Interpreting joint pain: quantitative sensory testing in musculoskeletal management

Area of Science:

• Orthopaedic Physical Therapy
• Pain Science
• Neurology

Background:

• Musculoskeletal injuries commonly cause nociceptive pain.
• Chronic pain can involve altered nociceptive processing, leading to neuropathic-like symptoms.
• Clinicians face challenges interpreting sensory changes in chronic pain patients.

Purpose of the Study:

• To review altered nociceptive processing and somatosensory changes after musculoskeletal injury.
• To explore the clinical utility of Quantitative Sensory Testing (QST) in orthopaedic physical therapy.
• To provide evidence supporting QST for diagnosing and managing chronic pain.

Main Methods:

• Review of clinical and laboratory evidence on altered nociceptive processing.
• Discussion of somatosensory changes, including hyperalgesia and allodynia.
• Examination of QST as an objective measure of sensory function.

Main Results:

• Chronic musculoskeletal injuries can lead to altered pain processing and neuropathic-like sensory findings.
• QST can objectively assess somatosensory changes and nociceptive pathway alterations.
• Examples include osteoarthritis of the knee and low back pain.

Conclusions:

• QST may serve as a valuable clinical tool in orthopaedic physical therapy.
• Objective sensory testing can aid clinical decision-making and prognosis determination.
• Understanding altered nociceptive processing is crucial for effective pain management.