uu.seUppsala University Publications
Change search
Link to record
Permanent link

Direct link
BETA
Publications (10 of 25) Show all publications
Jonsson, K. & Peterson, M. (2019). Peak expiratory flow rate and thoracic mobility in people with fibromyalgia. A cross sectional study. Scandinavian Journal of Pain, 19(4), 755-763
Open this publication in new window or tab >>Peak expiratory flow rate and thoracic mobility in people with fibromyalgia. A cross sectional study
2019 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 19, no 4, p. 755-763Article in journal (Refereed) Published
Abstract [en]

Background and aims:

Fibromyalgia (FM) is characterized by chronic widespread pain and affects approximately 1-3% of the general population. Respiratory function has not been given much consideration in people with FM. Few studies have been published concerning FM and respiratory function and conflicting data still exist. The aim of this study was to compare differences in forced expiration, but also to investigate chest expansion, spinal mobility and segmental pain intensity between a group with fibromyalgia and heal thy controls.

Methods:

Forty-one women with diagnosed FM based on American College of Rheumatology 1990 criteria and forty-one controls without pain matched for age and gender participated in this cross-sectional study. For evaluation of forced expiration, a Wright peak expiratory flow rate meter was used. A tape measure was used to measure the mobility of the thorax at maximum inhalation and exhalation known as chest expansion. Spinal mobility was measured with the Cervico-thoracic ratio method. The spinal mobility was measured as range of motion from C7 to 15 cm below in flexion and manual palpation was conducted between C7-T5. For differences in pain intensity a palpation-index was defined for each level, respectively; C7-T1, T1-2, T2-3, T3-4 and T4-5 by calculating the mean value for the four different palpation points for each motion segment. A combined measure of expiration and thoracic mobility (expiratory/inspiratory ratio) was calculated by dividing peak expiratory flow rate (L/min) with chest expansion (cm). Statistical analyses included descriptive statistics to describe subjects and controls, means and standard deviation to compare differences between groups and student-t and Chi-square (chi(2)) tests, using SPSS 22 software. Confidence interval was set to 95%.

Results:

In the FM group 17 had the diagnosis for more than 5 years and 24 less than 5 years. The FM group demonstrated significantly lower forced expiration (p < 0.018), less thoracic expansion (p < 0.001), reduced spinal mobility (p < 0.029), higher expiratory-inspiratory ratio value (p < 0.001) and increased palpation pain over C7-T5 (p < 0.001) compared to healthy controls. There were more smokers in the FM group (n = 9) compared to the controls (n = 5) though this difference was not statistically significant (p < 0.24) and excluding the few smokers yielded similar result. No significant correlations for manual palpation, chest expansion, peak expiratory flow rate and spinal mobility were found in the FM group.

Conclusions:

Women with FM demonstrated significantly lower forced expiration and thoracic mobility compared to healthy controls.

Implications:

The results of this study point to a plausible restriction of respiratory function which in turn may have effect on physical endurance and work capacity in people with FM.

Keywords
fibromyalgia, peak expiratory flow, chest expansion, spinal mobility
National Category
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-396658 (URN)10.1515/sjpain-2019-0044 (DOI)000489140000012 ()31343985 (PubMedID)
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2020-01-17Bibliographically approved
Torstensson, T., Butler, S., Lindgren, A., Peterson, M., Nilsson-Wikmar, L., Eriksson, M. & Kristiansson, P. (2018). Anatomical landmarks of the intra-pelvic side-wall as sources of pain in women with and without pregnancy-related chronic pelvic pain after childbirth: a descriptive study. BMC Women's Health, 18, Article ID 54.
Open this publication in new window or tab >>Anatomical landmarks of the intra-pelvic side-wall as sources of pain in women with and without pregnancy-related chronic pelvic pain after childbirth: a descriptive study
Show others...
2018 (English)In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 18, article id 54Article in journal (Refereed) Published
Abstract [en]

