TY - JOUR
T1 - Young females with long-standing patellofemoral pain display impaired conditioned pain modulation, increased temporal summation of pain, and widespread hyperalgesia
AU - Holden, Sinead
AU - Straszek, Christian Lund
AU - Rathleff, Michael Skovdal
AU - Petersen, Kristian Kjær
AU - Roos, E. M.
AU - Graven-Nielsen, Thomas
PY - 2018/12
Y1 - 2018/12
N2 - Patellofemoral pain (PFP) is a common and recurrent knee condition in young females, characterized by pressure hyperalgesia and reduced pain inhibitory control. This study investigated antinociceptive and pronociceptive profiles in young females with long-standing (>5 years) PFP (current-PFP), those who recovered from adolescent PFP (recovered-PFP), and pain-free controls. This preregistered, 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 conditioned pain modulation (CPM) assessed by increase of cuff pain thresholds 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, assessed by pain intensity recordings on a visual analogue scale during repeated cuff pressure pain stimulations on the leg. Compared with 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 which were also reduced compared to current-PFP (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 temporal summation of pain, compared to controls (mean difference: 0.7-0.8 visual analogue scale change; P < 0.05). Compared with controls, the recovered-PFP also 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 recovered-PFP group. The implications of these findings in the recurrent nature of PFP requires further studies.
AB - Patellofemoral pain (PFP) is a common and recurrent knee condition in young females, characterized by pressure hyperalgesia and reduced pain inhibitory control. This study investigated antinociceptive and pronociceptive profiles in young females with long-standing (>5 years) PFP (current-PFP), those who recovered from adolescent PFP (recovered-PFP), and pain-free controls. This preregistered, 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 conditioned pain modulation (CPM) assessed by increase of cuff pain thresholds 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, assessed by pain intensity recordings on a visual analogue scale during repeated cuff pressure pain stimulations on the leg. Compared with 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 which were also reduced compared to current-PFP (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 temporal summation of pain, compared to controls (mean difference: 0.7-0.8 visual analogue scale change; P < 0.05). Compared with controls, the recovered-PFP also 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 recovered-PFP group. The implications of these findings in the recurrent nature of PFP requires further studies.
UR - http://www.scopus.com/inward/record.url?scp=85056617416&partnerID=8YFLogxK
U2 - 10.1097/j.pain.0000000000001356
DO - 10.1097/j.pain.0000000000001356
M3 - Journal article
C2 - 30074593
SN - 0304-3959
VL - 159
SP - 2530
EP - 2537
JO - Pain
JF - Pain
IS - 12
ER -