Pressure Pain Hypersensitivity and Ultrasound Changes in the Radial Nerve in Patients with Unilateral Lateral Epicondylalgia: A Case–Control Study
Some authors have proposed the potential role of the radial nerve in lateral epicondylalgia. The aims of this study were to investigate the presence of pressure pain hyperalgesia and nerve swelling (increased cross-sectional area) assessed with ultrasound imaging on the radial nerve in people with l...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-07-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/15/2488 |
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| author | Ignacio Cancela-Cilleruelo Jorge Rodríguez-Jiménez César Fernández-de-las-Peñas Joshua A. Cleland José L. Arias-Buría |
| author_facet | Ignacio Cancela-Cilleruelo Jorge Rodríguez-Jiménez César Fernández-de-las-Peñas Joshua A. Cleland José L. Arias-Buría |
| author_sort | Ignacio Cancela-Cilleruelo |
| collection | DOAJ |
| description | Some authors have proposed the potential role of the radial nerve in lateral epicondylalgia. The aims of this study were to investigate the presence of pressure pain hyperalgesia and nerve swelling (increased cross-sectional area) assessed with ultrasound imaging on the radial nerve in people with lateral epicondylalgia, and to investigate if an association exists between pressure pain sensitivity and cross-sectional area. A total of 37 patients with lateral epicondylalgia (43% women, age: 45.5 ± 9.5 years) and 37 age- and sex-matched pain-free controls were recruited for participation. Pressure pain thresholds (PPTs) were assessed bilaterally on the radial nerve at the spiral groove, the arcade of Frohse, and the anatomic snuffbox in a blinded design. Further, the cross-sectional area of the radial nerve at the spiral groove and antecubital fossa was also assessed. The results demonstrated lower PPTs on the radial nerve of the affected side in individuals with lateral epicondylalgia as compared with the unaffected side (<i>p</i> < 0.01) and with both sides in healthy controls (<i>p</i> < 0.001). Additionally, the cross-sectional area of the radial nerve on the affected side in patients was higher compared with the unaffected side (<i>p</i> < 0.01) and both sides in healthy controls (<i>p</i> < 0.001). The cross-sectional area of the radial nerve at the spiral groove was negatively associated with PPTs over the radial nerve at the spiral groove (r = −0.496, <i>p</i> = 0.002) and positively associated with function (r = 0.325, <i>p</i> = 0.045). Our findings revealed generalized pressure pain hyperalgesia and also nerve swelling of the radial nerve in people with lateral epicondylalgia, suggesting the presence of a widespread sensitization of nerve tissues in this population. The radial nerve could represent a potential peripheral drive to initial and maintain altered pain processing in lateral epicondylalgia. |
| first_indexed | 2024-03-11T00:29:01Z |
| format | Article |
| id | doaj.art-0d4255795cf44689b5c8770536edcd92 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-11T00:29:01Z |
| publishDate | 2023-07-01 |
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| series | Diagnostics |
| spelling | doaj.art-0d4255795cf44689b5c8770536edcd922023-11-18T22:46:12ZengMDPI AGDiagnostics2075-44182023-07-011315248810.3390/diagnostics13152488Pressure Pain Hypersensitivity and Ultrasound Changes in the Radial Nerve in Patients with Unilateral Lateral Epicondylalgia: A Case–Control StudyIgnacio Cancela-Cilleruelo0Jorge Rodríguez-Jiménez1César Fernández-de-las-Peñas2Joshua A. Cleland3José L. Arias-Buría4Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28922 Alcorcón, SpainDepartment of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, SpainDepartment of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, SpainDoctor of Physical Therapy Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USADepartment of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, SpainSome authors have proposed the potential role of the radial nerve in lateral epicondylalgia. The aims of this study were to investigate the presence of pressure pain hyperalgesia and nerve swelling (increased cross-sectional area) assessed with ultrasound imaging on the radial nerve in people with lateral epicondylalgia, and to investigate if an association exists between pressure pain sensitivity and cross-sectional area. A total of 37 patients with lateral epicondylalgia (43% women, age: 45.5 ± 9.5 years) and 37 age- and sex-matched pain-free controls were recruited for participation. Pressure pain thresholds (PPTs) were assessed bilaterally on the radial nerve at the spiral groove, the arcade of Frohse, and the anatomic snuffbox in a blinded design. Further, the cross-sectional area of the radial nerve at the spiral groove and antecubital fossa was also assessed. The results demonstrated lower PPTs on the radial nerve of the affected side in individuals with lateral epicondylalgia as compared with the unaffected side (<i>p</i> < 0.01) and with both sides in healthy controls (<i>p</i> < 0.001). Additionally, the cross-sectional area of the radial nerve on the affected side in patients was higher compared with the unaffected side (<i>p</i> < 0.01) and both sides in healthy controls (<i>p</i> < 0.001). The cross-sectional area of the radial nerve at the spiral groove was negatively associated with PPTs over the radial nerve at the spiral groove (r = −0.496, <i>p</i> = 0.002) and positively associated with function (r = 0.325, <i>p</i> = 0.045). Our findings revealed generalized pressure pain hyperalgesia and also nerve swelling of the radial nerve in people with lateral epicondylalgia, suggesting the presence of a widespread sensitization of nerve tissues in this population. The radial nerve could represent a potential peripheral drive to initial and maintain altered pain processing in lateral epicondylalgia.https://www.mdpi.com/2075-4418/13/15/2488lateral epicondylalgiapressure pain thresholdcross-sectional arearadial nerve |
| spellingShingle | Ignacio Cancela-Cilleruelo Jorge Rodríguez-Jiménez César Fernández-de-las-Peñas Joshua A. Cleland José L. Arias-Buría Pressure Pain Hypersensitivity and Ultrasound Changes in the Radial Nerve in Patients with Unilateral Lateral Epicondylalgia: A Case–Control Study Diagnostics lateral epicondylalgia pressure pain threshold cross-sectional area radial nerve |
| title | Pressure Pain Hypersensitivity and Ultrasound Changes in the Radial Nerve in Patients with Unilateral Lateral Epicondylalgia: A Case–Control Study |
| title_full | Pressure Pain Hypersensitivity and Ultrasound Changes in the Radial Nerve in Patients with Unilateral Lateral Epicondylalgia: A Case–Control Study |
| title_fullStr | Pressure Pain Hypersensitivity and Ultrasound Changes in the Radial Nerve in Patients with Unilateral Lateral Epicondylalgia: A Case–Control Study |
| title_full_unstemmed | Pressure Pain Hypersensitivity and Ultrasound Changes in the Radial Nerve in Patients with Unilateral Lateral Epicondylalgia: A Case–Control Study |
| title_short | Pressure Pain Hypersensitivity and Ultrasound Changes in the Radial Nerve in Patients with Unilateral Lateral Epicondylalgia: A Case–Control Study |
| title_sort | pressure pain hypersensitivity and ultrasound changes in the radial nerve in patients with unilateral lateral epicondylalgia a case control study |
| topic | lateral epicondylalgia pressure pain threshold cross-sectional area radial nerve |
| url | https://www.mdpi.com/2075-4418/13/15/2488 |
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