Pain Modulatory Profiles in Massage for Individuals With Neck Pain

University of Florida

Status: Completed

Conditions: Musculoskeletal Pain; Neck Pain

Treatments: Other: Pain Inducing Massage; Other: Light Touch Massage; Other: Coldpressor

Study type: Interventional

Funder types: Other

Identifiers

NCT03534739

IRB201800840

Details and patient eligibility

About

One in ten adults experience widespread pain. Neck pain, for example, is a prevalent condition with a high rate of recurrence that affects between 10.4% and 21.3% of the population annually.

Massage is a common manual therapy intervention for individuals with musculoskeletal pain. However, the mechanisms of massage are not well established. Also, the conditioned pain modulation (CPM) paradigm is a dynamic quantitative sensory testing measure of a pain inhibitory process in which pain sensitivity is lessened in response to a remotely applied painful stimulus.

This study will evaluate the association between pain inducing massage and the conditioned pain modulation paradigm in participants with a history of neck pain.

Full description

Conditioned pain modulation (CPM) is the physical manifestation of the diffuse noxious inhibitory control (DNIC), an endogenous pain inhibitory pathway in which pain inhibits pain. Conditioned pain modulation is less efficient in individuals with chronic pain conditions and it is a predictor for the development of chronic pain.

Massage is a common manual therapy intervention for individuals with musculoskeletal pain. Greater changes in pain sensitivity occur following pain inducing massage suggesting a mechanism dependent upon the efficiency of the conditioned pain modulation response. Previous research has indicated pain inducing massage is more effective than pain free massage suggesting a mechanism dependent upon conditioned pain modulation.

The study team will evaluate the association between pain inducing massage and the conditioned pain modulation paradigm. Participants with neck pain will be randomly assigned to receive a pain inducing massage, pain free massage, or a coldpressor task. Pre-and post intervention pain will be assessed. The study team will determine if analgesia induced by pain inducing massage is similar to the conditioned pain modulation paradigm and if baseline conditioned pain modulation predicts responders to pain inducing massage and short term clinical outcomes in patients with a history of neck pain.

Enrollment: 26 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• currently experiencing neck pain with or without arm pain
• neck pain symptom intensity rated as 4/10 or higher during the last 24 hours
• neck pain for greater than or equal to 3 months

Exclusion criteria

• non-English speaking
• systemic medical conditions known to affect sensation (e.g. diabetes, hypertension)
• history of neck surgery or fracture within the past 6 months
• current history of chronic pain condition other than neck pain
• diagnosis of cervical radiculopathy or cervical myelopathy
• history of whiplash; g) currently using blood thinning medication
• any blood clotting disorder such as hemophilia
• any contraindication to application of ice, such as: uncontrolled hypertension, cold urticaria, cryoglobulinemia, paroxysmal cold hemoglobinuria, and circulatory compromise.

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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26 participants in 3 patient groups, including a placebo group

Pain Inducing Massage

Experimental group

Description:

Participants will receive manual pressure applied to one myofascial trigger point.

Treatment:

Other: Pain Inducing Massage

Light Touch Massage

Active Comparator group

Description:

Participants will receive light touch applied to one myofascial trigger point.

Treatment:

Other: Light Touch Massage

Coldpressor

Placebo Comparator group

Description:

Participants will place hand into water cooled to 6 degrees Celsius (males) or 8 degrees Celsius (females).

Treatment:

Other: Coldpressor