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PubMed1989

Measurement of pain threshold in patients with rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and healthy controls.

Pain threshold was measured using a pressure algometer in 126 subjects, of whom 54 were females and 72 males. These subjects included 18 males and 18 females with rheumatoid arthritis, 18 males and 18 females with osteoarthritis, 18 males with ankylosing spondylitis, and 18 male and 18 female healthy control volunteers. Six points were studied on each side of the body: 2 cm above the eyebrow on the forehead, lateral aspect of the arm at the insertion of the deltoid muscle, midpoint of the ulna, hypothenar eminence in the palm, midpoint of the quadriceps muscle, and midpoint of the antero-medial aspect of the tibia. None of these points corresponded to the "trigger" points in fibromyalgia. The pain threshold was statistically significantly higher in patients with ankylosing spondylitis than in patients with osteoarthritis, and these in turn were statistically higher than in the normal subjects. Patients with rheumatoid arthritis had significantly lower pain thresholds than the normal subjects. No laterality in pain threshold was identified, but females had in general a lower pain threshold.

Adult↗
PubMed1991

Cephalic and extracephalic pressure pain thresholds in chronic tension-type headache.

Pressure pain thresholds were assessed with an algometer (Somedic Inc.), over the forehead, temple and suboccipital region as well as over the Achilles tendon. A group of 32 patients suffering from chronic tension-type headache was compared to 20 healthy controls and to 10 migraineurs without aura. Although individual values were widely scattered, pressure pain thresholds were on average significantly lower in chronic tension-type headache, not only at pericranial sites but also over the Achilles tendon. Only 50% of these patients had one or more pericranial thresholds 1.5 S.D. below the mean of controls. After muscular biofeedback therapy, all pain thresholds were on average increased. Along with results obtained previously, the present data support the hypothesis that diffuse disruption of central pain-modulating systems, possibly due to a modified limbic input to the brain-stem, is pivotal in the pathophysiology of chronic tension-type headache.

Adult↗
PubMed1974

Pain threshold analysis in patients with osteoarthrosis of hip.

The pain threshold was measured in patients with osteoarthrosis of the hip. The pain threshold was significantly lower in patients who required surgery than in controls. After successful surgery the threshold rose to normal levels. In patients with few or no symptoms from their osteoarthritic hips the pain threshold was high. Insensitivity to pain does not predispose towards osteoarthrosis of the hip. Indeed, the severity of symptoms can be directly related to an increased sensitivity to pain in osteoarthritic subjects.

Aged↗
PubMed2003

The effects of stages of the estrous cycle on pain thresholds in female white rats.

The effects of stages in the estrous cycle on electrical pain thresholds were studied in white rats in conditions of chronic measurement. On recording day 3, females in the diestrus and estrus stages showed sharp increases in shudder and paw-shuffling thresholds. Females in proestrus and metestrus showed no change in thresholds as compared with those in the first days of recording. Starting from day 7, there were progressive decreases in electrical pain thresholds regardless of the stage of the estrous cycle. Data for all animals showed that regular measurement of pain thresholds induces a smooth two-fold increase in body resistance from day 1 to day 7. This was followed by a sharp drop on day 8, with parallel decreases in body resistance and electrical pain thresholds. Thus, chronic measurement of electrical pain thresholds and body resistance changed in a complex fashion, and threshold values depended on the stage of the estrous cycle.

Animals↗
PubMed1998

Hypnotizability, pain threshold, and dissociative experiences.

BACKGROUND: There may be an association between pain threshold, hypnotizability, and dissociative experiences. The purpose of the present study was to examine this association. METHODS: Forty-one healthy subjects were included in the study. Pain thresholds were determined using a manual algometer. The Dissociative Experiences Scale was administered to all subjects. Hypnotizability of the subjects was assessed by the eye roll sign of the Hypnotic Induction Profile. There were 14, 15, and 12 subjects in the Grade 1, 2, and 3 groups, respectively. RESULTS: Highly hypnotizable subjects had lower pain thresholds and were more likely to report dissociative experiences than the less hypnotizable subjects. CONCLUSIONS: There is an association between pain threshold, hypnotizability, and dissociative experiences. It may be suggested that dissociative and somatic symptoms may be integrally linked and related to hypnotic suggestibility.

Adult↗
PubMed2005

Poor sleep and depression are independently associated with a reduced pain threshold. Results of a population based study.

