Key result
Resting diastolic blood pressure correlates positively with cervical pain thresholds in controls but not chronic WAD.
Why the study?
Autonomic nervous system dysfunction has been implicated in chronic whiplash-associated disorder, but the relationship between autonomic variables and clinical factors is not well understood.
Does chronic whiplash-associated disorder disrupt the normal physiological association between resting blood pressure and pain sensitivity?
Cross-Sectional (n=61)
No
Does chronic whiplash-associated disorder disrupt the normal physiological association between resting blood pressure and pain sensitivity?
Effect estimate: r = 0.53
Absolute Event Rate: 0.05% vs 0.53%
p-value: p=0.007
The absence of hypertension-associated hypoalgesia in chronic WAD suggests a disruption of autonomic pain modulation pathways in this condition.
May indicate autonomic pain modulation disruption in chronic WAD; hypothesis-generating and should not yet change practice.
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.
No takes yet. Share an insight, caveat, or question.
White et al. (2022) conducted a cross-sectional in Chronic Whiplash-Associated Disorder (WAD) Grade II (n=61). Chronic Whiplash-Associated Disorder vs. Pain-free controls was evaluated on Correlation between resting diastolic blood pressure and cervical spine pressure pain threshold (r = 0.53, p=0.007). In pain-free controls, resting diastolic blood pressure was positively correlated with cervical spine pressure pain threshold (r = 0.53, P = 0.007), but this association was absent in patients with chronic WAD.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: