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Tendinopathies and Pain Sensitisation: A Meta-Analysis with Meta-Regression.
Davide Previtali1, Alberto Mameli1, Stefano Zaffagnini2
1Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, Switzerland.
Biomedicines
|July 27, 2022
Summary
Tendinopathies often involve pain sensitization, affecting local and distant pain thresholds. While lateral epicondylalgia consistently shows sensitization, other tendinopathies present conflicting evidence, influenced by patient factors like age and activity.
Area of Science:
- Musculoskeletal conditions
- Pain research
- Rehabilitation science
Background:
- Pain sensitization is linked to treatment failure and chronic pain in musculoskeletal conditions like tendinopathies.
- Understanding pain sensitization mechanisms is crucial for effective tendinopathy management.
Purpose of the Study:
- To systematically analyze evidence on pain sensitization in various tendinopathies.
- To compare local and distant pain thresholds in affected individuals versus healthy controls.
- To investigate influencing factors such as age and activity level on pain sensitization.
Main Methods:
- Systematic literature search of PubMed, Cochrane, Scopus, and Web of Science.
- Inclusion of Level I-IV studies assessing pain sensitization in symptomatic tendinopathies.
- Meta-analysis of pressure pain thresholds (PPT) and meta-regression analyses.
Main Results:
- Affected individuals demonstrated significantly increased local, contralateral, and distant PPTs compared to controls.
- Lateral epicondylalgia consistently showed features of both central and peripheral sensitization.
- Results for other tendinopathies were conflicting; patient age and activity level influenced local PPTs.
Conclusions:
- Tendinopathies are generally characterized by pain sensitization, with varying evidence across different types.
- Lateral epicondylalgia exhibits clear signs of sensitization, unlike other tendinopathies where findings are more mixed.
- Patient characteristics like age and activity level are important confounders in pain sensitization assessments.