To determine the relative contributions of psychological factors and sleep disturbance to reduced pain threshold we conducted a cross-sectional two-phase population-based study. A total of 424 subjects were recruited, stratified by pain and distress status. Subjects completed a postal questionnaire that asked about current pain and covered aspects of psychological status and sleep disturbance. Samples of subjects stratified by the extent of bodily pain they reported and psychological status were invited to participate in an examination of pain threshold. The association between psychological status, sleep disturbance and a low pain threshold was examined using ordinal regression. High levels of psychological distress (OR=1.6, 95% CI (1.02, 2.5)), disturbed sleep (OR=2.2, 95% CI (1.4, 3.5)) and high scores on the HAD depression scale (OR=2.1, 95% CI (1.3, 3.2)) were all associated with having a low pain threshold. In multivariate analysis disturbed sleep and depression remained independently associated with a low pain threshold. These relationships persisted after adjustment for pain status. This study had demonstrated that depression and poor sleep are associated with a reduced pain threshold.

Adult↗
PubMed1979

[On circadian variations of the placebo effect on the pain threshold of healthy teeth: Contribution to a physiology of placebo effects (author's transl)].

Placebo doses can influence the pain threshold of healthy teeth according to the label. Systematic longitudinal researches over the day with measuring the utilization time of cold stimulus on healthy front teeth demonstrate that the placebo effect is subject to significant circadian variations. During daytime a pseudo-analgesic causes a stronger and steeper onset of increase of the tooth pain threshold than during the night, when the pain threshold is influenced only minimal or even inverse. The placebo effect can come up to 40% of the pain threshold increase caused by a usual analgesic; this portion, however, is as well subject to high circadian variations. The extent of the placebo effect corresponds to the order of magnitude of the spontaneous circadian variations of pain threshold and correlates positively to it. These correlations are considered as indicating that those vegetative mechanisms causing the circadian variations of the pain threshold are equally involved in affecting the placebo actions.

Circadian Rhythm↗
PubMed2006

Quantitative somatosensory testing of warm and heat-pain thresholds: the effect of body region and testing method.

OBJECTIVES: To study whether the sensitivity to noxious and innocuous heat varies across the body. METHODS: Heat-pain threshold and warm sensation threshold were measured in 20 patients, using the Method of Limits (MLI) and the Method of Levels (MLE) in 5 regions: the chest, forearm, mid thigh, and the dorsal surface of the hand and foot. RESULTS: With the Method of Limits, heat-pain threshold increased gradually from the lowest level in the chest (mean 42 degrees C) to peak level in the foot (44.5 degrees C, P < 0.001). With the Method of Levels, heat-pain threshold did not differ between body regions. Warm sensation thresholds measured with both Method of Limits and the Method of Levels was higher in the chest (36.2 degrees C) and foot (36.8 degrees C) compared to the other regions (mean of 35.3 degrees C, P < 0.01). The correlation between heat-pain threshold and warm sensation threshold was low to moderate, depending on the tested region. Differences in heat-pain threshold and warm sensation threshold between the methods were highest in the legs and smallest in the chest. The correlation between the Method of Limits and Method of Levels was moderate for heat-pain threshold (0.57) and good for warm sensation threshold (0.71). DISCUSSION: The sensitivity to noxious heat is uniform across the body when measured with a reaction-time-free method (Method of Levels), but is greater in proximal than in distal regions, when measured with a reaction-time-dependent method (Method of Limits). Regardless of measuring method, the sensitivity to innocuous heat is not uniform across the body. It is concluded that the Method of Levels is preferred when heat-pain threshold is to be compared between body regions. For heat-pain threshold, within-patient comparisons can be made between each pair of regions tested. However, for warm sensation threshold, within-patient comparisons should be conducted between contralateral symmetrical regions.

Adult↗
PubMed1999

Elevated pain threshold in anorexia nervosa subjects.

BACKGROUND: Conflicting data have been published regarding pain threshold in subjects with anorexia nervosa (AN), with some studies indicating elevated pain threshold and others indicating normal thresholds. Previous research has indicated the presence of elevated pain threshold in eating disorder subjects with binge-eating behavior. METHODS: In this study pressure pain detection thresholds (PDT) (assessed by a pressure analgesiometer) in binge-eating/purging and restricting subtypes of AN subjects were compared to control subjects. RESULTS: PDT was elevated in AN compared to control subjects at baseline. There was no difference in PDT between the subgroups of AN subjects. CONCLUSIONS: The etiology of elevated PDT in AN subjects is most likely different from the etiology of elevated PDT in bulimia nervosa subjects.

