Pain Modulatory Profiles in Massage for Individuals With Neck Pain
Condition: Musculoskeletal Pain; Neck Pain
MeSH terms: Musculoskeletal Pain; Neck Pain
Study type: Interventional

Summary: 
      One in ten adults experience widespread pain. Neck pain, for example, is a prevalent
      condition with a high rate of recurrence that affects between 10.4% and 21.3% of the
      population annually.

      Massage is a common manual therapy intervention for individuals with musculoskeletal pain.
      However, the mechanisms of massage are not well established. Also, the conditioned pain
      modulation (CPM) paradigm is a dynamic quantitative sensory testing measure of a pain
      inhibitory process in which pain sensitivity is lessened in response to a remotely applied
      painful stimulus.

      This study will evaluate the association between pain inducing massage and the conditioned
      pain modulation paradigm in participants with a history of neck pain.
    

Detailed description: 
      Conditioned pain modulation (CPM) is the physical manifestation of the diffuse noxious
      inhibitory control (DNIC), an endogenous pain inhibitory pathway in which pain inhibits pain.
      Conditioned pain modulation is less efficient in individuals with chronic pain conditions and
      it is a predictor for the development of chronic pain.

      Massage is a common manual therapy intervention for individuals with musculoskeletal pain.
      Greater changes in pain sensitivity occur following pain inducing massage suggesting a
      mechanism dependent upon the efficiency of the conditioned pain modulation response. Previous
      research has indicated pain inducing massage is more effective than pain free massage
      suggesting a mechanism dependent upon conditioned pain modulation.

      The study team will evaluate the association between pain inducing massage and the
      conditioned pain modulation paradigm. Participants with neck pain will be randomly assigned
      to receive a pain inducing massage, pain free massage, or a coldpressor task. Pre-and post
      intervention pain will be assessed. The study team will determine if analgesia induced by
      pain inducing massage is similar to the conditioned pain modulation paradigm and if baseline
      conditioned pain modulation predicts responders to pain inducing massage and short term
      clinical outcomes in patients with a history of neck pain.
    

Intervention name(s): Pain Inducing Massage; Light Touch Massage; Coldpressor
Intervention type(s): Other; Other; Other
Intervention description(s): Participants will receive 60 seconds of manual pressure applied to one myofascial trigger point so the participant rates the pain = 5/10 on a scale from 0 to 10. This will be followed by 30 seconds of complete pressure release. This will occur 4 times.; Participants will receive 60 seconds of light touch applied to one myofascial trigger point so the participant rates the pain = 0/10 on a scale from 0 to 10. This will be followed by 30 seconds of complete pressure release. This will occur 4 times.; Participants will place their non-dominant hand into water cooled by a refrigeration unit temperature of 6 degrees Celsius (males) or 8 degrees Celsius (females). The participant will place his or her hand in the cooled water for 60 seconds followed by a 30 second break in which the participant will remove his or her hand from the water. This will occur 4 times.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Participants with neck pain will be randomly assigned to receive a pain inducing massage, pain free massage, or a coldpressor task.
Masking: Single (Investigator)
Primary purpose: Supportive Care
Keywords: conditioned pain modulation (CPM); diffuse noxious inhibitory control (DNIC); massage; hypoalgesia