Resting diastolic blood pressure was positively correlated with cervical spine pressure pain threshold in pain-free controls (r=0.53, P=0.007), but this association was disrupted in chronic WAD.
Cross-Sectional (n=61)
No
The normal association between blood pressure and pain sensitivity appears disrupted in chronic whiplash-associated disorder, suggesting autonomic pathway involvement in its pathophysiology.
Effect estimate: r = 0.53
p-value: p=0.007
OBJECTIVE: Autonomic nervous system dysfunction has been implicated in chronic whiplash-associated disorder (WAD). However, the relationship between autonomic variables (e.g., resting heart rate and blood pressure) and clinical factors in chronic WAD is not well understood. This study sought to examine the associations between resting heart rate, resting blood pressure, pain processing and psychological variables in chronic WAD and in pain-free controls. DESIGN: Secondary analysis of a cross-sectional study. SETTING: University clinical research laboratory. SUBJECTS: Thirty-six people with chronic WAD Grade II (mean SD age 40.1 14.6 years, 28 females) and 25 pain-free controls (35.6 13.0 years, 17 females). METHODS: Participants had resting heart rate, systolic and diastolic blood pressure measured. Pain processing measures comprised: (i) pain pressure threshold at the cervical spine, hand and leg, (ii) temporal summation at the cervical spine and hand, and (iii) conditioned pain modulation. Psychological outcomes included measures of kinesiophobia, pain catastrophizing and post-traumatic stress symptoms. Correlations between autonomic variables, pain processing and psychological variables were determined (P < .05, 5% FDR). RESULTS: No significant correlations between autonomic and pain processing variables, or autonomic and psychological variables were found in the chronic WAD group. In the control group, diastolic blood pressure was positively correlated with cervical spine pressure pain threshold (r = 0.53, P = .007). CONCLUSIONS: An association between blood pressure and pain sensitivity was observed in the control group but not the chronic WAD group. Such an association appears to be disrupted in chronic WAD, which may infer involvement of autonomic pathways in the pathophysiology of this condition.
White et al. (Thu,) conducted a cross-sectional in Chronic whiplash-associated disorder (WAD) (n=61). Chronic whiplash-associated disorder vs. Pain-free controls was evaluated on Correlations between autonomic variables, pain processing and psychological variables (r = 0.53, p=0.007). Resting diastolic blood pressure was positively correlated with cervical spine pressure pain threshold in pain-free controls (r=0.53, P=0.007), but this association was disrupted in chronic WAD.