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Sensory Hyperalgesia is Characteristic of Nonspecific Arm Pain: A Comparison With Cervical Radiculopathy and Pain-Free Controls

Moloney, Niamh PhD*,†; Hall, Toby PhD; Doody, Catherine PhD

doi: 10.1097/AJP.0b013e31827c7ae8
Original Articles

Objectives: Nonspecific arm pain (NSAP) is a common clinical entity, the pathophysiological mechanisms of which are poorly understood. The purpose of this study was to investigate sensory profiles in individuals with nonspecific arm pain compared with cervical radiculopathy and pain-free controls.

Methods: Forty office workers with NSAP, 17 people with cervical radiculopathy, and 40 pain-free controls were assessed by means of quantitative sensory testing (thermal and vibration detection thresholds; thermal and pressure pain thresholds), tests for neural tissue sensitivity, and questionnaires. Between-group comparisons were conducted using Kruskal-Wallis tests. An exploratory factor analysis was used to determine characteristic features in NSAP.

Results: Both patient groups demonstrated cold and pressure pain sensitivity (P<0.003; P<0.05) and neural tissue sensitivity (P<0.001). The NSAP group also demonstrated heat pain sensitivity (P<0.001). Both patient groups demonstrated hypoaesthesia to vibration thresholds (P<0.05), whereas thermal hypoaesthesia was only evident in the cervical radiculopathy group (P<0.05). Exploratory factor analysis revealed pressure and thermal pain sensitivity as the key characteristics of this NSAP group.

Discussion: Sensory profiles in NSAP and cervical radiculopathy differ. NSAP is characterized by widespread sensitivity to thermal and pressure pain in the absence of thermal hypoaesthesia, whereas cervical radiculopathy is characterized by the presence of thermal and vibratory hypoaesthesia as well as more localized cold and pressure pain sensitivity. The identification of widespread sensory hypersensitivity in NSAP has important implications for clinical decision making.

*Department of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia

Department of Public Health, Physiotherapy and Population Science, University College Dublin, Ireland

School of Physiotherapy, Curtin University of Technology, Perth, Wester Australia

The authors declare no conflict of interest. Supported by the Irish Research Council for Science, Engineering, and Technology, Dublin; Chartered Physiotherapists in Musculoskeletal Therapy, Ireland; and Chartered Physiotherapists in Occupational Health and Ergonomics, Ireland.

Reprints: Niamh Moloney, PhD, Department of Physiotherapy, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia (e-mail: niamh.moloney@sydney.edu.au).

Received May 1, 2012

Accepted November 4, 2012

© 2013 by Lippincott Williams & Wilkins