Background: Chronic pelvic pain (CPP) affects 15-24% of women and can have a devastating impact on quality of life. Laparoscopy is often used in the investigation, although in one third of the examinations there is no visible pathology and the women may be dismissed without further investigation. Also, the contribution of skeletal, muscular, periosteal and ligamentous tissues to CPP remains to be further elucidated. The objective of the present study was to compare pain intensity provoked from anatomical landmarks of the intra-pelvic side-wall in women with pregnancy-related CPP after childbirth and women without such pain. Methods: This is a descriptive study of 36 non-randomly selected parous women with CPP after childbirth and 29 likewise selected parous women after childbirth without CPP. Pain was determined by questionnaire and clinical examination. The primary outcome measure was reported pain intensity provoked on 13 anatomical landmarks of the intra-pelvic side-wall. All women reported their perceived pain intensity for each anatomical landmark on Likert scales and an individual sum score was calculated. Results: Women with chronic pelvic pain were older than women without CPP. At several intra-pelvic landmarks high intensity pain was provoked in women with CPP compared with less intense pain provoked at fewer landmarks in women without low back or pelvic pain (p < 0.0001). The average sum of pain intensity scores was about 4 times higher in women with CPP (1.3) as compared with those without low back or pelvic pain (0.3), p < 0. 0001. This association remained when adjusting for the age difference between the pain groups in linear regression analysis. In addition, reported pain intensity at worst past week was independently associated with sum of pain intensity scores. The maximum individual sum of pain intensity scores among women without CPP was exceeded by that of 85% of the women with CPP. Conclusions: Parous women with CPP after childbirth had a heightened pain intensity over 13 anatomical landmarks during pelvic examination compared with parous women without CPP. These results need to be confirmed in a larger cohort with different types of CPP.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Anatomical landmarks, Intra-pelvic side-wall, Chronic pelvic pain, Pregnancy-related
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-354347 (URN)10.1186/s12905-018-0542-z (DOI)000428659500002 ()29587728 (PubMedID)
Available from: 2018-06-27 Created: 2018-06-27 Last updated: 2018-06-27Bibliographically approved
Börjesson, S., Nordin, K., Fjällskog, M.-L., Rissanen, R., Peterson, M. & Arving, C. (2018). Colored body images reveal the perceived intensity anddistribution of pain in women with breast cancer treated with adjuvant taxanes:: a prospective multi-method study of pain experience. Scandinavian Journal of Pain, 581-591
Open this publication in new window or tab >>Colored body images reveal the perceived intensity anddistribution of pain in women with breast cancer treated with adjuvant taxanes:: a prospective multi-method study of pain experience
Show others...
2018 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, p. 581-591Article, review/survey (Refereed) Published
Abstract [en]

Background and aims:

Breast cancer is the most prevalent adult cancer worldwide. A broader use of screening for early detection and adjuvant systemic therapy with chemotherapy has resulted in improved survival rates. Taxane-containing chemotherapy is one of the cornerstones of the treatment. However, taxane-containing chemotherapy may result in acute chemotherapy-induced nociceptive and neuropathic pain. Since this pain may be an additional burden for the patient both during and after taxane chemotherapy, it is important to rapidly discover and treat it. There is yet no gold standard for assessing taxane-induced pain. In the clinic, applying multiple methods for collecting information on pain may better describe the patients’ pain experiences. The aim was to document the pain during and after taxane through the contribution of different methods for collecting information on taxane-induced pain. Fifty-three women scheduled for adjuvant sequential chemotherapy at doses of ≥75 mg/m2 of docetaxel and epirubicin were enrolled in the study.

Methods:

Prospective pain assessments were done on a visual analog scale (VAS) before and during each cycle of treatment for about 5 months, and using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire’s (EORTC-QLQ-C30) two pain questions at baseline, 3 months, and 12 months. Participants scoring pain on the VAS >30 and undergoing an interview also colored their pain on a body image during treatment and at 12 months.

Results:

Surprisingly widespread, intense pain was detected using a multi-method approach. The colored body image showed pain being perceived on 51% of the body surface area during treatment, and on 18% 12 months after inclusion. In general, the pain started and peaked in intensity after the first cycle of taxane. After Cycle 3, most women reported an increase in pain on the VAS. Some women continued to report some pain even during the epirubicin cycles. The VAS scores dropped after the last chemotherapy cycle, but not to the baseline level. At baseline, 3 months and 12 months after inclusion, the women who estimated VAS >30 reported higher levels of pain on the pain questions of the EORTC-QLQ-C30.

Conclusions:

This study contributes information on how different pain assessment tools offer different information in the assessment of pain. The colored body image brings another dimension to pain diagnostics, providing additional information on the involved body areas and the pain intensities as experienced by the women. A multi-method approach to assessing pain offers many advantages. The timing of the assessment is important to properly assess pain.

