Pain Intensity, Pressure Pain Hypersensitivity, Central Sensitization, and Pain Catastrophizing Related to Vascular Alterations in Raynaud’s Phenomenon: A Preliminary Case–Control Study

• Published in: Pain medicine (Malden, Mass.) Vol. 21; no. 5; pp. 891 - 901
• Main Authors: Tapia-Haro, Rosa Maria, Guisado-Barrilao, Rafael, Garcia-Rios, Maria del Carmen, lvarez, Enrique Raya-A, Perez-Marmol, Jose Manuel, Aguilar-Ferrandiz, Maria Encarnacion
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.05.2020
• Subjects: Case-Control Studies; Catastrophization; Central Nervous System Sensitization; Complications and side effects; Development and progression; Diagnosis; Humans; Hypersensitivity; Pain; Pain perception; Pressure; Raynaud Disease; Raynaud's disease; Risk factors; Vasoconstriction; Spain; Central Nervous System Sensitization; Peripheral Vascular Diseases; Pain; Catastrophization; Raynaud Disease
• ISSN: 1526-2375; 1526-4637
• DOI: 10.1093/pm/pnz089

Abstract Objective To evaluate pain intensity, widespread pressure pain, central sensitization (CS), and catastrophizing between subjects with primary and secondary Raynaud’s phenomenon (RP) and healthy controls and to compare the relationships between vascular impairment and pain perception. Methods A preliminary case–control study was performed with a total sample of 57 participants (37 with RP). Sociodemographic data, clinical/vascular data, and pain variables (pain intensity, pressure pain sensitivity, pain magnitude and threshold, CS, and catastrophizing) were registered. Results were analyzed by analysis of covariance and Pearson correlation. Results Participants with RP had a lower basal temperature (more vasoconstriction) in their hands (P ≤ 0.012), higher pain intensity (P ≤ 0.001), higher electrical pain magnitude (P < 0.001), and lower pressure pain (P ≤ 0.05) and electrical pain (P < 0.001) thresholds in comparison with healthy controls. Secondary RP participants showed a significantly higher level of CS compared with controls and primary RP participants (P = 0.001). Catastrophizing was higher in the primary and secondary RP (P ≤ 0.001) groups than in controls. No correlations were observed between severity of vasoconstriction and pain variables. Conclusions RP participants showed bilateral hypersensitivity to pressure pain. However, the severity of vascular alterations seems not to be related to central pain experiences. Additional mechanisms such as catastrophizing may influence pain in RP; nevertheless, central sensitization only appears to be involved in the secondary form of RP.