title: Clinical Ratings of Pain Sensitivity Correlate With Quantitative Measures in People With Chronic Neck Pain and Healthy Controls: Cross-Sectional Study.
abstract: BACKGROUND
  Correlations between clinical and quantitative measures of pain sensitivity are poor, making it difficult for clinicians to detect people with pain sensitivity. Clinical detection of pain sensitivity is important because these people have a different prognosis and may require different treatment.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the relationship between clinical and quantitative measures of pain sensitivity across individuals with and without neck pain.
  
  
  METHODS
  This cross-sectional study included 40 participants with chronic neck pain and 40 age- and sex-matched controls. Participants underwent quantitative sensory testing of cold pain thresholds (CPTs) and pressure pain thresholds (PPTs). Clinical tests for pain sensitivity were the ice pain test and the pressure pain test. All tests were undertaken at standardized local (neck and upper trapezius muscles) and remote (wrist and tibialis anterior muscles) sites. Median and interquartile range (IQR) were calculated for neck pain and control groups, and parametric and nonparametric tests were used to compare groups. Correlation coefficients were calculated between quantitative and clinical measures.
  
  
  RESULTS
  There were significant differences for clinical and quantitative measures of cold and pressure sensitivity between the neck pain and control groups (eg, CPT neck pain group: median=22.31°C, IQR=18.58°C; control group: median=5.0°C, IQR=0.74°C). Moderate-to-good correlations were found between the clinical ice pain test and CPT at all sites (.46 to .68) except at the wrist (.29 to .40). Fair correlations were found for the clinical pressure pain test and PPT (-.26 to -.45). Psychological variables contributing to quantitative measures of pain sensitivity included catastrophization, sleep quality, and female sex.
  
  
  CONCLUSIONS
  Clinical pressure pain tests were not quantitatively standardized in this study.
  
  
  CONCLUSIONS
  The ice pain test may be useful as a clinical correlate of CPT at all sites except the wrist, whereas the pressure pain test is less convincing as a clinical correlate of PPT.
authors.affiliation: T. Rebbeck, PhD, FACP, MAppSc(ManipPhty), BAppSc(Phty), Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, C43A Cumberland Campus, New South Wales 2006, Australia. trudy.rebbeck@sydney.edu.au.
authors.forename: Trudy
authors.initials: T
authors.lastname: Rebbeck
authors.affiliation: N. Moloney, PhD, MManipTher, BPhysio(Hons), Department of Health Professions, Faculty of Medicine, Macquarie University, Sydney, Australia.
authors.forename: Niamh
authors.initials: N
authors.lastname: Moloney
authors.affiliation: R. Azoory, MHlthSc (ManipPhty), BSc(PT), BA(Psych), Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Azoory
authors.affiliation: M. Hübscher, PhD(Sport Sciences), MA(Sport Sciences), Neuroscience Research Australia, The University of New South Wales, Sydney, Australia.
authors.forename: Markus
authors.initials: M
authors.lastname: Hübscher
authors.affiliation: R. Waller, MManipTher, School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Waller
authors.affiliation: R. Gibbons, BScPhysiotherapy(Hons), School of Physiotherapy and Exercise Science, Curtin University.
authors.forename: Rebekah
authors.initials: R
authors.lastname: Gibbons
authors.affiliation: D. Beales, PhD, FACP, MManipTher, BSc(Physio), School of Physiotherapy and Exercise Science, Curtin University.
authors.forename: Darren
authors.initials: D
authors.lastname: Beales
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D059350:Chronic Pain / Q000503:physiopathology* / Q000523:psychology; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000503:physiopathology* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold / Q000502:physiology*; D011795:Surveys and Questionnaires