Referred sensation location can be altered by a strong heterotopic nociceptive stimulus: implications for clinical pain conditions.


Journal

Pain
ISSN: 1872-6623
Titre abrégé: Pain
Pays: United States
ID NLM: 7508686

Informations de publication

Date de publication:
01 05 2023
Historique:
received: 16 05 2022
accepted: 10 10 2022
medline: 18 4 2023
pubmed: 18 10 2022
entrez: 17 10 2022
Statut: ppublish

Résumé

Referred sensations (RS) are a common clinical phenomenon in patients with musculoskeletal pain; however, the underlying mechanisms of RS and implications for diagnosis and management are poorly understood. The location of referral seems to have a preferred site, but studies have suggested it can be redirected to a site of previous injury and pain. However, it is not known if the same phenomenon can occur for a much shorter-lasting painful stimulus in the trigeminal system. The aim of this study was to assess if RS location elicited with standardized palpation of the masseter muscle could be altered following a 10-minute painful infusion of hypertonic saline into the retromolar region. A total of 56 healthy participants participated in this cross-over study performed in 2 sessions separated by 1 hour. At each session, baseline and postinfusion assessments of masseter muscle mechanical sensitivity were performed using 2 different forces (0.5 kg and 2 kg). Between assessments, hypertonic saline (5%) or isotonic saline (control) were continuously infused into the retromolar region. Participants were asked to rate their mechanical sensitivity and any RS they experienced as well as to draw the location of the RS. No difference in mechanical sensitivity or RS frequency was seen after either infusion when compared with before infusion. However, the RS location was displaced on average 1.2 cm between the baseline and postinfusion assessments for the hypertonic saline infusion, which was significantly increased when compared with the isotonic saline infusion which was on average 0.4 cm. These novel findings indicate the potential to modify the location of RS in the trigeminal system following a relatively brief noxious input. Clinicians need to be aware of the possible rerouting of RS in patients with complex orofacial pain.

Identifiants

pubmed: 36251968
doi: 10.1097/j.pain.0000000000002809
pii: 00006396-202305000-00023
doi:

Substances chimiques

Saline Solution, Hypertonic 0

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e242-e250

Informations de copyright

Copyright © 2022 International Association for the Study of Pain.

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Auteurs

Benedetta Salis (B)

Department of Dentistry, University of Cagliari, Cagliari, Italy.

Peter Svensson (P)

Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark.
Faculty of Odontology, Malmø University, Malmø, Sweden.

Fernando G Exposto (FG)

Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark.

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