Nunes Alexandre, Petersen Kristian, Espanha Margarida, Arendt-Nielsen Lars
Biomechanics and Functional Morphology Laboratory , CIPER , Faculdade de Motricidade Humana da Universidade de Lisboa , Cruz-Quebrada , Portugal.
Escola Superior de Saúde Jean Piaget do Algarve, Silves, Portugal.
Scand J Pain. 2021 Feb 25;21(3):457-473. doi: 10.1515/sjpain-2020-0107. Print 2021 Jul 27.
Office workers with chronic neck pain demonstrates signs of widespread hyperalgesia, less efficient descending pain modulation, which could indicate sensitization of central pain pathways. No studies have assessed a wide variety of office workers with different chronic neck pain disorders and assessed the impact of pain intensity on assessments of central pain pathways. This study aimed to assessed pressure pain thresholds (PPTs), temporal summation of pain (TSP) and conditioned pain modulation (CPM) and to associate these with pain intensity and disability in subgroups of office workers.
One hundred-and-seventy-one office workers were distributed into groups of asymptomatic and chronic neck pain subjects. Chronic neck pain was categorized as chronic trapezius myalgia and chronic non-specific neck pain and as 'mild-pain' (Visual Analog Scale [VAS]≤3) and 'moderate-pain' (VAS>3) groups. PPTs, TSP, CPM, and Copenhagen Psychosocial Questionnaire II were assessed in all subjects. Neck Disability Index and Pain Catastrophizing Scale were assessed in all the symptomatic office workers.
PPTs were lower in moderate pain (n=49) and chronic trapezius myalgia (n=56) compared with asymptomatic subjects (n=62, p<0.05). TSP was facilitated in moderate pain group compared with mild pain (n=60, p<0.0001) group and asymptomatic subjects (p<0.0001). No differences were found in CPM comparing the different groups (p<0.05). Multiple regression analysis identified Neck Disability Index and TSP as independent factors for prediction of pain intensity in chronic trapezius myalgia (R=0.319) and chronic non-specific neck pain (R=0.208). Somatic stress, stress and sleep as independent factors in chronic non-specific neck pain (R=0.525), and stress in moderate pain group (R=0.494) for the prediction of disability.
Office workers with chronic trapezius myalgia and moderate pain intensity showed significant signs of widespread pressure hyperalgesia. Moreover, the moderate pain group demonstrated facilitated TSP indicating sensitization of central pain pathways. Neck Disability Index and TSP were independent predictors for pain intensity in pain groups. Sleep and stress were independent predictors for disability.
患有慢性颈部疼痛的办公室职员表现出广泛痛觉过敏、下行性疼痛调制效率降低的迹象，这可能表明中枢性疼痛通路致敏。尚无研究评估过患有不同慢性颈部疼痛疾病的各类办公室职员，也未评估疼痛强度对中枢性疼痛通路评估的影响。本研究旨在评估压力疼痛阈值（PPT）、疼痛时间总和（TSP）和条件性疼痛调制（CPM），并将这些指标与办公室职员亚组中的疼痛强度和残疾情况相关联。
171名办公室职员被分为无症状组和慢性颈部疼痛组。慢性颈部疼痛分为慢性斜方肌肌痛和慢性非特异性颈部疼痛，并进一步分为“轻度疼痛”（视觉模拟量表[VAS]≤3）和“中度疼痛”（VAS>3）组。对所有受试者评估PPT、TSP、CPM和哥本哈根心理社会问卷II。对所有有症状的办公室职员评估颈部残疾指数和疼痛灾难化量表。
与无症状组（n = 62，p<0.05）相比，中度疼痛组（n = 49）和慢性斜方肌肌痛组（n = 56）的PPT较低。与轻度疼痛组（n = 60，p<0.0001）和无症状组（p<0.0001）相比，中度疼痛组的TSP增强。比较不同组的CPM未发现差异（p<0.05）。多元回归分析确定，颈部残疾指数和TSP是慢性斜方肌肌痛（R = 0.319）和慢性非特异性颈部疼痛（R = 0.208）中疼痛强度预测的独立因素。躯体应激、应激和睡眠是慢性非特异性颈部疼痛（R = 0.525）以及中度疼痛组中残疾预测的独立因素（R = 0.494）。
患有慢性斜方肌肌痛且疼痛强度为中度的办公室职员表现出广泛压力性痛觉过敏的显著迹象。此外，中度疼痛组的TSP增强，表明中枢性疼痛通路致敏。颈部残疾指数和TSP是疼痛组中疼痛强度的独立预测因素。睡眠和应激是残疾的独立预测因素。
