Abstract
BackgroundTo investigate the development of pain intensity and pressure pain thresholds during and 24 h after a light dynamic physical load among patients with chronic neck-shoulder pain.MethodsTwenty-six patients with chronic neck-shoulder pain and 12 healthy controls were included. The participants arm-cycled on an ergometer. Effort was rated with the Borg Rating of Perceived Exertion scale (RPE), and pain intensity with an numeric rating scale (NRS). Pressure pain thresholds were measured by an algometer. Participants started a pain diary 1 week before the physical exercise and continued until 1 week after. Pain intensity was assessed before, during and the following two evenings after arm-cycling. Pressure pain thresholds were assessed before, 15 min after, 105 min after and 24 h after.ResultsThe chronic pain group showed increased pain intensity during, and the following two evenings after the arm cycling, and decreased pain thresholds immediately after the arm cycling involving painful regions. In the patient group there were no impact on pain thresholds in the neck the following day.ConclusionsPatients with chronic neck-shoulder pain reported increased pain intensity during and in the evenings after a light dynamic load involving painful regions. In addition, they showed decreased pain thresholds close to the exercise, indicating mechanical hyperalgesia.
Highlights
To investigate the development of pain intensity and pressure pain thresholds during and 24 h after a light dynamic physical load among patients with chronic neck-shoulder pain
Medications being taken by the controls included non-narcotic-containing analgesics (n = 3), and thyroid hormones (n = 1), nine participants were on long term treatment with antidepressants; at the time of the examination there were no clinical signs of severe ongoing depression
This study could not show that a light physical load had an impact on pain thresholds in the neck area the following day in patients with chronic neck-shoulder pain (Tables 4 and 5)
Summary
To investigate the development of pain intensity and pressure pain thresholds during and 24 h after a light dynamic physical load among patients with chronic neck-shoulder pain. Clinical experience suggests that some patients with chronic musculoskeletal pain may feel increased pain intensity the day after even light physical exertion. This is important to take into account in work ability assessments. Grimby-Ekman et al BMC Musculoskeletal Disorders (2020) 21:266 sensitivity during and immediately after exercise which probably can be achieved through activation of endogenous pain inhibitory mechanisms [6, 9, 10]. This latter phenomenon has been termed exercise-induced hypoalgesia (EIH) [7, 11]. Further there are limited knowledge about the temporal pattern of pain intensity and pain thresholds after upper extremity exertion in patients with chronic neck-shoulder pain
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