Adolescent↗
PubMed1993

The pressure pain threshold (PPT) of certain muscles in children suffering from recurrent abdominal pain of non-organic origin. An algometric study.

The origin of recurrent abdominal pain of "non-organic origin" is believed to be psychogenic in most cases. But the pathogenesis of the pain itself is unknown. To test the hypothesis that recurrent abdominal pain of non-organic origin is related to increased pain sensitivity in the myofascial elements of the abdominal wall itself, an investigation of pain pressure threshold of the abdominal wall, close to the umbilicus, was carried out. Altogether 140 children in the fourth school grade, approximately 11 years old, were tested for pressure pain threshold. Two groups were constituted: one without pain symptoms (no recurrent abdominal pain, chest pains or headache (n = 50)) and one with recurrent abdominal pain (n = 49). The pressure pain threshold differed significantly (p < 0.0001). To support the hypothesis that recurrent abdominal pain is a part phenomenon of a specific pattern of muscular tension and tenderness, the pressure pain threshold was tested in five other muscles, with significant results.

Abdominal Pain↗
PubMed1990

Glycemic control of pain threshold in diabetic and control rats.

Pain threshold was assessed via tail flick latency in alloxan-diabetic, streptozotocin-diabetic, BB/W-diabetic, and control laboratory rats. In addition, tail flick latency was determined under conditions of both euglycemia (60-120 mg/dl) and hyperglycemia (greater than 250 mg/dl). Conditions of hyperglycemia resulted in a significant decrease in tail flick latency in both diabetic and control animals. More interestingly, tail flick latency was returned to control values in diabetic rats following normalization of blood glucose levels. It is concluded that elevated blood glucose levels result in a decrease in pain threshold in both diabetic and control rats. In addition, a permanent state of painful symptoms may be avoided in clinical diabetes by improvement of diabetic control.

Animals↗
PubMed1986

The effect of two sites of high frequency vibration on cutaneous pain threshold.

The purpose of this study was to evaluate the effect of two sites of high frequency vibration on experimentally produced pain thresholds. Subjects were assigned to one of two experimental groups. Vibration was applied proximal to the site of pain threshold measurement in one group and distal to the measurement site in the other group. The cutaneous pain threshold was measured at the ulnar aspect of the wrist in both groups prior to, during, and following 5 min of vibration. Subjects were 30 right-handed, Caucasian males with a negative history of upper extremity dysfunction. A repeated measures analysis of variance (ANOVA) was used to analyze the data. There was a significant interaction between vibration site and time of pain threshold measurement. Post hoc analysis of that interaction indicated that a significant difference between experimental groups occurred only during vibration; the distal group values were significantly higher than the proximal group values (P less than 0.03). For the distal group, pain threshold values were significantly higher during vibration than pre vibration and post vibration (P less than 0.05). In the proximal group, there was no significant difference in pain threshold values across the 3 time periods. The results of this study indicate that vibration applied distal to the site of pain can provide temporary analgesia.

Adolescent↗
PubMed2002

Interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis.

OBJECTIVE: To evaluate the interobserver reproducibility of the assessment of severity of complaints, grip strength, and pressure pain threshold in patients with lateral epicondylitis in primary care. DESIGN: Two physiotherapists assessed independently, and in randomized order, the severity of complaints scored on an 11-point numeric rating scale, pain-free grip strength, maximum grip strength, and pressure pain threshold. SETTING: Primary care center in the Netherlands. PARTICIPANTS: Fifty patients were assessed by both physiotherapists. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs) were calculated to assess interobserver reliability. The Bland and Altman method was used to assess interobserver agreement, which included calculation of the mean difference between the observers (d), the 95% CI for d, the standard deviation of the differences, and the 95% limits of agreement. Finally, the smallest detectable difference (SDD) was calculated. RESULTS: The ICC for the severity of complaints was.90. The ICCs for the pain-free grip strength and maximum grip strength were.97 and.98, respectively. The pressure pain threshold showed a lower reliability (ICC=.77). The interobserver agreement for all outcome measures was good, but systematic differences in assessment between the physiotherapists were found for the maximum grip strength and pressure pain threshold. For pressure pain threshold, the SDD was clearly larger than the predefined acceptable difference of 10% of the total range of measurement. CONCLUSIONS: The interobserver reliability of severity of complaints and grip strength was excellent, whereas the pressure pain threshold showed unsatisfactory reliability. Grip strength and overall assessment of the severity of complaints are useful and reliable measures for the assessment of lateral epicondylitis. Pain-free grip strength, in particular, is relatively easy to perform and has been shown to be associated with other measures of functional disability in patients with lateral epicondylitis. We, therefore, recommend the use of pain-free grip strength in both research and clinical practice.

