Young females with long standing patellofemoral pain display impaired conditioned pain modulation, increased temporal summation of pain and widespread hyperalgesia

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Abstract

Patellofemoral pain (PFP) is a common recurring knee condition in young females, characterized by pressure hyperalgesia and reduced pain inhibitory control. This study investigated anti-nociceptive and pro-nociceptive pain profiles in young females with long-standing (>5 years) PFP (current-PFP), to those who recovered from adolescent PFP (recovered-PFP), and pain-free controls. This pre-registered, assessor blinded, cross-sectional study, included 87 females younger than 25 years: 36 current-PFP, 22 recovered-PFP, and 29 pain-free controls. The primary outcome was conditioning pain modulation (CPM) assessed by the increase of cuff pain tolerance thresholds assessed during painful cuff conditioning on the contralateral leg. Secondary outcomes included pressure pain thresholds at the knee, shin and forearm, and temporal summation of pain (TSP), assessed by pain intensity recordings on a visual analogue scale (VAS) during repeated cuff pressure pain stimulations on the leg. Compared to the recovered-PFP, the current-PFP had impaired CPM (mean-difference: 11.6%; P=0.004) and reduced pressure pain thresholds at the knee, shin and forearm (mean-difference: 85-225 kPa; P<0.05). There were no differences between current-PFP and controls in CPM. Current-PFP and recovered-PFP demonstrated facilitated TSP, compared to controls, (mean-difference: 0.7-0.8 VAS-change; P<0.05). Compared with controls the recovered-PFP had reduced pressure pain thresholds at the knee, which were higher than the current-PFP (mean-difference: 110-225 kPa; P<0.05). In conclusion, both current-PFP and recovered-PFP displayed altered pain mechanisms compared to controls with no history of knee-pain, despite resolution of symptoms in the recurrent-PFP group. The implications of these findings in the recurrent nature of PFP requires further studies.

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Detaljer

Patellofemoral pain (PFP) is a common recurring knee condition in young females, characterized by pressure hyperalgesia and reduced pain inhibitory control. This study investigated anti-nociceptive and pro-nociceptive pain profiles in young females with long-standing (>5 years) PFP (current-PFP), to those who recovered from adolescent PFP (recovered-PFP), and pain-free controls. This pre-registered, assessor blinded, cross-sectional study, included 87 females younger than 25 years: 36 current-PFP, 22 recovered-PFP, and 29 pain-free controls. The primary outcome was conditioning pain modulation (CPM) assessed by the increase of cuff pain tolerance thresholds assessed during painful cuff conditioning on the contralateral leg. Secondary outcomes included pressure pain thresholds at the knee, shin and forearm, and temporal summation of pain (TSP), assessed by pain intensity recordings on a visual analogue scale (VAS) during repeated cuff pressure pain stimulations on the leg. Compared to the recovered-PFP, the current-PFP had impaired CPM (mean-difference: 11.6%; P=0.004) and reduced pressure pain thresholds at the knee, shin and forearm (mean-difference: 85-225 kPa; P<0.05). There were no differences between current-PFP and controls in CPM. Current-PFP and recovered-PFP demonstrated facilitated TSP, compared to controls, (mean-difference: 0.7-0.8 VAS-change; P<0.05). Compared with controls the recovered-PFP had reduced pressure pain thresholds at the knee, which were higher than the current-PFP (mean-difference: 110-225 kPa; P<0.05). In conclusion, both current-PFP and recovered-PFP displayed altered pain mechanisms compared to controls with no history of knee-pain, despite resolution of symptoms in the recurrent-PFP group. The implications of these findings in the recurrent nature of PFP requires further studies.

OriginalsprogEngelsk
TidsskriftPain
ISSN0304-3959
DOI
StatusE-pub ahead of print - 1 aug. 2018
PublikationsartForskning
Peer reviewJa
ID: 284283151