Implications:

Pain relief needs to be included in the chemotherapy treatment, with individual assessment and treatment of pain, in the same way as is done in chemotherapy-triggered nausea. There is a time window whereby the risk of pain development is at its highest within 24–48 h after receiving taxane chemotherapy. Proper attention to pain evaluation and treatment should be in focus during this time window.

Place, publisher, year, edition, pages
Berlin/Boston: , 2018
National Category
Cancer and Oncology
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-356212 (URN)10.1515/sjpain-2018-0050 (DOI)000451213600006 ()29949517 (PubMedID)
Funder
Swedish Cancer Society, 100001
Available from: 2018-07-23 Created: 2018-07-23 Last updated: 2019-01-18Bibliographically approved
Lagali, N. S., Allgeier, S., Guimaraes, P., Badian, R. A., Ruggeri, A., Koehler, B., . . . Rolandsson, O. (2018). Wide-field corneal subbasal nerve plexus mosaics in age-controlled healthy and type 2 diabetes populations. Scientific Data, 5, Article ID 180075.
Open this publication in new window or tab >>Wide-field corneal subbasal nerve plexus mosaics in age-controlled healthy and type 2 diabetes populations
Show others...
2018 (English)In: Scientific Data, E-ISSN 2052-4463, Vol. 5, article id 180075Article in journal (Refereed) Published
Abstract [en]

A dense nerve plexus in the clear outer window of the eye, the cornea, can be imaged in vivo to enable non-invasive monitoring of peripheral nerve degeneration in diabetes. However, a limited field of view of corneal nerves, operator-dependent image quality, and subjective image sampling methods have led to difficulty in establishing robust diagnostic measures relating to the progression of diabetes and its complications. Here, we use machine-based algorithms to provide wide-area mosaics of the cornea's subbasal nerve plexus (SBP) also accounting for depth (axial) fluctuation of the plexus. Degradation of the SBP with age has been mitigated as a confounding factor by providing a dataset comprising healthy and type 2 diabetes subjects of the same age. To maximize reuse, the dataset includes bilateral eye data, associated clinical parameters, and machine-generated SBP nerve density values obtained through automatic segmentation and nerve tracing algorithms. The dataset can be used to examine nerve degradation patterns to develop tools to non-invasively monitor diabetes progression while avoiding narrow-field imaging and image selection biases.

National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-354955 (URN)10.1038/sdata.2018.75 (DOI)000430690900003 ()29688226 (PubMedID)
Funder
German Research Foundation (DFG), KO 5003/1-1
Available from: 2018-06-25 Created: 2018-06-25 Last updated: 2018-06-25Bibliographically approved
Peterson, M., Pingel, R., Lagali, N., Dahlin, L. B. & Rolandsson, O. (2017). Association between HbA1c and peripheral neuropathy in a 10-year follow-up study of people with normal glucose tolerance, impaired glucose tolerance and Type 2 diabetes. Paper presented at 16th World Congress on Pain, SEP 26-30, 2016, Yokohama, JAPAN. Diabetic Medicine, 34(12), 1756-1764
Open this publication in new window or tab >>Association between HbA1c and peripheral neuropathy in a 10-year follow-up study of people with normal glucose tolerance, impaired glucose tolerance and Type 2 diabetes
Show others...
2017 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 34, no 12, p. 1756-1764Article in journal (Refereed) Published
Abstract [en]

Aims: To explore the association between HbA(1c) and sural nerve function in a group of people with normal glucose tolerance, impaired glucose tolerance or Type 2 diabetes.

Methods: We conducted a 10-year follow-up study in 87 out of an original 119 participants. At study commencement (2004), 64 men and 55 women (mean age 61.1 years) with normal glucose tolerance (n=39), impaired glucose tolerance (n=29), or Type 2 diabetes (n=51) were enrolled. At the 2014 follow-up (men, n=46, women, n=41; mean age 71.1 years), 36, nine and 42 participants in the normal glucose tolerance, impaired glucose tolerance and Type 2 diabetes categories, respectively, were re-tested. Biometric data and blood samples were collected, with an electrophysiological examination performed on both occasions.

Results: At follow-up, we measured the amplitude of the sural nerve in 74 of the 87 participants. The mean amplitude had decreased from 10.9 V (2004) to 7.0 mu V (2014; P<0.001). A 1% increase in HbA(1c) was associated with a similar to 1% average decrease in the amplitude of the sural nerve, irrespective of group classification. Crude and adjusted estimates ranged from -0.84 (95% CI -1.32, -0.37) to -1.25 (95% CI -2.31, -0.18). Although the mean conduction velocity of those measured at both occasions (n=73) decreased from 47.6 m/s to 45.8 m/s (P=0.009), any association with HbA(1c) level was weak. Results were robust with regard to potential confounders and missing data.

