Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia

Background: Fibromyalgia (FM) syndrome is characterized by widespread pain, fatigue, and generalized increased pain sensitivity. Appropriate and simple pain models are methods employed to assess pain mechanisms that can potentially lead to improved treatments. Pressure pain thresholds (PPTs) or mapp...

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Autores: Arroyo Fernández, Rubén, Bravo Esteban-Herreros, Elisabeth, Doménech García, Víctor, Ferri Morales, Asunción
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universidad de Castilla-La Mancha
Repositorio:RUIdeRA. Repositorio Institucional de la UCLM
OAI Identifier:oai:ruidera.uclm.es:10578/25618
Acceso en línea:https://hdl.handle.net/10578/25618
Access Level:acceso abierto
Palabra clave:Referred pain
Pain sensitivity
Fibromyalgia
Central sensitization
Suprathreshold
Pressure pain threshold
Biomarker
Facilitated pain mechanisms
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spelling Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in FibromyalgiaArroyo Fernández, RubénBravo Esteban-Herreros, ElisabethDoménech García, VíctorFerri Morales, AsunciónReferred painPain sensitivityFibromyalgiaCentral sensitizationSuprathresholdPressure pain thresholdBiomarkerFacilitated pain mechanismsBackground: Fibromyalgia (FM) syndrome is characterized by widespread pain, fatigue, and generalized increased pain sensitivity. Appropriate and simple pain models are methods employed to assess pain mechanisms that can potentially lead to improved treatments. Pressure pain thresholds (PPTs) or mapping the referred pain area produced by pressure stimulation at suprathreshold intensities are used to assess pain mechanisms. The optimal suprathreshold stimulation intensity to elicit referred pain with minimal discomfort for patients with FM has yet to be determined. Objectives: The aim of this study was to compare the area and intensity of pressure-induced referred pain in patients with FM as elicited by systematic increases in PPTs, compared with controls. Study Design: Observational, crossed-section study. Setting: Research laboratory. Methods: Twenty-six patients with FM and 26 healthy controls, age- and gender-matched, were included. Suprathreshold stimulation was applied to the infraspinatus muscle of the dominant side at 4 different intensities (PPT +20%, +30%, +40%, and +50%), after which referred pain was evaluated by measuring the area of pain in pixels using a digital body chart and its intensity on a Visual Analog Scale. Factors related to anxiety condition, pain catastrophizing, depression, and quality of life were recorded. Results: The referred pain areas were larger in the FM group compared with healthy individuals at 120% (P = 0.024), 130% (P = 0.001), 140% (P = 0.001), and 150% (P = 0.001) PPT, however, within the FM group no differences were found between the intensity of suprathreshold stimulation and the size of the referred pain areas (P = 0.135) or pain intensity (P > 0.05). There was a positive correlation between the size of referred pain areas and pain catastrophizing in the FM group (r = 0.457, P = 0.032). Limitations: This study presents some limitations, among which is the variability found in the referred pain areas. Conclusions: These findings show that referred pain induced by applying a suprathreshold pressure of 120% PPT can be a useful biomarker to assess sensitized pain mechanisms in patients suffering from FM.American Society of Interventional Pain Physicians (ASIPP)202020202020info:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://hdl.handle.net/10578/25618reponame:RUIdeRA. Repositorio Institucional de la UCLMinstname:Universidad de Castilla-La ManchaInglésinfo:eu-repo/semantics/openAccessoai:ruidera.uclm.es:10578/256182026-05-27T07:36:41Z
dc.title.none.fl_str_mv Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia
title Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia
spellingShingle Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia
Arroyo Fernández, Rubén
Referred pain
Pain sensitivity
Fibromyalgia
Central sensitization
Suprathreshold
Pressure pain threshold
Biomarker
Facilitated pain mechanisms
title_short Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia
title_full Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia
title_fullStr Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia
title_full_unstemmed Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia
title_sort Pressure-Induced Referred Pain as a Biomarker of Pain Sensitivity in Fibromyalgia
dc.creator.none.fl_str_mv Arroyo Fernández, Rubén
Bravo Esteban-Herreros, Elisabeth
Doménech García, Víctor
Ferri Morales, Asunción
author Arroyo Fernández, Rubén
author_facet Arroyo Fernández, Rubén
Bravo Esteban-Herreros, Elisabeth
Doménech García, Víctor
Ferri Morales, Asunción
author_role author
author2 Bravo Esteban-Herreros, Elisabeth
Doménech García, Víctor
Ferri Morales, Asunción
author2_role author
author
author
dc.subject.none.fl_str_mv Referred pain
Pain sensitivity
Fibromyalgia
Central sensitization
Suprathreshold
Pressure pain threshold
Biomarker
Facilitated pain mechanisms
topic Referred pain
Pain sensitivity
Fibromyalgia
Central sensitization
Suprathreshold
Pressure pain threshold
Biomarker
Facilitated pain mechanisms
description Background: Fibromyalgia (FM) syndrome is characterized by widespread pain, fatigue, and generalized increased pain sensitivity. Appropriate and simple pain models are methods employed to assess pain mechanisms that can potentially lead to improved treatments. Pressure pain thresholds (PPTs) or mapping the referred pain area produced by pressure stimulation at suprathreshold intensities are used to assess pain mechanisms. The optimal suprathreshold stimulation intensity to elicit referred pain with minimal discomfort for patients with FM has yet to be determined. Objectives: The aim of this study was to compare the area and intensity of pressure-induced referred pain in patients with FM as elicited by systematic increases in PPTs, compared with controls. Study Design: Observational, crossed-section study. Setting: Research laboratory. Methods: Twenty-six patients with FM and 26 healthy controls, age- and gender-matched, were included. Suprathreshold stimulation was applied to the infraspinatus muscle of the dominant side at 4 different intensities (PPT +20%, +30%, +40%, and +50%), after which referred pain was evaluated by measuring the area of pain in pixels using a digital body chart and its intensity on a Visual Analog Scale. Factors related to anxiety condition, pain catastrophizing, depression, and quality of life were recorded. Results: The referred pain areas were larger in the FM group compared with healthy individuals at 120% (P = 0.024), 130% (P = 0.001), 140% (P = 0.001), and 150% (P = 0.001) PPT, however, within the FM group no differences were found between the intensity of suprathreshold stimulation and the size of the referred pain areas (P = 0.135) or pain intensity (P > 0.05). There was a positive correlation between the size of referred pain areas and pain catastrophizing in the FM group (r = 0.457, P = 0.032). Limitations: This study presents some limitations, among which is the variability found in the referred pain areas. Conclusions: These findings show that referred pain induced by applying a suprathreshold pressure of 120% PPT can be a useful biomarker to assess sensitized pain mechanisms in patients suffering from FM.
publishDate 2020
dc.date.none.fl_str_mv 2020
2020
2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10578/25618
url https://hdl.handle.net/10578/25618
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv American Society of Interventional Pain Physicians (ASIPP)
publisher.none.fl_str_mv American Society of Interventional Pain Physicians (ASIPP)
dc.source.none.fl_str_mv reponame:RUIdeRA. Repositorio Institucional de la UCLM
instname:Universidad de Castilla-La Mancha
instname_str Universidad de Castilla-La Mancha
reponame_str RUIdeRA. Repositorio Institucional de la UCLM
collection RUIdeRA. Repositorio Institucional de la UCLM
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301603

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