Abnormal Quantitative Sensory Testing is Associated With Persistent Pain One Year After TKA

As many as 15% of patients report at least moderate persistent pain after TKA. Such pain may be related the presence of widespread hyperalgesia and neuropathic-type pain. The study asked if there was a difference among patients who report moderate to severe pain or no pain at least 12 months post TKA regarding (1) pressure pain threshold, (2) thermal (cold/heat) pain and detection thresholds, and (3) self-reported neuropathic pain. Fifty-three volunteers were recruited from patients reporting no pain or moderate to severe pain, according to the Knee Society Score. Differences between the moderate-to-severe and no-pain groups regarding pressure pain, heat and cold thresholds, and self-reported neuropathic-type pain were analyzed using independent t-tests. Patients in the moderate-to-severe pain group exhibited reduced pressure pain threshold in the knee with the TKA (p=0.025) and at the elbow (p=0.002). This group also showed greater pain sensitivity to cold at the knee (p=0.008) and elbow (p=0.010), and increased heat pain sensitivity at the elbow (p=0.032). Cold and heat detection thresholds were impaired in this group at the elbow (cold, p=0.034; heat, p=0.010), although only heat detection was impaired at the knee (p=0.009). The moderate-to-severe pain group reported more neuropathic-type pain (p=0.001) as well.

Persistent pain after TKA was associated with widespread pressure, cold hyperalgesia, and a higher amount of neuropathic-type pain.

Neck Pain

Out of all 291 conditions studied in the Global Burden of Disease 2010 Study, neck pain ranked 4th highest in terms of disability and 21st in terms of overall burden.

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