Conclusions: Our data suggest an association between sural nerve amplitude and HbA(1c) at all levels of HbA(1c). Decreased amplitude was more pronounced than was diminished conduction velocity, supporting the notion that axonal degeneration is an earlier and more prominent effect of hyperglycaemia than demyelination.

National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:uu:diva-342209 (URN)10.1111/dme.13514 (DOI)000415191800015 ()28929513 (PubMedID)
Conference
16th World Congress on Pain, SEP 26-30, 2016, Yokohama, JAPAN
Available from: 2018-02-20 Created: 2018-02-20 Last updated: 2018-02-20Bibliographically approved
Alim, M. A., Ackermann, P. W., Eliasson, P., Blomgran, P., Kristiansson, P., Pejler, G. & Peterson, M. (2017). Increased mast cell degranulation and co-localization of mast cells with the NMDA receptor-1 during healing after Achilles tendon rupture. Cell and Tissue Research, 370(3), 451-460
Open this publication in new window or tab >>Increased mast cell degranulation and co-localization of mast cells with the NMDA receptor-1 during healing after Achilles tendon rupture
Show others...
2017 (English)In: Cell and Tissue Research, ISSN 0302-766X, E-ISSN 1432-0878, Vol. 370, no 3, p. 451-460Article in journal (Refereed) Published
Abstract [en]

The role of inflammation and the mechanism of tendon healing after rupture has historically been a matter of controversy. The purpose of the present study is to investigate the role of mast cells and their relation to the NMDA receptor-1 (a glutamate receptor) during healing after Achilles tendon rupture. Eight female Sprague Dawley rats had their right Achilles tendon transected. Three weeks after rupture, histological quantification of mast cell numbers and their state of degranulation was assessed by histochemistry. Co-localization of mast cell tryptase (a mast cell marker) and NMDA receptor-1 was determined by immunofluorescence. The intact left Achilles tendon was used as control. An increased number of mast cells and a higher proportion of degranulated mast cells were found in the healing Achilles tendon compared to the intact. In addition, increased co-localization of mast cell tryptase and NMDA receptor-1 was seen in the areas of myotendinous junction, mid-tendon proper and bone tendon junction of the healing versus the intact tendon. These findings introduce a possible role for mast cells in the healing phase after Achilles tendon rupture.

Place, publisher, year, edition, pages
Berlin Heidelberg: , 2017
Keywords
Achilles tendon healing, Mast cells, NMDA, Rats, Tryptase
National Category
Cell and Molecular Biology
Research subject
Orthopaedics; Immunology
Identifiers
urn:nbn:se:uu:diva-395522 (URN)10.1007/s00441-017-2684-y (DOI)000416358400010 ()28975451 (PubMedID)
Available from: 2019-10-20 Created: 2019-10-20 Last updated: 2020-02-06Bibliographically approved
Lagali, N. S., Allgeier, S., Guimaraes, P., Badian, R. A., Ruggeri, A., Koehler, B., . . . Rolandsson, O. (2017). Reduced Corneal Nerve Fiber Density in Type 2 Diabetes by Wide-Area Mosaic Analysis. Investigative Ophthalmology and Visual Science, 58(14), 6318-6327
Open this publication in new window or tab >>Reduced Corneal Nerve Fiber Density in Type 2 Diabetes by Wide-Area Mosaic Analysis
Show others...
2017 (English)In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 58, no 14, p. 6318-6327Article in journal (Refereed) Published
Abstract [en]

PURPOSE

To determine if corneal subbasal nerve plexus (SBP) parameters derived from wide-area depth-corrected mosaic images are associated with type 2 diabetes.

METHODS

One hundred sixty-three mosaics were produced from eyes of 82 subjects by laser-scanning in vivo confocal microscopy (IVCM). Subjects were of the same age, without (43 subjects) or with type 2 diabetes (39 subjects). Mosaic corneal nerve fiber length density (mCNFL) and apical whorl corneal nerve fiber length density (wCNFL) were quantified and related to the presence and duration of diabetes (short duration < 10 years and long duration >= 10 years).

