Journal article
Local Anesthetic Injection Resolves Movement Pain, Motor Dysfunction, and Pain Catastrophizing in Individuals With Chronic Achilles Tendinopathy: A Nonrandomized Clinical Trial
The journal of orthopaedic and sports physical therapy, Vol.50(6), pp.334-343
06/2020
DOI: 10.2519/jospt.2020.9242
PMID: 32349638
Abstract
Objectives
Peripherally directed treatments (targeted exercise, surgery) can reduce, but not fully eliminate, pain for up to 40% of patients with Achilles tendinopathy. The objectives of the present study were (1) to identify indicators of altered central processing in participants with Achilles tendinopathy compared to controls, and (2) to determine which indicators of altered central processing would persist after a local anesthetic injection in patients with Achilles tendinopathy.
Design
Mechanistic clinical trial.
Methods
Forty-six adults (23 with chronic Achilles tendinopathy, 23 matched controls) repeated (1) a movement-evoked pain rating, (2) motor performance assessment, (3) pain psychology questionnaires, and (4) quantitative sensory testing. Participants with Achilles tendinopathy received a local anesthetic injection before repeat testing and controls did not. Mixed-effects analyses of variance examined the effects of group, time, and group by time.
Results
The Achilles tendinopathy group had movement-evoked pain, motor dysfunction, and higher pain psychological factors (pain catastrophizing, kinesiophobia) compared to controls (P<.05). The Achilles tendinopathy group did not have indicators of nociplastic pain with quantitative sensory testing (P>.05). In those with Achilles tendinopathy, local anesthetic injection eliminated pain and normalized the observed deficits in heel-raise performance and pain catastrophizing (group-by-time effect, P<.01), but not in kinesiophobia (P = .45). Injection did not affect measures of nociplastic pain (P>.05).
Conclusion
People with Achilles tendinopathy had elevated pain psychological factors and motor dysfunction but no signs of nociplastic pain with quantitative sensory testing. Removal of nociceptive input normalized movement-evoked pain and some indicators of altered central processing (motor dysfunction, pain catastrophizing), but not kinesiophobia.
Details
- Title: Subtitle
- Local Anesthetic Injection Resolves Movement Pain, Motor Dysfunction, and Pain Catastrophizing in Individuals With Chronic Achilles Tendinopathy: A Nonrandomized Clinical Trial
- Creators
- Ruth L ChimentiMederic M HallConnor P DilgerEricka N MerriwetherJason M WilkenKathleen A Sluka
- Resource Type
- Journal article
- Publication Details
- The journal of orthopaedic and sports physical therapy, Vol.50(6), pp.334-343
- DOI
- 10.2519/jospt.2020.9242
- PMID
- 32349638
- NLM abbreviation
- J Orthop Sports Phys Ther
- ISSN
- 0190-6011
- eISSN
- 1938-1344
- Language
- English
- Date published
- 06/2020
- Academic Unit
- Radiology; Iowa Neuroscience Institute; Orthopedics and Rehabilitation; Family and Community Medicine; Nursing; Physical Therapy and Rehabilitation Science; Neuroscience and Pharmacology
- Record Identifier
- 9984070873002771
Metrics
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