The Prognostic Value of Pain Sensitization in Patients With Lateral Epicondylitis

Young Hak Roh, Hyun Sik Gong, Goo Hyun Baek

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: Pain sensitization is a contributing factor to conditions of chronic pain. The aim of this study was to evaluate the influence of pain sensitization on the prognosis of lateral epicondylitis (LE) treated by self-stretching exercises and the use of a counterforce brace. Methods: We enrolled 131 patients who presented with isolated LE symptoms for less than 6 months. We initially measured pain sensitization by assessing patients’ pressure pain thresholds (PPTs) in the contralateral middorsal forearm and administering a pain sensitization questionnaire (PSQ). For outcome assessments, we assessed the self-administered, patient-reported Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire at 6 and 12 months’ follow-up. Results: Initial PSQ scores correlated moderately with baseline DASH scores and slightly with symptom duration; PPTs correlated slightly with baseline DASH scores. After we accounted for confounding variables, patient-reported disability was associated with lower PPTs, higher PSQ scores, and manual labor at 6 months. These 3 factors accounted for 36% of variance in the DASH scores; however, at 12 months only the PSQ score was associated with higher DASH scores, accounting for 14% of variance. Conclusions: Pain sensitization during the early stages of LE correlated with initial symptom severity and duration and was associated with persistently increasing disability after 1 year of nonsurgical treatment. More research is needed to show whether early identification and treatment of pain sensitization will enhance LE treatment outcomes. Type of study/level of evidence: Prognostic IV.

Original languageEnglish
Pages (from-to)250.e1-250.e7
JournalJournal of Hand Surgery
Volume44
Issue number3
DOIs
StatePublished - Mar 2019

Keywords

  • Conservative treatment
  • lateral epicondylitis
  • pain sensitization
  • prognosis

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