RESULTS

In mosaics with a mean size of 6 mm(2) in subjects aged 69.1 +/- 1.2 years, mCNFL in type 2 diabetes was reduced relative to nondiabetic subjects (13.1 +/- 4.2 vs. 15.0 +/- 3.2 mm/mm(2), P = 0.018). Also reduced relative to nondiabetic subjects was mCNFL in both short-duration (14.0 +/- 4.0 mm/mm(2), 3.2 +/- 3.9 years since diagnosis) and long-duration diabetes (12.7 +/- 4.2 mm/mm(2), 15.4 +/- 4.2 years since diagnosis; ANOVA P = 0.023). Lower mCNFL was associated with presence of diabetes (P = 0.032) and increased hemoglobin A1c (HbA1c) levels (P = 0.047). By contrast, wCNFL was unaffected by diabetes or HbA1c (P > 0.05). Global SBP patterns revealed marked degeneration of secondary nerve fiber branches outside the whorl region in long-duration diabetes.

CONCLUSIONS

Wide-area mosaic images provide reference values for mCNFL and wCNFL and reveal a progressive degeneration of the SBP with increasing duration of type 2 diabetes.

Keywords
confocal microscopy, corneal nerves, subbasal nerve, diabetes mellitus
National Category
Ophthalmology
Identifiers
urn:nbn:se:uu:diva-350559 (URN)10.1167/iovs.17-22257 (DOI)000426781300038 ()29242906 (PubMedID)
Available from: 2018-05-09 Created: 2018-05-09 Last updated: 2018-05-09Bibliographically approved
Aarnio, M., Appel, L., Fredriksson, M., Gordh, T., Wolf, O., Sörensen, J., . . . Linnman, C. (2017). Visualization of painful inflammation in patients with pain after traumatic ankle sprain using [(11)C]-D-deprenyl PET/CT.. Scandinavian Journal of Pain, 17(1), 418-424
Open this publication in new window or tab >>Visualization of painful inflammation in patients with pain after traumatic ankle sprain using [(11)C]-D-deprenyl PET/CT.
Show others...
2017 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 17, no 1, p. 418-424Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND AIMS: Positron emission tomography (PET) with the radioligand [(11)C]-D-deprenyl has shown increased signal at location of pain in patients with rheumatoid arthritis and chronic whiplash injury. The binding site of [(11)C]-D-deprenyl in peripheral tissues is suggested to be mitochondrial monoamine oxidase in cells engaged in post-traumatic inflammation and tissue repair processes. The association between [(11)C]-D-deprenyl uptake and the transition from acute to chronic pain remain unknown. Further imaging studies of musculoskeletal pain at the molecular level would benefit from establishing a clinical model in a common and well-defined injury in otherwise healthy and drug-naïve subjects. The aim of this study was to investigate if [(11)C]-D-deprenyl uptake would be acutely elevated in unilateral ankle sprain and if tracer uptake would be reduced as a function of healing, and correlated with pain localizations and pain experience.

METHODS: Eight otherwise healthy patients with unilateral ankle sprain were recruited at the emergency department. All underwent [(11)C]-D-deprenyl PET/CT in the acute phase, at one month and 6-14 months after injury.

RESULTS: Acute [(11)C]-D-deprenyl uptake at the injury site was a factor of 10.7 (range 2.9-37.3) higher than the intact ankle. During healing, [(11)C]-D-deprenyl uptake decreased, but did not normalize until after 11 months. Patients experiencing persistent pain had prolonged [(11)C]-D-deprenyl uptake in painful locations.

CONCLUSIONS AND IMPLICATIONS: The data provide further support that [(11)C]-D-deprenyl PET can visualize, quantify and follow processes in peripheral tissue that may relate to soft tissue injuries, inflammation and associated nociceptive signaling. Such an objective correlate would represent a progress in pain research, as well as in clinical pain diagnostics and management.

Place, publisher, year, edition, pages
Walter de Gruyter, 2017
Keywords
Ankle injuries, Carbon-11, Deprenyl, Inflammation, PET, Pain
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-333782 (URN)10.1016/j.sjpain.2017.10.008 (DOI)000419851500070 ()29126847 (PubMedID)
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2019-09-25Bibliographically approved
Drevin, J., Stern, J., Annerbäck, E.-M., Peterson, M., Butler, S., Tydén, T., . . . Kristiansson, P. (2015). Adverse childhood experiences influence development of pain during pregnancy.. Acta Obstetricia et Gynecologica Scandinavica, 94(8), 840-846
Open this publication in new window or tab >>Adverse childhood experiences influence development of pain during pregnancy.
Show others...
2015 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 94, no 8, p. 840-846Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate the association between adverse childhood experiences (ACE) and pain with onset during pregnancy.

