Abstract
Our aim was to quantify spatial differences in pressure and thermal pain sensitivity
maps between patients with unilateral lateral epicondylalgia (LE) and age- and sex-matched
controls. Pressure (PPT), cold (CPT), and heat (HPT) pain thresholds were assessed
over 12 points forming a 3 × 4 matrix (4 points in the superior part, 4 points in
the middle, and 4 points in the lower part around the lateral epicondyle) bilaterally
in 16 subjects with strictly unilateral LE and 16 age- and sex-matched controls in
a blinded design. Topographical pain sensitivity maps to pressure and thermal stimulation
over the elbow in patients with LE and healthy controls were calculated. A multilevel
3-way ANCOVA test was applied to detect differences in topographical maps between
groups. Subjects with LE showed bilateral lower PPT, higher CPT (pain at higher temperature)
and lower HPT (pain at lower temperature) at all the measurement points as compared
to controls (all, P < .01). PPT were lower at points over the extensor carpi radialis brevis (ECRB) muscle
as compared to points over the extensor digitorum communis muscle (P < .01) and over the extensor carpi ulnaris muscle (P < .001). CPT and HPT were not significantly different between points (P > .05). Topographical pressure and thermal pain sensitivity maps revealed bilateral
hyperalgesia in patients with strictly unilateral LE. LE patients exhibited heterogeneously
distributed pressure pain hyperalgesia while cold or heat maps were homogenous. The
most sensitive localizations for PPT assessment corresponded to the muscle belly of
the ECRB. Our results confirm the role of ECRB muscle in LE and argue for evidence
of peripheral and central sensitization mechanisms in patients with strictly unilateral
symptoms.
Perspective
Topographical pressure and thermal sensitivity maps revealed bilateral hyperalgesia
in patients with strictly unilateral lateral epicondylalgia (LE). LE patients exhibited
heterogeneously distributed pressure pain hyperalgesia while cold or heat pain maps
were homogenous. The most sensitive localizations for PPT assessment corresponded
to the muscle belly of the ECRB.
Key words
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Article Info
Publication History
Published online: June 17, 2011
Accepted:
April 3,
2011
Received in revised form:
March 23,
2011
Received:
February 5,
2011
Footnotes
The present study has partially supported by a grant from the Danish Working Environment Authority (“Undersøgelse af manifestationer, årsagsmekanismer samt progression af smerter hos computerbrugere” project) Gigtforeningen, and Arbejdsmiljofondet .
Authors have no conflict of interest to declare for this manuscript.
Identification
Copyright
© 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.
