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Pain tolerance in patients presenting to primary care and physiotherapy services with upper limb disorders
  1. Claire Ryall1,
  2. David Coggon1,
  3. Robert Peveler2,
  4. Isabel Reading1,
  5. Keith T Palmer1
  1. 1MRC Epidemiology Resource Centre, University of Southampton, Southhampton, UK
  2. 2Clinical Neurosciences, University of Southampton, Southhampton, UK
  1. Correspondence to:
 Professor D Coggon
 MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK; dnc{at}mrc.soton.ac.uk

Abstract

Background: Arm pain is a common cause of incapacity for work and is often attributed to occupational activities, but in many cases the pathogenesis is unclear.

Objective: To investigate whether arm pain in the absence of identifiable underlying pathology is associated with reduced tolerance of painful sensory stimuli.

Methods: 133 incident cases of arm pain, recruited from primary care and physiotherapy services, were classified according to a validated diagnostic algorithm. Pain tolerance was measured at three sites in each arm in response to electrocutaneous stimulation. Associations with pain tolerance (the geometric mean of the six measurements at 5 Hz) were assessed by linear regression, and findings were summarised as proportional changes in pain tolerance.

Results: Pain tolerance was generally lower than in an earlier community survey. Women had a lower tolerance than men. After allowance for sex, age, use of analgesics and anatomical extent of pain, there was no indication of reduced tolerance in patients with non-specific pain relative to those with specific local pathology.

Conclusions: Pain tolerance may be generally reduced in patients presenting to medical services with arm pain, but those with non-specific pain do not seem to have lower tolerance than those with identifiable local pathology.

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Footnotes

  • Published Online First 19 December 2006

  • Competing interests: None declared.

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