Science In Brief

Chiropractic Litterature Review

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The Study: The effect of pressure pain sensitivity and patient factors on self-reported pain-disability in patients with chronic neck pain

The Facts:

  1. The authors studied the relationship of pain pressure sensitivity and patient factors to the disability of patients who were suffering from chronic neck pain. 
  2. They studied 44 subjects who suffered from a moderate level of chronic neck pain. 
  3. The patients completed a self assessment of their pains and disability and of their level of comorbidities. The comordidities were on a Katz comorbidity scale (See Editor's comments) which looks at 12 co-morbid conditions and then gives them a value based upon whether the patient currently has the condition, were receiving treatment for the condition and if the condition caused them to limit their activities. 
  4. Pain pressure sensitivity was measured using a JTECH pressure algometer. 
  5. Higher pain pressure threshold and sensitivity was correlated with less self reported pain disability. 
  6. Age did not correlate to either pain or disability. 
  7. The role of gender was less clear. Females tended to be more sensitive to pressure pain than males however, that sensitivity did not appear to be correlated with differences in self related disability. 
  8. The greatest predictor of pain disability was found to be cormorbidity factors. 
  9. Pain pressure sensitivity "may play a role in outcome measures of pain and disability but between-subject comparisons should consider gender and comorbidity issues." 

Take Home:

Pain pressure sensitivity can be useful for outcome assessment but "must be considered with caution until larger samples are used to confirm any interactions between comorbidity and" pain pressure sensitivity.

Reviewer: Roger Coleman DC

Editor's Comments:

If you aren't particularly familiar with the concept of comorbidity or the instruments used in this study to measure it (I certainly wasn't), here's a brief introduction to the subject.*

The term comorbidity refers to the presence of additional factors or disorders which are observed to be "co-occuring" with the primary disease/disorder...in this study, chronic neck pain.

The Katz comorbidity scale used in this study (also called the "Self Administered Comorbidity Questionnaire" ) looks at a number of basic factors such as age, sex, race, level of education, insurance status, type of services provided (medical vs. surgical), mean length of stay in hospital, mean total hospital charges, and the Mean Charlson Index Score.

"The Charlson Comorbidity Index predicts the ten year mortality for a patient who may have a range of comorbid conditions, such as heart disease, AIDS, or cancer (a total of 22 conditions). Each of the 22 conditions is assigned a score depending upon the risk of dying associated with the condition. Finally, scores are summed to provide a total score used to predict risk of mortality.

*Source: Wikipedia

Editor: Mark R. Payne DC

Reference: Uddin Z, MacDermid JC, Woodhouse LJ, Triano JJ, Galea V, Gross Ar.  The effect of pressure pain sensitivity and patient factors on self-reported pain-disability in patients with chronic neck pain. Open Orthop J. 2014 Sep 30;8:302-9.            

Link to Abstract: http://www.ncbi.nlm.nih.gov/pubmed/25320651

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