Bilateral mechanical-pain sensitivity over the trigeminal region in patients with chronic mechanical neck pain.
The aim of this study was to investigate bilateral pressure-pain sensitivity over the trigeminal region, the cervical spine, and the tibialis anterior muscle in patients with mechanical chronic neck pain. Twenty-three patients with neck pain (56% women), aged 20 to 37 years old, and 23 matched controls (aged 20 to 38 years) were included. Pressure pain thresholds (PPTs) were bilaterally assessed over masseter, temporalis, and upper trapezius muscles, the C5-C6 zygapophyseal joint, and the tibialis anterior muscle in a blinded design. The results showed that PPT levels were significantly decreased bilaterally over the masseter, temporalis, and upper trapezius muscles, and also the C5-C6 zygapophyseal joint (P < .001), but not over the tibialis anterior muscle (P = .4) in patients with mechanical chronic neck pain when compared to controls. The magnitude of PPT decreases was greater in the cervical region as compared to the trigeminal region (P < .01). PPTs over the masseter muscles were negatively correlated to both duration of pain symptoms and neck-pain intensity (P < .001). Our findings revealed pressure-pain hyperalgesia in the trigeminal region in patients with mechanical chronic neck pain, suggesting spreading of sensitization to the trigeminal region in this patient population.


CONCLUSIONS
This article reveals the presence of bilateral pressure-pain hypersensitivity in the trigeminal region in patients with idiopathic neck pain, suggesting a sensitization process of the trigemino-cervical nucleus caudalis in this population. This finding has implications for development of management strategies.
La Touche
Roy
R
Faculty of Medicine, Department of Physical Therapy, Universidad San Pablo CEU, Madrid, Spain.
Fernández-de-Las-Peñas
César
C
Fernández-Carnero
Josué
J
Díaz-Parreño
Santiago
S
Paris-Alemany
Alba
A
Arendt-Nielsen
Lars
L
D000328:Adult; D002574:Cervical Vertebrae / Q000294:innervation / Q000503:physiopathology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000209:etiology* / Q000503:physiopathology*; D008297:Male; D008410:Masticatory Muscles / Q000294:innervation / Q000503:physiopathology; D008465:Mechanoreceptors / Q000502:physiology; D009334:Neck Muscles / Q000294:innervation / Q000503:physiopathology; D019547:Neck Pain / Q000150:complications* / Q000503:physiopathology*; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold / Q000502:physiology; D014275:Trigeminal Caudal Nucleus / Q000503:physiopathology; D020433:Trigeminal Nerve Diseases / Q000209:etiology* / Q000503:physiopathology*; D055815:Young Adult; D021801:Zygapophyseal Joint / Q000294:innervation / Q000503:physiopathology