Widespread Pressure Pain Hypersensitivity, Health History, and Trigger Points in Patients with Chronic Neck Pain: A Preliminary Study

Pain Med. 2019 Dec 1;20(12):2516-2527. doi: 10.1093/pm/pnz035.


Background: Pain sensitivity in chronic neck pain patients may be influenced by health conditions related to higher levels of widespread pressure pain hypersensitivity (sensitization). Trigger points have also been reported to play a role in the sensitization process.

Objectives: To investigate the association between pressure pain thresholds, trigger points, and health conditions in patients with chronic neck pain.

Design: Original research, preliminary study.

Setting: A private clinic.

Subjects: Thirty-four chronic mechanical neck pain patients and 34 chronic whiplash-associated neck pain patients, giving a final sample of 68 chronic neck pain patients.

Methods: Patients underwent an assessment of pressure pain thresholds over the upper trapezius, extensor carpi radialis longus, and tibialis anterior muscles and were screened for the presence of trigger points in the upper trapezius muscle. Further, information about health history conditions was obtained and collected in a form.

Results: Significantly negative correlations between all pressure pain thresholds and duration of health history conditions were found (all P < 0.02). Significantly lower pressure pain thresholds (all P < 0.01) were found in patients with active trigger points as compared with those with latent trigger points.

Conclusion: Widespread pressure pain hypersensitivity was associated with duration of health history conditions, suggesting that long-lasting health complaints may act as a triggering/perpetuating factor, driving sensitization in individuals with chronic neck pain. Active trigger points may be associated with higher widespread pressure hypersensitivity.

Keywords: Central Sensitization; Health History; Trigger Points.

MeSH terms

  • Adult
  • Chronic Pain / physiopathology*
  • Female
  • Humans
  • Hyperalgesia / physiopathology*
  • Male
  • Middle Aged
  • Neck Pain / physiopathology*
  • Pain Threshold
  • Pressure
  • Touch
  • Trigger Points / physiopathology*