Summers Simon J, Schabrun Siobhan M, Hirata Rogerio P, Graven-Nielsen Thomas, Cavaleri Rocco, Chipchase Lucy S
School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia.
Neuroscience Research Australia, Sydney, New South Wales, Australia.
Pain Rep. 2019 Apr 2;4(3):e737. doi: 10.1097/PR9.0000000000000737. eCollection 2019 May-Jun.
Joint position sense (JPS) is impaired in clinical musculoskeletal pain conditions, but when this impairment develops in the transition from initial to prolonged pain is not known.
This study assessed whether progressively developing sustained experimentally induced muscle pain impacts JPS in healthy individuals.
Twenty-eight healthy individuals received injection of nerve growth factor (NGF) into the right extensor carpi radialis brevis muscle on days 0 and 2 to induce sustained pain and hyperalgesia. Wrist JPS was assessed 2 days before day 0 (day -2), before the injection on days 0 and 2, and on days 4 and 14. Joint position sense was quantified as the ability to return the wrist to a neutral position following movements in the direction of radial and ulnar deviation. A 3-dimensional motion analysis system was used to calculate absolute, relative, and joint-angle repositioning errors. Numerical rating scale scores of pain intensity, body chart pain drawings, and pressure pain thresholds (PPTs) were recorded on each day.
Compared with baseline, pressure pain thresholds decreased while pain intensity and area increased at day 2 ( < 0.001) and day 4 ( < 0.001) before returning to baseline on day 14 ( > 0.13). Relative to day 0, there was no change in wrist JPS at day 2, 4, and 14 following movements in either target direction ( > 0.05).
Despite the presence of sustained muscle pain and hyperalgesia for 4 days at the elbow, no statistical change in wrist joint position error was observed. These findings suggest that pain and hyperalgesia lasting as long as 4 days does not impair JPS.
在临床肌肉骨骼疼痛病症中,关节位置觉(JPS)会受损,但尚不清楚这种损伤在从初始疼痛转变为持续性疼痛的过程中是何时出现的。
本研究评估了在健康个体中,逐渐发展的持续性实验性诱导肌肉疼痛是否会影响关节位置觉。
28名健康个体在第0天和第2天接受了向右侧桡侧腕短伸肌注射神经生长因子(NGF),以诱导持续性疼痛和痛觉过敏。在第0天(-2天)前2天、第0天和第2天注射前以及第4天和第14天评估腕关节位置觉。关节位置觉通过在桡偏和尺偏方向运动后将手腕恢复到中立位置的能力来量化。使用三维运动分析系统计算绝对、相对和关节角度重新定位误差。每天记录疼痛强度的数字评分量表分数、身体图表疼痛绘图和压痛阈值(PPTs)。
与基线相比,在第2天(<0.001)和第4天(<0.001)时压痛阈值降低,而疼痛强度和面积增加,在第14天恢复到基线水平(>0.13)。相对于第0天,在第2天、第4天和第14天无论向哪个目标方向运动,腕关节位置觉均无变化(>0.05)。
尽管肘部存在持续4天的肌肉疼痛和痛觉过敏,但未观察到腕关节位置误差有统计学变化。这些结果表明,长达4天的疼痛和痛觉过敏不会损害关节位置觉。