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在被动颈部旋转时可再现单侧颈部疼痛的女性中,局部和广泛的压痛性痛觉过敏并无侧别特异性。

Local and Widespread Pressure Pain Hyperalgesia Is Not Side Specific in Females with Unilateral Neck Pain that Can Be Reproduced during Passive Neck Rotation.

作者信息

Piña-Pozo Fernando, Heredia-Rizo Alberto Marcos, Madeleine Pascal, Escobio-Prieto Isabel, Luque-Carrasco Antonio, Oliva-Pascual-Vaca Ángel

机构信息

Physiotherapy Department, University School Francisco Maldonado, University of Seville, 41640 Osuna, Spain.

Health Area of Osuna, Andalusian Health Service, 41640 Osuna, Spain.

出版信息

J Clin Med. 2019 Aug 18;8(8):1246. doi: 10.3390/jcm8081246.

Abstract

Current evidence for widespread hyperalgesia in non-specific neck pain (NSNP) is unclear. It is currently recommended to group NSNP patients according to pain-provoking movements. The aim of this study was to investigate local and widespread pain sensitivity in females with unilateral NSNP that is reproducible during passive neck rotation compared with matched controls, and to compare the side specific effect of pain location on pressure pain sensitivity among females with unilateral NSNP. Thirty-six females with unilateral NSNP evoked during passive ipsilateral ( = 20) or contralateral ( = 16) rotation toward the painful side were compared with 20 controls. Participants reported their pain intensity at rest and during passive neck rotation and completed the Neck Disability Index. Pressure pain thresholds (PPTs) were assessed bilaterally over the anterior scalene; the sternocleidomastoid; the levator scapulae; lateral to the spinous process of C6; the median, ulnar, and radial nerves; and the tibialis anterior. The ANOVA revealed lower PPTs in females with unilateral NSNP compared with the controls (all at < 0.001), but no differences were found between the sides, nor was there any Group × side interaction. Among females with NSNP, those with higher pain intensity during ipsilateral rotation toward the painful side showed lower PPTs over the anterior scalene, median nerve, ulnar nerve, and tibialis anterior (all, < 0.05) than females with higher pain intensity during contralateral rotation toward the painful side. These findings demonstrated bilateral local and widespread pressure pain hyperalgesia in females with unilateral NSNP that was reproducible during passive neck rotation compared with controls. There was no side specific effect of pain location on PPTs among females with unilateral NSNP.

摘要

目前关于非特异性颈部疼痛(NSNP)中广泛存在痛觉过敏的证据尚不清楚。目前建议根据引发疼痛的动作对NSNP患者进行分组。本研究的目的是调查与匹配的对照组相比,在被动颈部旋转时可再现的单侧NSNP女性的局部和广泛疼痛敏感性,并比较单侧NSNP女性中疼痛部位对压痛敏感性的侧别特异性影响。将36名在被动向患侧同侧(n = 20)或对侧(n = 16)旋转时诱发单侧NSNP的女性与20名对照组进行比较。参与者报告了他们休息时和被动颈部旋转时的疼痛强度,并完成了颈部功能障碍指数。在双侧的前斜角肌、胸锁乳突肌、肩胛提肌、C6棘突外侧、正中神经、尺神经、桡神经以及胫前肌处评估压痛阈值(PPTs)。方差分析显示,与对照组相比,单侧NSNP女性的PPTs较低(均P < 0.001),但两侧之间未发现差异,也没有组×侧交互作用。在患有NSNP的女性中,与向患侧对侧旋转时疼痛强度较高的女性相比,向患侧同侧旋转时疼痛强度较高的女性在前斜角肌、正中神经、尺神经和胫前肌处的PPTs较低(均P < 0.05)。这些发现表明,与对照组相比,单侧NSNP女性在被动颈部旋转时可再现双侧局部和广泛的压痛觉过敏。在单侧NSNP女性中,疼痛部位对PPTs没有侧别特异性影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6c9/6723679/22b36ffca02f/jcm-08-01246-g001.jpg

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