Widespread impairment of tactile spatial acuity and sensory-motor control in patients with chronic nonspecific neck pain with neuropathic features

Musculoskelet Sci Pract. 2020 Jun:47:102138. doi: 10.1016/j.msksp.2020.102138. Epub 2020 Feb 25.

Abstract

Objective: To assess differences in tactile spatial acuity and in sensory-motor control between patients with chronic nonspecific neck pain (CNSNP) with and without neuropathic features (NF), as well as asymptomatic.

Methods: 183 participants were included, 135 had CNSNP classified by the Self-report version of Leeds Assessment of Neuropathic Symptoms and Signs scale in order to identify pain with NF: (1) CNSNP with NF (n = 67), (2) CNSNP with No-NF (n = 68), and (3) asymptomatic subjects (n = 48). The following tests in the following order were assessed after determining the participants' clinical characteristics: 1) two-point discrimination, 2) joint position error, and 3) craniocervical flexion test.

Results: Both neck pain groups showed a significant reduction in their ability to discriminate two points in the trapezium and masseter, as well as a significant deficit of a moderate to large magnitude in craniocervical motor control compared with the asymptomatic group. However, only the CNSNP with NF group showed a significant impairment of the two-point discrimination in the tibia (d = 0.57) and a significant impairment of the kinesthetic sense (neck rotation, d = 0.73; neck lateroflexion, d = 0.69), compared with the asymptomatic group. Significant differences in pain intensity, disability and psychological factors between the CNSNP groups were also found, observing the poorest results in the NF group.

Conclusions: Patients with CNSNP with NF have a greater sensory, motor and psychological impairment than those without NF, more pain intensity, disability and negative psychological factors, as well as more impaired tactile spatial acuity in areas remote to the pain and impaired cervical kinesthetic sense.

Keywords: Neck pain/diagnosis; Position sense; Proprioception; Somatosensory discrimination disorder; Tactile sense.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chronic Pain / diagnosis
  • Chronic Pain / physiopathology
  • Chronic Pain / therapy
  • Cross-Sectional Studies
  • Female
  • Functional Laterality
  • Humans
  • Male
  • Middle Aged
  • Motor Activity
  • Neck Pain / complications*
  • Neck Pain / diagnosis
  • Neck Pain / physiopathology*
  • Neck Pain / therapy*
  • Pain / etiology*
  • Pain / physiopathology
  • Peripheral Nervous System Diseases / etiology*
  • Peripheral Nervous System Diseases / physiopathology
  • Peripheral Nervous System Diseases / therapy*
  • Range of Motion, Articular / physiology*
  • Severity of Illness Index
  • Spain
  • Touch Perception*
  • Young Adult

Supplementary concepts

  • Neuropathy, Painful