Adult↗
PubMed1986

Effects of naloxone on dental pain threshold following muscle exercise and low frequency transcutaneous nerve stimulation: a comparative study in man.

Previous studies have shown that muscle exercise and low frequency transcutaneous nerve stimulation (TNS) give rise to an analgesic effect in humans and animals. Endorphin has been proposed to mediate this analgesia. In this investigation, the effect of muscle exercise and low frequency TNS, on dental pain thresholds was studied and the possible involvement of endorphinergic mechanisms was investigated using naloxone as an antagonist. Dental pain thresholds were measured in 11 volunteers following leg or arm exercise and after low frequency TNS of the hands or face. After exercise (20 min) or stimulation (30 min) either 0.8 mg naloxone (2 ml) or saline (2 ml) was injected i.v. in a double-blind fashion. Pain thresholds were measured repetitively before and after exercise or stimulation. Both leg and arm exercise increased pain threshold. Stimulation of the hands also increased pain threshold, but less than arm exercise. A marked increase in pain threshold was seen after face stimulation. These changes in pain threshold were unaffected following injections of either naloxone or saline, except for an early and short-lasting reduction when naloxone was injected following arm exercise. The increases in pain threshold following muscle exercise and after low frequency TNS, showed similarities suggesting that a common mechanism might be involved. The pain threshold increase after arm exercise could only be partially mediated by endorphinergic mechanisms.

Adult↗
PubMed2000

Effects of extremely low frequency magnetic fields on pain thresholds in mice: roles of melatonin and opioids.

1. We studied the effects of extremely low frequency (ELF, 60 Hz) magnetic fields (MFs) on pain thresholds using the hot plate test. The implication of opioid and benzodiazepine system in the MFs-induced alteration of pain thresholds was also studied. 2. There was an increase at night time and a decrease at daytime of pain thresholds in normal mice. Exposure of MFs (24 h, 20 gauss (G)) inhibited the increase of pain thresholds at night time and even produced hyperalgesia at daytime. 3. The increase of pain thresholds induced by melatonin at daytime was inhibited by exposure to MFs (24 h, 20 G) or opioid antagonist naloxone. The MFs and naloxone synergically inhibited hypoalgesia produced by melatonin. The hyperalgesia at daytime after MFs exposure was potentiated by the benzodiazepine agonist, diazepam, and inhibited by the benzodiazepine antagonist, flumazenil. There was no significant difference in all rotarod performance we tested. 4. From these results, it is suggested that exposure to MFs inhibits the increase of pain thresholds at night time and produces hyperalgesia at daytime with the involvement of opioid and benzodiazepine systems.

Animals↗
PubMed2002

The effect of soft tissue deloading tape on thoracic spine pressure pain thresholds in asymptomatic subjects.

The application of tape to deload soft tissue is used in the management of thoracic spine pain. A reported clinical feature of this treatment is reduced tenderness of the spine during postero-anterior mobilizations. A randomized, single blind, placebo controlled, repeated measures design study was employed to investigate the effects of deloading tape on pressure pain threshold measurements at the level of the T7 spinous process in an asymptomatic group of 24 subjects. Pressure pain thresholds were assessed prior to and following the application of deloading tape, placebo sham tape and no-tape control conditions. All subjects received all three conditions in a randomized order on three separate days. Differences between the pre- and post-measurements were used as indicators of change in a subject's pressure pain threshold. No significant change in pressure pain threshold measurements was found between conditions. In summary, this study demonstrated that deloading tape applied to the level of the T7 spinous process did not significantly change pressure pain threshold measurements in asymptomatic subjects, raising the possibility that any pain relieving effect may well be conditional upon pain being present.

Adult↗