"Shooting pain" in lumbar radiculopathy and trigeminal neuralgia, and ideas concerning its neural substrates.
Journal
Pain
ISSN: 1872-6623
Titre abrégé: Pain
Pays: United States
ID NLM: 7508686
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
pubmed:
28
10
2019
medline:
3
2
2021
entrez:
26
10
2019
Statut:
ppublish
Résumé
Patients with radicular low back pain (radicular LBP, sciatica) frequently describe their pain as "shooting" or "radiating." The dictionary meaning of these words implies rapid movement, and indeed, many sufferers report feeling pain moving rapidly from the lower back or buttock into the leg. But, others do not. Moreover, the sensation of movement is paradoxical; it is neither predicted nor accounted for by current ideas about the pathophysiology of radicular LBP. We have used a structured questionnaire to evaluate the sensory qualities associated with "shooting" and "radiating" in 155 patients, 98 with radicular LBP and 57 with trigeminal neuralgia, a second chronic pain condition in which shooting/radiating are experienced. Results indicated a spectrum of different sensations in different people. Although many sciatica patients reported rapid downward movement of their pain, even more reported downward expansion of the area of pain, some reported upward movement, and for some, there was no spatial dynamic at all. The velocity of movement or expansion was also variable. By cross-referencing sensations experienced in the sciatica and trigeminal neuralgia cohorts with known signal processing modes in the somatosensory system, we propose testable hypotheses concerning the pathophysiology of the various vectorial sensations reported, their direction and velocity, and the structures in which they are generated. Systematic evaluation of qualitative features of "shooting" and "radiating" pain at the time of diagnosis can shed light on the pain mechanism in the individual patient and perhaps contribute to a better therapeutic outcomes.
Identifiants
pubmed: 31651576
doi: 10.1097/j.pain.0000000000001729
pii: 00006396-202002000-00009
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
308-318Références
Abeles M. Corticonics: neural circuits of the cerebral cortex. Cambridge: University Press, 1991.
Albrecht DS, Ahmed SU, Kettner NW, Borra RJH, Cohen-Adad J, Deng H, Houle TT, Opalacz A, Roth SA, Melo MFV, Chen L, Mao J, Hooker JM, Loggia ML, Zhang Y. Neuroinflammation of the spinal cord and nerve roots in chronic radicular pain patients. PAIN 2018;159:968–77.
Amir R, Michaelis M, Devor M. Membrane potential oscillations in dorsal root ganglion neurons: role in normal electrogenesis and in neuropathic pain. J Neurosci 1999;19:8589–96.
Baron R, Binder A, Attal N, Casale R, Dickenson AH, Treede RD. Neuropathic low back pain in clinical practice. Eur J Pain 2016;20:861–73.
Bjorland S, Moen A, Schistad E, Gjerstad J, Roe C. Genes associated with persistent lumbar radicular pain: a systematic review. BMC Musculoskelet Disord 2016;17:500.
Bogduk N. On the definitions and physiology of back pain, referred pain, and radicular pain. PAIN 2009;147:17–19.
Bove GM, Ransil BJ, Lin HC, Leem JG. Inflammation induces ectopic mechanical sensitivity in axons of nociceptors innervating deep tissues. J Neurophysiol 2003;90:1949–55.
Brown PB, Fuchs JL. Somatotopic representation of hindlimb skin in cat dorsal horn. J Neurophysiol 1975;38:1–9.
Chung DY, Sadeghian H, Qin T, Lule S, Lee H, Karakaya F, Goins S, Oka F, Yaseen MA, Houben T, Tolner EA, van den Maagdenberg A, Whalen MJ, Sakadzic S, Ayata C. Determinants of optogenetic cortical spreading depolarizations. Cereb Cortex 2019;29:1150–61.
Costanzo RM, Gardner EP. A quantitative analysis of responses of direction-sensitive neurons in somatosensory cortex of awake monkeys. J Neurophysiol 1980;43:1319–41.
Defrin R, Devor M, Brill S. Tactile allodynia in patients with lumbar radicular pain (sciatica). PAIN 2014;155:2551–9.
Depeault A, Meftah el M, Chapman CE. Neuronal correlates of tactile speed in primary somatosensory cortex. J Neurophysiol 2013;110:1554–66.
Devor M, Amir R, Rappaport ZH. Pathophysiology of trigeminal neuralgia: the ignition hypothesis. Clin J Pain 2002;18:413.
Devor M, Wall PD. Dorsal horn cells with proximal cutaneous receptive fields. Brain Res 1976;118:325–8.
Devor M, Wall PD. Effect of peripheral nerve injury on receptive fields of cells in the cat spinal cord. J Comp Neurol 1981;199:277–91.
Deyo RA, Mirza SK. Clinical practice: herniated lumbar intervertebral disk. N Engl J Med 2016;374:1763–72.
Deyo RA, Weinstein JN. Low back pain. N Engl J Med 2001;344:363–70.
