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Subgroups based on thermal and pressure pain thresholds in women with chronic whiplash display differences in clinical presentation - an explorative study

Börsbo, Björn (författare)
Linköpings universitet,Rehabiliteringsmedicin,Hälsouniversitetet
Liedberg, Gunilla M (författare)
Linköpings universitet,Hälsa, Aktivitet, Vård (HAV),Hälsouniversitetet
Wallin, Mia (författare)
Linköpings universitet,Hälsa, Aktivitet, Vård (HAV),Hälsouniversitetet
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Gerdle, Björn (författare)
Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Smärt och rehabiliteringscentrum,Avdelningen för samhällsmedicin
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 (creator_code:org_t)
2012
2012
Engelska.
Ingår i: Journal of Pain Research. - 1178-7090. ; 5, s. 511-521
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Purpose: To investigate the presence of subgroups in chronic whiplash-associated disorders (WAD) based on pain thresholds for pressure (PPT), cold (CPT), and heat (HPT) and to compare these subgroups with respect to symptomatology, disability, and health aspects. Methods: Two groups of female subjects – patients with chronic WAD (n = 28) and healthy controls (CON; n = 29) – were investigated. Quantitative sensory testing (QST) for thermal thresholds and algometry for PPT at four sites in the body (over the trapezius and tibialis anterior bilaterally) were determined. Habitual pain intensities, psychological strain, disability, and health aspects were registered using a questionnaire.Results: A cluster analysis based on PPT, CPT, and HPT identified two subgroups of chronic WAD: one sensitive subgroup (s-WAD; n = 21), and one less sensitive subgroup (ls-WAD; n = 6). S-WAD displayed widespread hyperalgesia, whereas ls-WAD had localized hyperalgesia in the neck area, with tendencies to supernormal values in remote areas of the body. Generally, s-WAD had a significantly worse situation than the CON with respect to symptomatology, disability, and health aspects. The ls-WAD group was intermediary between s-WAD and CON in these aspects.Conclusion: Different explanations, eg, severity of the pain condition per se, etiological factors, and pre-trauma differences in pain sensitivity, may exist for the differences in pain thresholds between the two subgroups. Future research should investigate the role of pain thresholds in the chronic stage to determine the efficacy of treatment interventions.

Nyckelord

cold pain threshold
pain
pressure pain threshold
heat pain threshold
subgroup
whiplash
WAD
MEDICINE
MEDICIN

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