Document Detail


Pressure pain perception at the injured foot: the impact of diabetic neuropathy.
MedLine Citation:
PMID:  23196268     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: At feet with painless diabetic neuropathy (PDN) and a healed fracture (quiescent Charcot-foot), cutaneous pressure pain perception threshold (CPPPT) is elevated beyond the range of measurement, whereas deep pressure pain perception threshold (DPPPT) may be normal. It is unknown, how these thresholds behave under the conditions of a foot injury. We therefore measured CPPPT and DPPPT in the vicinity of a unilateral active foot injury.
PATIENTS AND METHODS: 18 diabetic patients with PDN and plantar injury, partly involving the skeleton (Wagner grade I-II ulcer), 10 non-neuropathic subjects with acute painful skeletal injury (sprain, fracture) and 20 healthy control subjects without foot injury were studied. CPPPT was measured using calibrated monofilaments, and DPPPT was measured by Algometer II® over muscle and joint.
RESULTS: Compared to control subjects, non-neuropathic acutely injured (and contralateral) feet displayed lowered CPPPT and DPPPT. Conversely, ulcerated and contralateral feet with PDN displayed unmeasurably elevated thresholds in 100% (CPPPT), 72% (DPPPT over joint), and 28% (DPPPT over muscle) of patients, respectively.
CONCLUSION: In the vicinity of an active foot injury, physiologic hyperalgesia was demonstrated in the non-neuropathic subjects, but not in the patients with PDN in whom neglect of foot trauma is, therefore, common.
Authors:
T Wienemann; E A Chantelau; A Richter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of musculoskeletal & neuronal interactions     Volume:  12     ISSN:  1108-7161     ISO Abbreviation:  J Musculoskelet Neuronal Interact     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-30     Completed Date:  2013-05-17     Revised Date:  2013-07-18    
Medline Journal Info:
Nlm Unique ID:  101084496     Medline TA:  J Musculoskelet Neuronal Interact     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  254-61     Citation Subset:  IM    
Affiliation:
Diabetic Foot Clinic, Department of Metabolic Diseases, Heinrich-Heine-University Düsseldorf, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cross-Sectional Studies
Diabetic Foot / physiopathology*
Female
Foot / physiopathology
Foot Ulcer / physiopathology*
Humans
Male
Middle Aged
Pain Perception / physiology*
Pain Threshold / physiology*
Physical Stimulation
Comments/Corrections
Erratum In:
J Musculoskelet Neuronal Interact. 2013 Jun;13(2):264

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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