title: Mechanical pain sensitivity and the severity of chronic neck pain and disability are not modulated across the menstrual cycle.
abstract: Despite the high prevalence of neck pain among women, menstrual effects on regional pain outcomes have not been investigated in this clinical population. This study evaluated menstrual effects on mechanical pain sensitivity (pressure pain threshold [PPT]), neck pain intensity (numeric pain rating scale [NPRS]), and neck-related disability (Neck Disability Index [NDI]) in 22 normally menstruating (NM) and 17 hormonal contraceptive users with chronic neck pain. Sex hormones, PPT, and NDI were measured during the early follicular (F1), late follicular (F2), and luteal (L) menstrual phases. Daily NPRS scores were recorded in an online symptom diary and averaged within each phase. Estradiol and progesterone increased only for NM women in F2 and L, respectively. Phase effects on PPT (η(2) = .003), NDI (η(2) = .003), and NPRS (η(2) = .016) for NM women were small and did not differ from those for the hormonal contraceptive users (P ≥ .386). Averaged across the menstrual cycle, PPT scores explained 29% of the variance in NPRS scores for NM women but were not associated with NDI scores in either group. Results indicate that the magnitude of menstrual effects on mechanical pain sensitivity and the severity of neck pain and disability do not exceed thresholds of clinically detectable change in women with chronic neck pain.
  
  
  CONCLUSIONS
  Fluctuations in evoked and clinical pain outcomes across the menstrual cycle do not appear to be of sufficient magnitude to impact clinical decision making for women with chronic neck pain.
authors.affiliation: Rehabilitation Science and Physical Therapy Programs, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
authors.forename: Jaclyn E
authors.initials: JE
authors.lastname: Balter
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Molner
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Kohrt
authors.forename: Katrina S
authors.initials: KS
authors.lastname: Maluf
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology*; D019547:Neck Pain / Q000503:physiopathology*; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology*; D012720:Severity of Illness Index; D064171:Superficial Back Muscles / Q000503:physiopathology
keywords: Disability; contraception; pressure pain threshold; sex hormones; trapezius muscle
references.citation: Health Care Women Int. 2003 Mar;24(3):221-9
references.pmid: 12746013
references.citation: Neurosci Biobehav Rev. 2000 Jun;24(4):485-501
references.pmid: 10817845
references.citation: J Pain. 2006 Mar;7(3):151-60
references.pmid: 16516820
references.citation: Med Clin North Am. 2001 Jul;85(4):1017-35
references.pmid: 11480256
references.citation: Eur J Pain. 2010 Jan;14(1):77-82
references.pmid: 19217329
references.citation: Am J Physiol Regul Integr Comp Physiol. 2006 Aug;291(2):R245-56
references.pmid: 16484434
references.citation: Brain Res Bull. 2005 Aug 15;66(3):179-88
references.pmid: 16023915
references.citation: Pain. 2007 Nov;132 Suppl 1:S3-S12
references.pmid: 17951003
references.citation: Clin Exp Rheumatol. 2005 Nov-Dec;23(6):819-28
references.pmid: 16396700
references.citation: Eur J Pain. 2001;5(1):27-37
references.pmid: 11394920
references.citation: Pain. 2013 Apr;154(4):515-524
references.pmid: 23318125
references.citation: J Neurosci. 2006 May 24;26(21):5777-85
references.pmid: 16723535
references.citation: Arch Phys Med Rehabil. 1988 Apr;69(4):286-91
references.pmid: 3281631
references.citation: J Biomed Inform. 2009 Apr;42(2):377-81
references.pmid: 18929686
references.citation: J Pain. 2010 Apr;11(4):330-42
references.pmid: 19853526
references.citation: Neuropsychobiology. 2010;61(3):131-40
references.pmid: 20110738
references.citation: Cranio. 2008 Jul;26(3):211-5
references.pmid: 18686498
references.citation: Pain. 1998 Aug;77(2):151-161
references.pmid: 9766833
references.citation: J Prosthet Dent. 1998 Jun;79(6):663-70
references.pmid: 9627895
references.citation: Fertil Steril. 2002 Jul;78(1):90-5
references.pmid: 12095496
references.citation: Exp Brain Res. 2010 Jun;203(2):329-38
references.pmid: 20419369
references.citation: Gend Med. 2009;6 Suppl 2:168-92
references.pmid: 19406368
references.citation: Pain. 1987 Jul;30(1):115-126
references.pmid: 3614975
references.citation: Percept Mot Skills. 2003 Feb;96(1):201-11
references.pmid: 12705527
references.citation: J Oral Rehabil. 2002 Nov;29(11):1042-51
references.pmid: 12453257
references.citation: Man Ther. 2010 Apr;15(2):154-9
references.pmid: 19892580
references.citation: Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S75-82
references.pmid: 18204403
references.citation: Pain. 1996 May-Jun;65(2-3):123-67
references.pmid: 8826503
references.citation: Pain. 1999 Jun;81(3):225-235
references.pmid: 10431710
references.citation: Clin Biochem Rev. 2006 Aug;27(3):139-46
references.pmid: 17268582
references.citation: J Orthop Sports Phys Ther. 2011 Sep;41(9):644-50
references.pmid: 21885906
references.citation: J Orthop Sports Phys Ther. 2000 Jan;30(1):13-20
references.pmid: 10705592
references.citation: J Occup Environ Med. 2010 Apr;52(4):424-7
references.pmid: 20357682
references.citation: Horm Behav. 2000 Sep;38(2):137-47
references.pmid: 10964528
references.citation: Arch Phys Med Rehabil. 2008 Jan;89(1):69-74
references.pmid: 18164333
references.citation: J Manipulative Physiol Ther. 1991 Sep;14(7):409-15
references.pmid: 1834753
references.citation: Pain. 2002 Apr;96(3):227-237
references.pmid: 11972994
references.citation: Clin J Pain. 2013 Feb;29(2):154-61
references.pmid: 22688607
references.citation: Pain. 2001 May;92(1-2):229-34
references.pmid: 11323144
references.citation: Pain. 2011 Mar;152(3):614-622
references.pmid: 21239109
references.citation: Clin J Pain. 2005 Mar-Apr;21(2):175-81
references.pmid: 15722811
references.citation: Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S93-100
references.pmid: 18204406
references.citation: Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S199-213
references.pmid: 18204393
references.citation: Pain. 2009 Nov;146(1-2):47-55
references.pmid: 19592167
references.citation: Pain. 1997 Jan;69(1-2):153-60
references.pmid: 9060026
references.citation: J Clin Psychol. 2011 Sep;67(9):942-68
references.pmid: 21647882
references.citation: Maturitas. 2009 Aug 20;63(4):292-6
references.pmid: 19595525