Cuff Pressure Pain Detection Is Associated with Both Sex and Physical Activity Level in Nonathletic Healthy Subjects

Purpose The aim of this study was to evaluate pressure pain sensitivity on leg and arm in 98 healthy persons (50 women) using cuff algometry. Furthermore, associations with sex and physical activity level were investigated. Method Normal physical activity level was defined as Godin Leisure-Time Exercise Questionnaire (GLTEQ) score ≤ 45 and high activity level as GLTEQ > 45. A pneumatic double-chamber cuff was placed around the arm or leg where a single chamber was inflated. The cuff inflation rate (1 kPa/s) was constant, and pain intensity was registered continuously on a 10 cm electronic visual analogue scale (VAS). The pain detection threshold (PDT) was defined as when the pressure was perceived as painful, and pain tolerance (PTT) was when the subject terminated the cuff inflation. For PTT, the corresponding VAS score was recorded (VAS-PTT). The protocol was repeated with two chambers inflated. Result Only single cuff results are given. For women compared with men, the PDT was lower when assessed in the arm ( P = 0.002), PTTs were lower in the arm and leg ( P < 0.001), and the VAS-PTT was higher in the arm and leg ( P < 0.033). Highly active participants compared with less active had higher PDT ( P = 0.027) in the leg. Women showed facilitated spatial summation ( P < 0.014) in the arm and leg and a steeper VAS slope (i.e., the slope of the VAS pressure curve between PDT and PPT) in the arm and leg ( P < 0.003). Conclusion This study indicates that reduced pressure pain sensitivity is associated both with male sex and physical activity level.

[1]  Panos Barlas,et al.  Gender differences in pressure pain threshold in healthy humans , 2003, Pain.

[2]  L. Arendt-Nielsen,et al.  Widespread pain hypersensitivity and facilitated temporal summation of deep tissue pain in whiplash associated disorder: an explorative study of women. , 2012, Journal of rehabilitation medicine.

[3]  Jon-Kar Zubieta,et al.  Alterations in Endogenous Opioid Functional Measures in Chronic Back Pain , 2013, The Journal of Neuroscience.

[4]  L. Arendt‐Nielsen,et al.  Deformation and pressure propagation in deep somatic tissue during painful cuff algometry , 2015, European journal of pain.

[5]  Lizeth Jazmín Ramírez,et al.  Assessment of musculoskeletal pain in the elderly , 2011 .

[6]  K. Koltyn,et al.  Exercise-Induced Hypoalgesia and Intensity of Exercise , 2002, Sports medicine.

[7]  B E Ainsworth,et al.  A simultaneous evaluation of 10 commonly used physical activity questionnaires. , 1993, Medicine and science in sports and exercise.

[8]  E. Keogh,et al.  Sex differences in adolescent chronic pain and pain-related coping , 2006, PAIN.

[9]  M. Umeda,et al.  Influence of moderate intensity physical activity levels and gender on conditioned pain modulation , 2016, Journal of sports sciences.

[10]  Lorie A. Kloda,et al.  A systematic literature review of 10years of research on sex/gender and experimental pain perception – Part 1: Are there really differences between women and men? , 2012, PAIN.

[11]  Rao P. Gullapalli,et al.  The role of circulating sex hormones in menstrual cycle–dependent modulation of pain-related brain activation , 2013, PAIN.

[12]  Janet L. Taylor,et al.  Aerobic training increases pain tolerance in healthy individuals. , 2014, Medicine and science in sports and exercise.

[13]  R. Fillingim,et al.  Sex differences in the perception of noxious experimental stimuli: a meta-analysis , 1998, Pain.

[14]  B. Gerdle,et al.  Intramuscular pain modulatory substances before and after exercise in women with chronic neck pain , 2015, European journal of pain.

[15]  R. Treede,et al.  Alterations in endogenous pain modulation in endurance athletes: An experimental study using quantitative sensory testing and the cold-pressor task , 2013, PAIN®.

[16]  J. Riley,et al.  A meta-analytic review of pain perception across the menstrual cycle , 1999, Pain.

[17]  M. Hartmann,et al.  Pain perception in athletes compared to normally active controls: A systematic review with meta-analysis , 2012, PAIN.

[18]  Lars Arendt-Nielsen,et al.  Pressure‐induced muscle pain and tissue biomechanics: A computational and experimental study , 2011, European journal of pain.

[19]  F. Birklein,et al.  Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): Standardized protocol and reference values , 2006, PAIN.

[20]  Lars Arendt-Nielsen,et al.  Pressure-pain function in desensitized and hypersensitized muscle and skin assessed by cuff algometry. , 2002, The journal of pain : official journal of the American Pain Society.

[21]  L. Arendt-Nielsen,et al.  Computer‐controlled pneumatic pressure algometry—a new technique for quantitative sensory testing , 2001, European journal of pain.

[22]  L. Arendt-Nielsen,et al.  Single-Point but Not Tonic Cuff Pressure Pain Sensitivity Is Associated with Level of Physical Fitness – A Study of Non-Athletic Healthy Subjects , 2015, PloS one.

[23]  T. Graven-Nielsen,et al.  Hypoalgesia After Exercise and the Cold Pressor Test is Reduced in Chronic Musculoskeletal Pain Patients With High Pain Sensitivity , 2016, The Clinical journal of pain.

[24]  C. Ring,et al.  Effects of isometric exercise on pain are mediated by blood pressure , 2008, Biological Psychology.

[25]  Stefan Lautenbacher,et al.  Spatial summation of heat pain in males and females. , 2001, Somatosensory & motor research.

[26]  R. Fillingim,et al.  Sex, gender, and pain: a review of recent clinical and experimental findings. , 2009, The journal of pain : official journal of the American Pain Society.

[27]  K. Koltyn,et al.  Perception of pain after resistance exercise. , 1998, British journal of sports medicine.

[28]  R. Shephard,et al.  A simple method to assess exercise behavior in the community. , 1969, Canadian journal of applied sport sciences. Journal canadien des sciences appliquees au sport.

[29]  P. Clifford,et al.  Intensity and duration threshold for aerobic exercise-induced analgesia to pressure pain. , 2004, Archives of physical medicine and rehabilitation.

[30]  A. Unruh Gender variations in clinical pain experience , 1996, Pain.

[31]  Lars Arendt-Nielsen,et al.  Spatial and temporal aspects of deep tissue pain assessed by cuff algometry , 2002, Pain.

[32]  Stephanie L. Fowler,et al.  Concept priming and pain: an experimental approach to understanding gender roles in sex-related pain differences , 2011, Journal of Behavioral Medicine.

[33]  Lars Arendt-Nielsen,et al.  Assessment of musculoskeletal pain sensitivity and temporal summation by cuff pressure algometry: a reliability study , 2015, Pain.

[34]  Laura M. Stapleton,et al.  Pain Catastrophizing Mediates the Relationship Between Self-Reported Strenuous Exercise Involvement and Pain Ratings: Moderating Role of Anxiety Sensitivity , 2009, Psychosomatic medicine.