Quantitative sensory testing: effect of site and skin temperature on thermal thresholds.
OBJECTIVE
To determine the effect of different sites and local skin temperature on thermal thresholds.


METHODS
Cool and warm detection and cold and heat pain thresholds were compared in 46 normal volunteers at the thenar eminence (TE), dorsum of the hand (DH), volar surface of the wrist (VW) and dorsum of the foot (DF).


RESULTS
The hand is more sensitive than the foot for cool and warm. TE is more sensitive for warm than DH and VW but the difference is clinically negligible. DH and VW are equally sensitive to warm. TE, DH, and VW are equally sensitive to cool. Inter-individual variance is smallest at TE. Warm and cool thresholds are independent of local skin temperature (range of 27-37 degrees C). TE is less sensitive for cold pain but otherwise the hand and the foot are equally sensitive to thermal pain.


CONCLUSIONS
Testing of thermal thresholds in normal subjects can be adequately conducted at several sites at the hand, however, TE is preferred given the small inter-individual variability. TE may be preferred for evaluating hyperalgesia to cold given its higher threshold. Warming or cooling of the skin is unnecessary within the range normally encountered in routine clinical evaluation.
Hagander
L G
LG
Fairview University Medical Center, University of Minnesota, Minneapolis 55455, USA.
Midani
H A
HA
Kuskowski
M A
MA
Parry
G J
GJ
D000328:Adult; D000465:Algorithms; D003080:Cold Temperature; D005260:Female; D005528:Foot; D006225:Hand; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D017288:Pain Threshold; D012016:Reference Values; D012684:Sensory Thresholds; D012881:Skin Temperature / Q000502:physiology*; D014953:Wrist