Abnormal autonomic phenomenon provoked by noxious muscle stimulation as a possible sign of mixed syndrome among chronic sciatica patients
[ 1 ] Instytut Mechaniki Stosowanej, Wydział Inżynierii Mechanicznej, Politechnika Poznańska | [ P ] employee
EN Background: Sciatic pain can possibly persist due to neuropathic, nociplastic, or mixed syndrome pain pathomechanism. Referred pain is considered a possible sign of nociplastic pain, thus the abnormal activity of the immune and autonomic nervous systems can be possible. To confirm abnormal autonomic reactivity within the referred pain zone of active trigger points, a new diagnostic tool that uses noxious muscle stimulation under infrared camera control – the Skorupska Protocol® test (the SP test®) – was applied. The SP test® is considered positive if the size of the noxiously provoked vasomotor response in the lower leg is bigger than 3%. Healthy subjects, who undergo the SP test®, are characterized by the absence of vasomotor reactivity. Objectives: The study aims at examining if chronic sciatica subjects with/without co-morbidity can develop an abnormal autonomic response to the SP test® spreading down to the lower leg in the sciatic pain zone. Methods: Two groups of chronic sciatica patients: group A (with referred pain (n=20)) and group B (without referred pain (n=20)) were examined using the SP test®. Results: The SP test provoked an abnormal vasomotor response, that covered the lower leg, sized: A 20.4 ± 19.9% vs B 3.77 ± 9.14%; p = 0.000; CI (0.347,0.348). Conclusions: The chronic sciatica patients who present with muscle referred pain co-morbidities can be objectively distinguished by abnormal autonomic nervous system activity confirmed by the SP test®. The observed phenomenon can possibly be applied to confirm the mixed syndrome/nociplastic pain involvement in chronic sciatica.
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