DESIGN: Cross-sectional study.

SETTING: Eighteen antenatal clinics in southern Mid-Sweden.

SAMPLE: Of 293 women invited to participate, 232 (79%) women agreed to participate in early pregnancy and were assessed in late pregnancy.

METHODS: Questionnaires were distributed in early and late pregnancy. The questionnaires sought information on socio-demography, ACE, pain location by pain drawing and pain intensity by visual analogue scales. Distribution of pain was coded in 41 predetermined areas.

MAIN OUTCOME MEASURES: Pain in third trimester with onset during present pregnancy: intensity, location and number of pain locations.

RESULTS: In late pregnancy, 62% of the women reported any ACE and 72% reported any pain location with onset during the present pregnancy. Among women reporting any ACE the median pain intensity was higher compared with women without such an experience (p = 0.01). The accumulated ACE displayed a positive association with the number of reported pain locations in late pregnancy (rs  = 0.19, p = 0.02). This association remained significant after adjusting for background factors in multiple regression analysis (p = 0.01). When ACE was dichotomized the prevalence of pain did not differ between women with and without ACE. The subgroup of women reporting physical abuse as a child reported a higher prevalence of sacral and pelvic pain (p = 0.0003 and p = 0.02, respectively).

CONCLUSIONS: Adverse childhood experiences were associated with higher pain intensities and larger pain distributions in late pregnancy, which are risk factors for transition to chronic pain postpartum.

National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-256150 (URN)10.1111/aogs.12674 (DOI)000357983900005 ()25965273 (PubMedID)
Available from: 2015-06-22 Created: 2015-06-22 Last updated: 2019-03-21Bibliographically approved
Torstensson, T., Butler, S., Lindgren, A., Peterson, M., Eriksson, M. & Kristiansson, P. (2015). Referred pain patterns provoked on intra-pelvic structures among women with and without chronic pelvic pain: a descriptive study. PLoS ONE, 10(3), Article ID e0119542.
Open this publication in new window or tab >>Referred pain patterns provoked on intra-pelvic structures among women with and without chronic pelvic pain: a descriptive study
Show others...
2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 3, article id e0119542Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:

To describe referred pain patterns provoked from intra-pelvic structures in women with chronic pelvic pain (CPP) persisting after childbirth with the purpose to improve diagnostics and give implications for treatment.

MATERIALS AND METHODS:

In this descriptive and comparative study 36 parous women with CPP were recruited from a physiotherapy department waiting list and by advertisements in newspapers. A control group of 29 parous women without CPP was consecutively assessed for eligibility from a midwifery surgery. Inclusion criterion for CPP was: moderate pain in the sacral region persisting at least six months after childbirth confirmed by pelvic pain provocation tests. Exclusion criteria in groups with and without CPP were: persistent back or pelvic pain with onset prior to pregnancy, previous back surgery and positive neurological signs. Pain was provoked by palpation of 13 predetermined intra-pelvic anatomical landmarks. The referred pain distribution was expressed in pain drawings and described in pain maps and calculated referred pain areas.

RESULTS:

Pain provoked by palpation of the posterior intra-pelvic landmarks was mostly referred to the sacral region and pain provoked by palpation of the ischial and pubic bones was mostly referred to the groin and pubic regions, with or without pain referred down the ipsilateral leg. The average pain distribution area provoked by palpation of all 13 anatomical landmarks was 30.3 mm² (19.2 to 53.7) in women with CPP as compared to 3.2 mm² (1.0 to 5.1) in women without CPP, p< 0.0001.

CONCLUSIONS:

Referred pain patterns provoked from intra-pelvic landmarks in women with CPP are consistent with sclerotomal sensory innervation. Magnification of referred pain patterns indicates allodynia and central sensitization. The results suggest that pain mapping can be used to evaluate and confirm the pain experience among women with CPP and contribute to diagnosis.

National Category
Clinical Medicine
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-211840 (URN)10.1371/journal.pone.0119542 (DOI)000352084200093 ()25793999 (PubMedID)
Available from: 2013-12-02 Created: 2013-12-02 Last updated: 2018-01-19Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-9523-3971

Search in DiVA

Show all publications