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Experimental Knee Pain Evoke Spreading Hyperalgesia and Facilitated Temporal Summation of Pain

Authors

  • Tanja Schjoedt Joergensen MSc,

    1. Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg
    2. Clinical Motor Function Laboratory, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg, Denmark
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  • Marius Henriksen PhD,

    1. Clinical Motor Function Laboratory, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg, Denmark
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  • Bente Danneskiold-Samsoee DMSc,

    1. Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg
    2. Clinical Motor Function Laboratory, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg, Denmark
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  • Henning Bliddal DMSc,

    1. Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg
    2. Clinical Motor Function Laboratory, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg, Denmark
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  • Thomas Graven-Nielsen DMSc

    Corresponding author
    • Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg
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  • Disclosure information/Acknowledgment of support: No other staff has been involved in this study.
  • Authors' contributions

    TSJ: main author of the manuscript; data collection, data analysis and writing.

    MH: contributed to the analysis and discussed and commented on the whole paper.

    BDS: discussed and commented on the whole paper and protocols.

    HB: discussion and commented on the whole paper and protocols.

    TGN: main responsible for outlining the manuscript, discussing, and commenting on the paper during the whole process.

  • Summary

    Experimental knee pain leads to hyperalgesia at the knee and facilitated temporal summation of pain outside the knee, indicating involvement of peripheral and central sensitization, in subjects with no history of knee pain. Experimental models of knee pain in healthy subjects may be advantageous to investigate mechanisms of the nociceptive system related to joint pain without any unwanted variability.

Reprint requests to: Thomas Graven-Nielsen, DMSc, PhD, Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7D-3, 9220 Aalborg E, Denmark. Tel: +45-9940-9832; Fax: +45-9815-4008; E-mail: tgn@hst.aau.dk.

Abstract

Objectives

This study evaluated the deep-tissue pressure pain sensitivity and temporal summation of pain within and around healthy knees exposed to experimental pain.

Design

The study was designed as a randomized crossover trial, with each subject tested on 1 day.

Setting

All tests were carried out at the Laboratory for Musculoskeletal Pain and Motor Control, Center for Sensory-Motor Interaction, Department of Health Science and Technology at Aalborg University, Denmark.

Subjects

Seventeen healthy subjects (10 males) participated in this study.

Interventions

Experimental pain model. Pain was induced in the infrapatellar fat pad by injection of hypertonic saline and the contralateral infrapatellar fat pad was injected with isotonic saline as control.

Outcome Measures

Pressure pain thresholds, temporal summation of pressure pain, and cutaneous mechanosensitivity were assessed on three occasions: baseline, immediately after the injection, and when pain had vanished. Assessments sites were located in the peripatellar region, vastus lateralis, and tibialis anterior muscles.

Results

The experimental knee pain model demonstrated 1) hyperalgesia to pressure stimulation on the infrapatellar fat pad during experimental pain, and 2) facilitated temporal summation of pressure pain at the infrapatellar fat pad and knee-related muscles.

Conclusion

The increased sensitivity and temporal summation found in this study were exclusive to deep -tissue with no contralateral decreased pain sensitivity. The study showed that acute knee joint pain leads to hyperalgesia and facilitated temporal summation in the infrapatellar fat pad and in muscles located distant to the injection site, in subjects with no history of knee pain.

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