Central sensitisation in musculoskeletal trauma

Middlebrook, Nicola ORCID: 0000-0003-2154-5723 (2020). Central sensitisation in musculoskeletal trauma. University of Birmingham. Ph.D.

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Abstract

Chronic pain is common following musculoskeletal trauma irrespective of injury severity, with patients often experiencing disability. Central sensitisation (CS), categorised by features such as widespread pain, allodynia and secondary hyperalgesia, offers an explanation to the development of chronic pain. This thesis investigated CS in musculoskeletal trauma with a systematic review finding a range of CS measures used. Few studies investigated measurement properties of CS measures. Two reliability studies were conducted evaluating quantitative sensory tests (QST) in asymptomatic and musculoskeletal trauma populations, with a new method of measuring temporal summation developed. An exploratory study investigated features of CS in participants following lower limb trauma using QST, pain drawings and multiple patient reported outcome measures. Reduced pain thresholds and greater pain extent was found in participants with greater levels of pain and disability at six months, suggesting features of CS. This thesis is the first to report features of CS in acute stages following lower limb fractures, enabling new knowledge and insight into CS acutely following injury and how this could influence pain and disability at six months. Greater understanding of pain processes at the acute stage of injury has potential to influence acute rehabilitation management to ensure better overall patient recovery.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):