Pain Research and Intervention Center of Excellence (PRICE) at the University of Florida, Gainesville, Florida; Department of Community Dentistry and Behavioral Science, the University of Florida, Gainesville, Florida; Department of Health and Exercise Science, University of Oklahoma, Norman, Oklahoma.
Department of Health and Exercise Science, University of Oklahoma, Norman, Oklahoma.
J Pain. 2022 Nov;23(11):1923-1932. doi: 10.1016/j.jpain.2022.06.010. Epub 2022 Jul 22.
Pain is a common symptom reported in COVID-19 patients. Impaired endogenous pain-modulatory mechanisms such as conditioned pain modulation (CPM), and exercise-induced hypoalgesia (EIH) have been found in chronic pain conditions but is often overlooked in acute conditions that evoke painful symptoms, such as COVID-19. The purpose was to compare pressure-pain sensitivity, CPM, and EIH function among individuals who previously had COVID-19, both symptomatically and asymptomatically, and a healthy control group. Pressure pain thresholds of 59 participants were assessed in the forearm and leg using a pressure algometer before and after 1) submersion of their dominant foot in cold water (2°C) for 1min; and 2) isometric knee extension performed to task-failure at 25% of their maximal contraction. The CPM response was attenuated in individuals who were infected with symptomatic COVID-19 (N = 26) compared to asymptomatic COVID-19 (N = 13) in arm (-1.0% ± 20.3 vs 33.3% ± 26.2; P < .001) and leg (12.8% ± 22.0 vs 33.8% ± 28.2; P = .014) and compared to controls (N = 20) in arm only (-1.0% ± 26.2 vs 23.4% ± 28.2; P = .004). The EIH response was not different between groups. CPM was impaired in individuals who had symptomatic COVID-19, which may have long-term implications on pain modulation. PERSPECTIVE: This study reveals that CPM was impaired in individuals who had symptomatic COVID-19 during the first wave of COVID-19, pre vaccine. These findings present a preliminary motive to study the long-term implications of COVID-19 and its effects on pain modulation.
疼痛是 COVID-19 患者常见的症状。在慢性疼痛情况下，已经发现内源性疼痛调节机制受损，如条件性疼痛调节（CPM）和运动引起的痛觉减退（EIH），但在引起疼痛症状的急性情况下，如 COVID-19，往往被忽视。本研究旨在比较先前患有 COVID-19（有症状和无症状）和健康对照组的个体的压力疼痛敏感性、CPM 和 EIH 功能。使用压力测痛计在前臂和腿部测量了 59 名参与者的压力疼痛阈值，在 1）将他们的优势脚浸入 2°C 的冷水中 1 分钟之后；和 2）在达到 25%最大收缩时进行等长膝关节伸展，直到达到任务失败。与无症状 COVID-19（N=13）相比，有症状 COVID-19（N=26）的个体的 CPM 反应在手臂（-1.0%±20.3 对 33.3%±26.2；P<.001）和腿部（12.8%±22.0 对 33.8%±28.2；P=.014）以及仅与对照组（N=20）相比，手臂的 CPM 反应减弱（-1.0%±26.2 对 23.4%±28.2；P=.004）。EIH 反应在各组之间没有差异。有症状 COVID-19 的个体的 CPM 受损，这可能对疼痛调节有长期影响。观点：本研究表明，在 COVID-19 第一波（疫苗前）期间，有症状 COVID-19 的个体的 CPM 受损。这些发现初步提示我们研究 COVID-19 的长期影响及其对疼痛调节的影响。
