Journal article

Tendinopathies and pain sensitisation : a meta-analysis with meta-regression

  • Previtali, Davide ORCID Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
  • Mameli, Alberto Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
  • Zaffagnini, Stefano ORCID II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
  • Marchettini, Paolo Fisiopatologia e Terapia del Dolore, Dipartimento di Farmacologia, Careggi Università di Firenze, Firenze, Italy ; Terapia del Dolore, Centro Diagnostico Italiano, Milan, Italy
  • Candrian, Christian ORCID Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland ; Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland
  • Filardo, Giuseppe ORCID Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland ; Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland ; Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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  • 2022
Published in:
  • Biomedicines. - 2022, vol. 10, p. 1749
English The presence of pain sensitisation has been documented and reported as being a possible cause of treatment failure and pain chronicity in several musculoskeletal conditions, such as tendinopathies. The aim of the present study is to analyse existing evidence on pain sensitisation in tendinopathies comparing the local and distant pain thresholds of healthy and affected subjects with distinct analysis for different tendinopathies. PubMed, Cochrane Central Register, Scopus, and Web Of Science were systematically searched after registration on PROSPERO (CRD42020164124). Level I to level IV studies evaluating the presence of pain sensitisation in patients with symptomatic tendinopathies, documented through a validated method, were included. A meta-analysis was performed to compare local, contralateral, and distant pain thresholds between patients and healthy controls with sub-analyses for different tendinopathies. Meta-regressions were conducted to evaluate the influence of age, activity level, and duration of symptoms on results. Thirty-four studies out of 2868 were included. The overall meta-analysis of local pressure pain thresholds (PPT) documented an increased sensitivity in affected subjects (p < 0.001). The analyses on contralateral PPTs (p < 0.001) and distant PPTs (p = 0.009) documented increased sensitivity in the affected group. The results of the sub-analyses on different tendinopathies were conflicting, except for those on lateral epicondylalgia. Patients’ activity level (p = 0.02) and age (p = 0.05) significantly influenced local PPT results. Tendinopathies are characterized by pain sensitisation, but, while features of both central and peripheral sensitisation can be constantly detected in lateral epicondylalgia, results on other tendinopathies were more conflicting. Patients’ characteristics are possible confounders that should be taken into account when addressing pain sensitisation.
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  • English
Classification
Medicine
License
CC BY
Open access status
gold
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Persistent URL
https://n2t.net/ark:/12658/srd1324940
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