Abstract
Voerman VF, van Egmond J, Crul BJP. Elevated detection thresholds for mechanical stimuli
in chronic pain patients: support for a central mechanism. Arch Phys Med Rehabil 2000;81:430-5.
Objective: To investigate the relation between pain provoking cervical segments identified by
diagnostic dorsal root blockades and elevation of detection thresholds in patients
suffering from chronic cervicobrachialgia (CCB). Design: Quantitative sensory testing (light touch) of the cervical dermatomes using Semmes-Weinstein
monofilaments. Setting: A university pain clinic. Subjects: Thirty-nine patients with CCB, with no clinical or diagnostic evidence of radiculopathy
or surgically treatable bony lesion and with one main pain-provoking cervical segment
identified by diagnostic dorsal root blockades. Outcome Measures: Detection thresholds with 95% confidence intervals (95% CI) of pain-provoking segments,
compared with surrounding and contralateral segments and with normal values for cervical
dermatomes. Results: Patients' detection thresholds were significantly (p <.001) higher than those for normal subjects: 3.51 (95% CI, 2.71-4.31) and 3.10 (95%
CI, 2.34-3.86), respectively. No significant differences existed between the segments.
The elevations were systematic. However, thresholds on the painful side were consistently,
slightly higher than those on the contralateral side. Conclusion: Supporting earlier studies, results from CCB patients in the present study showed
systematic elevation of detection thresholds (low threshold mechanoreceptors), an
adaptation in contrast with, but not contradictory to, central sensitization of high
threshold neurons in chronic pain. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy
of Physical Medicine and Rehabilitation
Keywords
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Article info
Publication history
Accepted:
July 19,
1999
Received in revised form:
July 19,
1999
Received:
October 27,
1998
Footnotes
☆No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
☆☆Reprint requests to V.F. Voerman, Department of Traumatic Brain Injury, Rehabilitation Centre Groot Klimmendaal PO Box 9044, 6800 GG Arnhem, The Netherlands.
★Supplier
Identification
Copyright
© 2000 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
