Relationships between pain thresholds, catastrophizing and gender in acute whiplash injury.
The mechanisms underlying sensory hypersensitivity (SH) in acute whiplash associated disorders (WAD) are not well understood. We examined the extent of the relationships between the sensory measures of pressure pain threshold (PPT) and cold pain threshold (CPT), catastrophizing, pain and disability levels and gender in acute WAD. Thirty-seven subjects reporting neck pain following a motor vehicle accident were examined within five weeks post-injury. Measures of neck pain and disability (Neck Disability Index, NDI) and catastrophizing (Pain Catastrophizing Scale, PCS) were taken. CPT was assessed in the cervical spine and PPTs were assessed in the cervical spine (PPTcx) and at a remote site (PPTdistal). CPT and PCS were moderately correlated (r=0.46; p < 0.01); however there were no significant relationships between PPT (cervical and distal) and PCS. Both CPT (r=0.55, p < 0.01) and PPTcx (r=-0.42, p < 0.01) were significantly correlated with NDI but PPTdistal was not (r=-0.08, p=0.65). Finally, gender modulated the relationships between sensory measures, catastrophizing, and pain and disability levels. In conclusion, subjects with higher levels of catastrophizing presented with sensory hypersensitivity to cold stimuli in the acute phase of whiplash. Differences between genders are in accordance with the growing body of evidence suggesting that the relationships between some psychological factors and injury-related symptoms are modulated by gender.
Rivest
Karine
K
CRIR, Jewish Rehabilitation Hospital site, Research Center, 3205 Place Alton Goldbloom, Laval, Quebec, Canada H7V 1R2. karine.rivest@mail.mcgill.ca
Côté
Julie N
JN
Dumas
Jean-Pierre
JP
Sterling
Michele
M
De Serres
Sophie J
SJ
D000208:Acute Disease; D000328:Adult; D003080:Cold Temperature / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold; D010812:Physical Stimulation; D011312:Pressure / Q000009:adverse effects; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000209:etiology; D012021:Reflex, Abnormal; D012737:Sex Factors; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology; D014911:Whiplash Injuries / Q000150:complications* / Q000523:psychology; D055815:Young Adult