Background & Aims

Pressure pain sensitivity assessments have been used with increasing frequency over the past decades to characterize and compare patients with painful musculoskeletal disorders. Although differences in these measures are often seen between people with painful disorders and pain-free individuals, and some evidence of prognostic prediction has emerged, clinical utility of these assessments has been limited in part by a lack of large cohort studies. This abstract presents cuff pressure pain sensitivity data from the population of Tromsø municipality, and how this pressure pain sensitivity is affected by age and sex.

Methods

Between March 2015 to November 2016, 21,083 individuals aged over 40 years living in the Tromsø municipality in northern Norway participated in the 7th wave of the Tromsø Study. Data on age and sex were gathered. During the test session, participants were seated with a blood pressure cuff placed around each lower leg, connected to a computerized pressure algometer, with a mouse to rate stimulus-provoked pain intensity on an electronic visual analogue scale (VAS; 0-10 cm). After brief training, the cuff was inflated at a rate of 1kPa/s inflation until pain tolerance was reached. The non-dominant leg was assessed first, then the dominant leg. Participants were asked to begin rating on the VAS soon as they felt the pressure become painful (pressure pain detection threshold, PDT, VAS=1) and to continue rating until they could no longer tolerate the stimulus (pressure pain tolerance threshold, PTT).

Results

In 18,939 participants at least one valid pain sensitivity test was recorded, and full cuff pain sensitivity data was available in 16,288 people (8128 females, age: 56.2±10.8 years). The mean ± SD (percentiles: 0, 25, 50, 75, 100) PDT was 22.8±10.0kPa (3.4, 15.8, 21.8, 28.1, 97.0; female: 21.5±9.0kPa, male: 24.0±10.7kPa) on the non-dominant leg and 25.0±11.8kPa (3.7, 16.9, 23.8, 31.4, 97.0; female: 23.3±10.6kPa, male: 26.8±12.6kPa) on the dominant leg. The mean PTT was 61.6±20.0kPa (11.9, 46.4, 58.7, 75.9, 100.0; female: 55.2±18.2kPa, male: 68.1±19.7kPa) on the non-dominant leg and 61.4±20.3kPa (9.2, 45.9, 58.5, 74.3, 100.0; female: 54.9±18.3kPa, male: 67.9±20.1kPa) on the dominant leg. In multilinear regression adjusted for self-reported pain (yes/no) and education (4 levels), there was a significant effect (coeff.[95%CI]) of age (-0.2 [-0.2,-0.2]) and sex (male: 3.2 [2.9,3.5]) on PDT; along with a significant effect of age (-.4 [-.5,-.4]) and sex (male: 13.3 [12.7,13.9]) on PTT.

Conclusions

This is, to date, the largest cohort study assessing standardized cuff pain detection and tolerance thresholds. Initial analysis suggests that, in terms of cuff pressure pain detection and tolerance threshold, adult males are less sensitive than adult females and increasing sensitivity to cuff pressure pain is observed with advancing age.

References

N/A

Presenting Author

Thomas Graven-Nielsen

Poster Authors

Megan McPhee

BPhty MScMed PhD

Center for Neuroplasticity and Pain, Aalborg University

Lead Author

Christopher Nielsen

PhD

Norwegian Institute of Public Health & Oslo University Hospital

Lead Author

Kristian Petersen

PhD

Aalborg University, Aalborg, Denmark

Lead Author

Dennis Boye Larsen (PhD)

Aalborg University

Lead Author

Lars Arendt-Nielsen

PhD

Aalborg University

Lead Author

Audun Stubhaug

University of Oslo

Lead Author

Ólöf Steingrímsdóttir

PhD

Norwegian Institute of Public Health & Oral Health Centre of Expertise in Eastern Norway

Lead Author

Thomas Graven-Nielsen

Thomas Graven-Nielsen

Lead Author

Topics

  • Epidemiology