Abstract
Few data have been available on the functional role of small fiber damage in patients
with peripheral nerve injuries with and without spontaneous pain. The aim of the present
study was to investigate the function of large myelinated nerve fibers as well as
small nerve fibers in a material of 60 patients with peripheral nerve injuries in
upper or lower extremities, 30 patients with spontaneous pain, and 30 patients without
pain. Patients were questioned about the characteristics of pain and investigated
clinically with EMG/neurography and assessment of thermal thresholds in the innervation
territory of the lesioned nerve as well as in the contralateral area. Sensation of
touch and warmth and cold detection was significantly reduced in the injured side
in both groups. There was a tendency, not significant, for heat pain thresholds to
be more elevated in the affected side compared with the healthy side in the pain group
only (47.8°C versus 45.1°C). There were no significant differences in thermal thresholds
between the 2 groups of patients. The main finding was a high percentage of hyperphenomena
(allodynia to light touch and reduced mechanical pain thresholds) in the pain group
only.
Perspective
Small fiber function did not significantly differ between patients with and without
pain, indicating that elevated thermal thresholds alone will not reflect mechanisms
responsible for the generation of pain. Hyperphenomena were present in the affected
side of the pain group only.
Key words
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Article info
Publication history
Published online: May 20, 2010
Accepted:
March 5,
2010
Received in revised form:
February 23,
2010
Received:
January 6,
2010
Footnotes
Supported by a grant from the South-Eastern Norway Regional Health Authority (Dr Kleggetveit).
The authors report no conflicts of interest.
Identification
Copyright
© 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.
