Quantitative Sensory Testing Following Orthopedic Trauma: A Longitudinal Multisite Feasibility Study

Orthopedic trauma is a major cause of disability worldwide; around half of the people who sustain orthopedic trauma develop chronic pain. Quantitative Sensory Testing (QST) is a standardized method of assessing pain sensitivity, which may be useful in characterizing pain after injury and predicting chronic pain. This primary aim of this project was to test the feasibility of a portable QST battery, administered to adults 6-weeks post major orthopedic trauma and surgery.

Twenty-nine participants (62% male; 52% black) who sustained major orthopedic trauma and surgery completed QST testing (including static measures, conditioned pain modulation, and mechanical temporal summation) at their 6-week postoperative visit and were invited to complete a 6-month follow-up survey. We examined feasibility and acceptability indices and explored associations between QST and clinical pain ratings.

Of all eligible patients, 77% were recruited. QST procedures were feasible and tolerable. No participant declined participation, withdrew for reasons related to study procedures, or discontinued QST due to discomfort. No patient experienced increased clinical pain after QST. Exploratory analyses identified a positive association between static QST and pain interference at T1. Feasibility challenges included poor 6-month retention (57%) and difficulty administering QST to patients with upper extremity injuries. High rates of analgesic use before testing (38%) poses an additional barrier for future QST studies in this population.

QST was acceptable and partially feasible; challenges included poor retention, high rates of analgesic use, and logistical barriers to accessing injury sites for testing. We pose several potential solutions for future research.