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BMC Musculoskeletal Disorders

, 11:29

First Online: 09 February 2010Received: 27 July 2009Accepted: 09 February 2010

Abstract

BackgroundThe cervical zygapophyseal joints may be a primary source of pain in up to 60% of individuals with chronic whiplash associated disorders WAD and may be a contributing factor for peripheral and centrally mediated pain sensory hypersensitivity. Sensory hypersensitivity has been associated with a poor prognosis. The purpose of the study was to determine if there is a change in measures indicative of sensory hypersensitivity in patients with chronic WAD grade II following a medial branch block MBB procedure in the cervical spine.

MethodsMeasures of sensory hypersensitivity were taken via quantitative sensory testing QST consisting of pressure pain thresholds PPT-s and cold pain thresholds CPT-s. In patients with chronic WAD n = 18, the measures were taken at three sites bilaterally, pre- and post- MBB. Reduced pain thresholds at remote sites have been considered an indicator of central hypersensitivity. A healthy age and gender matched comparison group n = 18 was measured at baseline. An independent t-test was applied to determine if there were any significant differences between the WAD and normative comparison groups at baseline with respect to cold pain and pressure pain thresholds. A dependent t-test was used to determine whether there were any significant differences between the pre and post intervention cold pain and pressure pain thresholds in the patients with chronic WAD.

ResultsAt baseline, PPT-s were decreased at all three sites in the WAD group p < 0.001. Cold pain thresholds were increased in the cervical spine in the WAD group p < 0.001. Post-MBB, the WAD group showed significant increases in PPT-s at all sites p < 0.05, and significant decreases in CPT-s at the cervical spine p < 0.001.

ConclusionsThe patients with chronic WAD showed evidence of widespread sensory hypersensitivity to mechanical and thermal stimuli. The WAD group revealed decreased sensory hypersensitivity following a decrease in their primary source of pain stemming from the cervical zygapophyseal joints.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-11-29 contains supplementary material, which is available to authorized users.

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Autor: Geoff M Schneider - Ashley D Smith - Allen Hooper - Paul Stratford - Kathryn J Schneider - Michael D Westaway - Bevan F

Fuente: https://link.springer.com/



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