Reduced cold pressor pain tolerance in non-recovered whiplash patients: a 1-year prospective study
Reduced cold pressor pain tolerance in non-recovered whiplash patients: a 1-year prospective study
复制标题
DOI：
10.1016/j.ejpain.2004.11.011
复制
发表时间：
2005-10-01
影响因子：
3.6
通讯作者：
Jensen, TS
中科院分区：
文献类型：
--
作者：
Kasch, H;Qerama, E;Jensen, TS
颈部扭伤和慢性颈部扭伤综合症是某些西方社区的主要健康问题，其中疼痛是主要症状。伤害感受系统的敏感性可能在颈部扭伤后无法恢复的过程中发挥作用。目的：本研究探讨了对疼痛刺激的耐受性是否可以预测颈部扭伤的结果。以前瞻性方式，对 141 名遭受汽车追尾事故（WAD 1-3 级）的急性颈部扭伤患者和 40 名脚踝受伤的对照组进行跟踪，并分别在受伤后 1 周、1、3、6 和 12 个月进行冷加压测试。在惯用手浸入冷水中 2 分钟之前、期间和之后获得疼痛和不适的 VAS 评分。 麦吉尔疼痛问卷显示，踝关节受伤对照者的初始疼痛评分高于相应的颈椎扭伤组，而颈椎扭伤 4 组受伤受试者在 6 个月时的评分较高；其他时间点的疼痛评分相似。颈椎扭伤康复者和踝关节受伤者之间的冷压痛没有发现差异。仅在颈部扭伤中出现无法恢复的情况。 11 名未康复的颈部扭伤患者（定义为：1 年后出现障碍）的疼痛峰值时间从受伤后 1 周缩短至 3 个月（P < 0.001）、6 个月（P < 0.01），但不是 12 个月。在整个观察期间，未恢复的颈椎扭伤患者与康复的颈椎扭伤患者相比，疼痛区域更大（P < 0.001）。颈椎扭伤后未恢复与最初的冷加压疼痛耐受力降低和峰值疼痛增加有关，表明中枢疼痛调节控制系统功能障碍在急性颈椎扭伤损伤后的慢性疼痛中发挥作用。 (c) 2004 年国际疼痛研究协会欧洲分会联合会。由爱思唯尔有限公司出版。保留所有权利。
Whiplash injury and chronic whiplash syndrome represent major health problems in certain western communities, pain being the main symptom. Sensitization of the nociceptive system may play a role for non-recovery after whiplash injury.Aims: This study examined if tolerance to endure pain stimuli may predict outcome in whiplash injury. In a prospective fashion, 141 acute whiplash patients exposed to rear-end car collision (WAD grade 1-3) and 40 ankle-injured controls were followed and exposed to a cold pressor test, respectively, 1 week, 1, 3, 6 and 12 months after the injury. VAS score of pain and discomfort was obtained before, during and after immersion of the dominant hand into cold water for 2 min.The McGill Pain Questionnaire showed that ankle-injured controls had higher initial pain scores than the corresponding whiplash group, while whiplash 4 injured subjects had higher scores at 6 months; pain scores being similar at other time points. No difference was found in cold pressor pain between recovered whiplash patients and ankle-injured subjects. Non-recovery was only encountered in whiplash injury. Eleven non-recovered whiplash patients (defined as: handicap after 1 year) showed reduced time to peak pain from 1 week to 3 months (P < 0.001), 6 months (P < 0.01), but not 12 months after the injury. A larger pain area was seen in non-recovered vs. recovered whiplash-injured subjects during the entire observation period (P < 0.001).Non-recovery after whiplash was associated with initially reduced cold pressor pain endurance and increased peak pain, suggesting that dysfunction of central pain modulating control systems plays a role in chronic pain after acute whiplash injury. (c) 2004 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved.