Comparing central pain processing in individuals with non-traumatic neck pain and healthy individuals: a systematic review and meta-analysis.

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Xie, Y
Jun, D
Thomas, L
Coombes, BK
Johnston, V
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2020
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http://creativecommons.org/licenses/by-nc-nd/4.0/
Abstract

This systematic review and meta-analysis examined the evidence for altered central pain processing in people with non-traumatic neck pain and the relationship between central pain processing, demographics and pain-related characteristics. Case-control studies reporting measures of altered central pain processing using quantitative sensory testing were reviewed. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) between people with non-traumatic neck pain and controls were calculated. Meta-analysis was performed using random-effects models when appropriate. Associations between SMDs with demographics and pain-related characteristics were explored on a study level using meta-regression. Twenty-six studies were eligible with 25 included for meta-analysis. Meta-analysis demonstrated mechanical hyperalgesia at remote non-painful sites in the full sample [sample size (n)=1305, SMD=-0.68] and in the subgroup with moderate/severe disability [n=165, SMD=-0.86] (moderate-quality evidence). Meta-regression indicated that remote mechanical hyperalgesia was negatively associated with age (R2=25.4%, P=0.031). Very-low- to low-quality evidence of remote cold and heat hyperalgesia and dysfunctional conditioned pain modulation were identified. This review suggests that altered central pain processing is present in people with non-traumatic neck pain and may be associated with disability levels and age. Perspective: This review found moderate-quality evidence of mechanical hyperalgesia at remote non-painful sites in patients with non-traumatic neck pain compared to controls, indicating altered central pain processing. However, more studies are needed to confirm findings from dynamic quantitative sensory testing.

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Journal of Pain
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© 2020 American Pain Society. Published by Elsevier Ltd. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
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Biomedical and clinical sciences
Psychology
central sensitization
idiopathic neck pain
meta-analysis
nonspecific neck pain
quantitative sensory testing
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Xie, Y; Jun, D; Thomas, L; Coombes, B; Johnston, V, Comparing central pain processing in individuals with non-traumatic neck pain and healthy individuals: a systematic review and meta-analysis., Journal of Pain, 2020
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