adjusted for pain tolerance.
Of individuals with WAD, 96% also reported other causes for pain. Individuals with WAD reported a higher number of painful locations [median (inter-quartile range): 5 (3.5-7) vs. 3 (2-5), p < 0.001] and higher pain intensity (crude mean difference = 0.78, p < 0.001) than individuals with chronic pain from other causes. Pain tolerance did not differ between these two groups. Compared to individuals without chronic pain, individuals with WAD and individuals with chronic pain from other causes had reduced pain tolerance.
Individuals with WAD report more additional causes of pain, more painful locations and higher pain intensity than individuals with chronic pain from other causes. The increased pain reporting was not accounted for by pain tolerance.
疼痛是挥鞭样损伤相关疾病（WAD）患者的主要症状。我们旨在比较WAD患者与因其他原因报告慢性疼痛的患者之间的疼痛特征，并确定实验性疼痛耐受性是否可解释潜在差异。
分析了第六次特罗姆瑟研究（2007 - 2008年，n = 12981）的数据。使用负二项回归比较WAD患者与因其他原因报告慢性疼痛的患者之间的疼痛部位数量，使用多项逻辑回归比较疼痛频率，使用多元线性回归比较疼痛强度。使用Cox回归测试实验性疼痛耐受性（冷加压试验）的差异；一个模型将WAD患者与因其他原因患慢性疼痛的患者进行比较，另一个模型将两组慢性疼痛患者与无慢性疼痛的患者进行比较。随后，针对疼痛耐受性对研究临床疼痛特征的回归模型进行调整。
WAD患者中，96%还报告了其他疼痛原因。与因其他原因患慢性疼痛的患者相比，WAD患者报告的疼痛部位更多[中位数（四分位间距）：5（3.5 - 7）对3（2 - 5），p < 0.001]，疼痛强度更高（粗均差 = 0.78，p < 0.001）。这两组之间的疼痛耐受性没有差异。与无慢性疼痛的患者相比，WAD患者和因其他原因患慢性疼痛的患者的疼痛耐受性降低。
与因其他原因患慢性疼痛的患者相比，WAD患者报告的额外疼痛原因更多、疼痛部位更多且疼痛强度更高。疼痛耐受性并不能解释疼痛报告的增加。
