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Widespread pressure pain hypersensitivity in elderly subjects with unilateral thumb carpometacarpal osteoarthritis

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HAND

Abstract

Background

Widespread pressure hypersensitivity is one of the signs that characterize central pain sensitization in subjects with knee and hip osteoarthritis (OA). The purpose of this study was to evaluate whether widespread pressure pain hyperalgesia is a feature of individuals with unilateral symptomatic thumb carpometacarpal (CMC) OA.

Methods

A total of 16 patients with unilateral symptomatic thumb CMC OA and 16 healthy sex- and age-matched controls were recruited. Pressure pain thresholds (PPTs) were assessed bilaterally over the first CMC joint; the C5–C6 zygapophyseal joint; the median, ulnar, and radial nerves; and tibialis anterior muscle. Grip and key strength, intensity of pain, and function QuickDASH were also measured.

Results

The analyses showed that patients with thumb CMC OA present bilaterally decreased PPTs over the first CMC joint, the C5–C6 zygapophyseal joint, and the tibialis anterior, median, ulnar and radial nerve as compared to controls (all, P < 0.01). Patients with thumb CMC OA also exhibited a bilateral reduction in pinch and grip strength than controls (P < 0.05). A significant correlation was found between PPT over the radial nerve and QuickDASH (r = 0.546, P = 0.029).

Conclusion

This study revealed bilateral widespread pressure pain hypersensitivity in individuals with unilateral symptomatic thumb CMC OA, suggesting that central pain processing mechanisms might be a feature of this pain population. These results should be taken into consideration when addressing future treatment approaches.

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Conflict of Interest

No conflict of interest has been declared by the author(s).

Statement of Human and Animal Rights

Ethical approval of the study was received by the institutional local board review (Department of Physical Therapy, Residenza Sanitaria Assistenziale “A. Maritano”, Sangano, Italy). All procedures were conducted according to the Declaration of Helsinki of 1975, as revised in 2000 (5).

Statement of Informed Consent

Informed consent was obtained from all participants and all procedures were conducted according to the Declaration of Helsinki

Author information

Authors and Affiliations

  1. Department of Research, A.I.FI. Piemonte Valle d’ Aosta, Turin, Italy

    Alessandro Chiarotto

  2. Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain

    Cesar Fernandez-de-las-Peñas

  3. Esthesiology Laboratory, Universidad Rey Juan Carlos, Alcorcón, Spain

    Cesar Fernandez-de-las-Peñas

  4. Parma, Italy

    Matteo Castaldo

  5. Physical and Rehabilitation Medicine, University of Brescia, Brescia, Italy

    Stefano Negrini

  6. IRCCS Don Gnocchi Foundation, Milan, Italy

    Stefano Negrini & Jorge Hugo Villafañe

  7. Regione Generala 11/16, 10045, Piossasco, Turin, Italy

    Jorge Hugo Villafañe

Authors
  1. Alessandro Chiarotto
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  2. Cesar Fernandez-de-las-Peñas
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  3. Matteo Castaldo
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  4. Stefano Negrini
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  5. Jorge Hugo Villafañe
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Corresponding author

Correspondence to Jorge Hugo Villafañe.

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Cite this article

Chiarotto, A., Fernandez-de-las-Peñas, C., Castaldo, M. et al. Widespread pressure pain hypersensitivity in elderly subjects with unilateral thumb carpometacarpal osteoarthritis. HAND 8, 422–429 (2013). https://doi.org/10.1007/s11552-013-9537-2

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  • DOI: https://doi.org/10.1007/s11552-013-9537-2

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