Background & Aims
Pain intensity and psychological factors have been found to be associated with the extent of brain alterations 1–4, which are implicated in pain chronification 5,6. However, it is unclear whether pain intensity is associated with the extent of somatosensory cortex reorganization in neck pain. Existing studies are conflicting and do not include individuals with idiopathic neck pain 7,8, 9. Tactile acuity, usually assessed by two-point discrimination, is an indirect measure of somatosensory brain reorganization 8,10. This study aimed to explore the association between neck pain intensity and tactile discrimination when controlling for personal and psychological factors.
Methods
This is an observational study using baseline data from a randomized clinical trial. Participants were recruited from the general population by advertisements and personal invitations and entered the study if reporting chronic idiopathic NP, defined as a recurrent or persistent pain that lasted for more than 3 months, with no trauma or etiology/diagnosis associated, which arises anywhere between the superior nuchal line and an imaginary transversal line through the first thoracic spinous process and lateral borders of the neck 4; and aged between 18 and 65 years old. They were assessed for pain characteristics (pain intensity, frequency, and duration), personal factors (sex and age), two-point discrimination threshold, and psychological aspects related to pain (kinesiophobia, fear-avoidance beliefs, and catastrophizing). A regression model with two-point discrimination threshold as the dependent variable was conducted.
Results
A total of 60 individuals (46 females) with chronic idiopathic neck pain were included in this study. Mean (±SD) pain intensity (VAS 0 to 10) was 4.98 (±1.84) and mean (±SD) two-point discrimination threshold was 2.11 (±1.49) cm. Age, kinesiophobia and pain two to three times a week were associated with higher values for two-point discrimination (F=7.28; R² =0.39; p<0.001), but pain intensity was not (p>0.05).
Conclusions
Decreased tactile acuity was associated with being older and reporting higher kinesiophobia and neck pain frequently, suggesting that these factors, but not pain intensity, are associated with higher levels of somatosensory cortex reorganization in individuals with chronic idiopathic NP. These findings might suggest that interventions targeting somatosensory discrimination might be more relevant for individuals with higher kinesiophobia and pain frequency, but further studies are needed to confirm the association of these variables with the somatosensory cortex reorganization and whether they impact the response to those interventions.
References
1. López-de-Uralde-Villanueva I, Tostado-Haro I, Noval-Granda B, Ferrer-Peña R, Del Corral T. Widespread impairment of tactile spatial acuity and sensory-motor control in patients with chronic nonspecific neck pain with neuropathic features. Musculoskelet Sci Pract. 2020;47:102138. doi:10.1016/j.msksp.2020.102138
2. Harvie DS, Edmond-Hank G, Smith AD. Tactile acuity is reduced in people with chronic neck pain. Musculoskelet Sci Pract. 2018;33:61-66. doi:10.1016/j.msksp.2017.11.009
3. Catley MJ, O’Connell NE, Berryman C, Ayhan FF, Moseley GL. Is Tactile Acuity Altered in People With Chronic Pain? A Systematic Review and Meta-analysis. J Pain. 2014;15(10):985-1000. doi:10.1016/j.jpain.2014.06.009
4. Nugraha B, Gutenbrunner C, Barke A, et al. The IASP classification of chronic pain for ICD-11: functioning properties of chronic pain. Pain. 2019;160(1):88-94. doi:10.1097/j.pain.0000000000001433
Presenting Author
Anabela Silva
Poster Authors
Topics
- Specific Pain Conditions/Pain in Specific Populations: Neck Pain