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Is patellofemoral pain neuropathic?

PainSci » bibliography » Jensen et al 2008
updated
Tags: patellar pain, etiology, neurology, arthritis, aging, pain problems, knee, leg, limbs, overuse injury, injury, running, exercise, self-treatment, treatment, pro

One article on PainSci cites Jensen 2008: The Complete Guide to Patellofemoral Pain Syndrome

PainSci notes on Jensen 2008:

Building on an earlier paper (Jensen 2007), Jensen, Kvale and Baerheim found “ample signs of sensory aberrations” in people with PFPS, which “may cause neuropathic pain.” In other words, when your knees ache, they don’t just ache: sensation in the whole area is altered, and it could also make pain more sensitive. It’s also possible that this alters things like reflexes and balance. Unfortunately, the details are not yet clear — further research required!

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVE: There is no consensus among experts regarding the etiology or management of patellofemoral pain syndrome (PFPS). Observations indicating dysfunction of the peripheral nervous system around the patellae have been reported. To what extent these sensory abnormalities cause pain has so far not been investigated. The aim of this study was to assess whether a subgroup of patients with unilateral PFPS have neuropathic pain related to the painful knee.

METHOD: A total of 91 patients with unilateral PFPS, between 18 and 40 years of age, and a comparable group of 23 healthy participants aged 18 to 44 years were included. Level of knee function, pain intensity, and qualities were assessed. Somatosensory assessments were carried out by bedside neurologic tests and quantitative sensory testing, assessing thermal, tactile, and vibration thresholds.

RESULTS: Ample signs of sensory aberrations with considerable heterogeneity and overlap regarding the degree and type of dysfunction of the nervous system were found in the painful area of the PFPS patients. No clear subgroup of patients with neuropathic pain or clustering of features related to neuropathic pain was identified.

DISCUSSION: This study hypothesizes that the observed sensory aberrations may cause neuropathic pain in patients with PFPS. There is no validated method for subgrouping patients with possible neuropathic pain and in this study considerable heterogeneity and overlap regarding signs and symptoms of neuropathic pain made subgrouping even more difficult. A mechanism-based understanding of the pain is, however, essential for the selection of adequate treatment strategies in painful musculoskeletal disorders.

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