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Investigation of central pain processing in shoulder pain: converging results from 2 musculoskeletal pain models.

Publication ,  Journal Article
Valencia, C; Kindler, LL; Fillingim, RB; George, SZ
Published in: J Pain
January 2012

UNLABELLED: Recent reports suggest deficits in conditioned pain modulation (CPM) and enhanced suprathreshold heat pain response (SHPR) potentially play a role in the development of chronic pain. The purpose of this study was to investigate whether central pain processing was altered in 2 musculoskeletal shoulder pain models. The goals of this study were to determine whether central pain processing: 1) differs between healthy subjects and patients with clinical shoulder pain; 2) changes with induction of exercise-induced muscle pain; and 3) changes 3 months after shoulder surgery. Fifty-eight patients with clinical shoulder pain and 56 age- and sex-matched healthy subjects were included in these analyses. The healthy cohort was examined before inducing EIMP, and 48 and 96 hours later. The clinical cohort was examined before shoulder surgery and 3 months later. CPM did not differ between the cohorts, however; SHPR was elevated for patients with shoulder pain compared to healthy controls. Induction of acute shoulder pain with EIMP resulted in increased shoulder pain intensity but did not change CPM or SHPR. Three months following shoulder surgery, clinical pain intensity decreased but CPM was unchanged from preoperative assessment. In contrast, SHPR was decreased and showed values comparable with healthy controls at 3 months. Therefore, the present study suggests that: 1) clinical shoulder pain is associated with measurable changes in central pain processing; 2) exercise-induced shoulder pain did not affect measures of central pain processing; and 3) elevated SHPR was normalized with shoulder surgery. Collectively our findings support neuroplastic changes in pain modulation were associated with decreases in clinical pain intensity only, and could be detected more readily with thermal stimuli. PERSPECTIVE: Longitudinal studies involving quantitative sensory testing are rare. In exploring 2 musculoskeletal shoulder pain models (exercise-induced muscle pain and surgical pain), conditioned pain modulation was unchanged from pre- to post-assessment in both models. Suprathreshold heat pain response decreased after shoulder surgery and was comparable to healthy controls, suggesting this measure may be sensitive to decreases in clinical pain intensity.

Duke Scholars

Published In

J Pain

DOI

EISSN

1528-8447

Publication Date

January 2012

Volume

13

Issue

1

Start / End Page

81 / 89

Location

United States

Related Subject Headings

  • Young Adult
  • Shoulder Pain
  • Physical Stimulation
  • Pain Threshold
  • Pain Measurement
  • Musculoskeletal Pain
  • Male
  • Humans
  • Female
  • Cohort Studies
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Valencia, C., Kindler, L. L., Fillingim, R. B., & George, S. Z. (2012). Investigation of central pain processing in shoulder pain: converging results from 2 musculoskeletal pain models. J Pain, 13(1), 81–89. https://doi.org/10.1016/j.jpain.2011.10.006
Valencia, Carolina, Lindsay L. Kindler, Roger B. Fillingim, and Steven Z. George. “Investigation of central pain processing in shoulder pain: converging results from 2 musculoskeletal pain models.J Pain 13, no. 1 (January 2012): 81–89. https://doi.org/10.1016/j.jpain.2011.10.006.
Valencia C, Kindler LL, Fillingim RB, George SZ. Investigation of central pain processing in shoulder pain: converging results from 2 musculoskeletal pain models. J Pain. 2012 Jan;13(1):81–9.
Valencia, Carolina, et al. “Investigation of central pain processing in shoulder pain: converging results from 2 musculoskeletal pain models.J Pain, vol. 13, no. 1, Jan. 2012, pp. 81–89. Pubmed, doi:10.1016/j.jpain.2011.10.006.
Valencia C, Kindler LL, Fillingim RB, George SZ. Investigation of central pain processing in shoulder pain: converging results from 2 musculoskeletal pain models. J Pain. 2012 Jan;13(1):81–89.
Journal cover image

Published In

J Pain

DOI

EISSN

1528-8447

Publication Date

January 2012

Volume

13

Issue

1

Start / End Page

81 / 89

Location

United States

Related Subject Headings

  • Young Adult
  • Shoulder Pain
  • Physical Stimulation
  • Pain Threshold
  • Pain Measurement
  • Musculoskeletal Pain
  • Male
  • Humans
  • Female
  • Cohort Studies