Drummond PD, Morellini N, Visser E, Finch PM. Parallels between lumbosacral radiculopathy and complex regional pain syndrome: alpha1-adrenoceptor upregulation, reduced dermal nerve fibre density, and hemisensory disturbances in postsurgical sciatica. PAIN 2019;160:1891–900.
Enger R, Tang W, Vindedal GF, Jensen V, Johannes Helm P, Sprengel R, Looger LL, Nagelhus EA. Dynamics of ionic shifts in cortical spreading depression. Cereb Cortex 2015;25:4469–76.
Freynhagen R, Rolke R, Baron R, Tolle TR, Rutjes AK, Schu S, Treede RD. Pseudoradicular and radicular low-back pain—a disease continuum rather than different entities? Answers from quantitative sensory testing. PAIN 2008;135:65–74.
Fried K, Sessle BJ, Devor M. The paradox of pain from tooth pulp: low-threshold “algoneurons”? PAIN 2012;152:2685–9.
Gardner EP, Johnson KO. Chapter 22: the somatosensory system: receptors and central pathways. In: Kandel ER, Schwartz JH, Jessell TM, Siegelbaum SA, Hudspeth AJ, editors. Principles of neuroscience. 5th ed. New York: McGraw-Hill, 2013. pp. 475–97.
Haglund MM, Ojemann GA, Hochman DW. Optical imaging of epileptiform and functional activity in human cerebral cortex. Nature 1992;358:668–71.
Hanani M. Intercellular communication in sensory ganglia by purinergic receptors and gap junctions: implications for chronic pain. Brain Res 2012;1487:183–91.
Herrera DG, Robertson HA. Application of potassium chloride to the brain surface induces the c-fos proto-oncogene: reversal by MK-801. Brain Res 1990;510:166–70.
Jungen MJ, Ter Meulen BC, van Osch T, Weinstein HC, Ostelo R. Inflammatory biomarkers in patients with sciatica: a systematic review. BMC Musculoskelet Disord 2019;20:156.
Khennouf L, Gesslein B, Brazhe A, Octeau JC, Kutuzov N, Khakh BS, Lauritzen M. Active role of capillary pericytes during stimulation-induced activity and spreading depolarization. Brain 2018;141:2032–46.
King CH, Beutler SS, Kaye AD, Urman RD. Pharmacologic properties of novel local anesthetic agents in anesthesia practice. Anesthesiol Clin 2017;35:315–25.
Koplovitch P, Devor M. Dilute lidocaine suppresses ectopic neuropathic discharge in dorsal root ganglia without blocking axonal propagation: a new approach to selective pain control. PAIN 2018;159:1244–56.
Liao C, Zhang W, Yang M, Zhong W, Liu P, Li S. Microvascular decompression for trigeminal neuralgia: the role of mechanical allodynia. World Neurosurg 2016;91:468–72.
Lisney SJW, Devor M. Afterdischarge and interactions among fibers in damaged peripheral nerve in the rat. Brain Res 1987;415:122–36.
Ljunggren AE. Descriptions of pain and other sensory modalities in patients with lumbago-sciatica and herniated intervertebral discs: interview administration of an adapted Mcgill Pain Questionnaire. PAIN 1983;16:265–76.
Ljunggren AE, Jacobsen T, Osvik A. Pain descriptions and surgical findings in patients with herniated lumbar intervertebral discs. PAIN 1988;35:39–46.
Mahn F, Hullemann P, Gockel U, Brosz M, Freynhagen R, Tolle TR, Baron R. Sensory symptom profiles and co-morbidities in painful radiculopathy. PLoS One 2011;6:e18018.
Mehring C, Akselrod M, Bashford L, Mace M, Choi H, Bluher M, Buschhoff AS, Pistohl T, Salomon R, Cheah A, Blanke O, Serino A, Burdet E. Augmented manipulation ability in humans with six-fingered hands. Nat Commun 2019;10:2401.
Miller JP, Acar F, Burchiel KJ. Classification of trigeminal neuralgia: clinical, therapeutic, and prognostic implications in a series of 144 patients undergoing microvascular decompression. J Neurosurg 2009;111:1231–4.
Mitrani E, Pearlman A, Stern B, Miari R, Goltsman H, Kunicher N, Panet A. Biopump: autologous skin-derived micro-organ genetically engineered to provide sustained continuous secretion of therapeutic proteins. Dermatol Ther 2011;24:489–97.
Mokdad AH; USA, Burden of Disease, Collaborators. The state of US health, 1990–2016: burden of diseases, injuries, and risk factors among US states. JAMA 2018;319:1444–72.
Moldakarimov S, Bazhenov M, Feldman DE, Sejnowski TJ. Structured networks support sparse traveling waves in rodent somatosensory cortex. Proc Natl Acad Sci U S A 2018;115:5277–82.
Munday I, Kneebone I, Newton-John T. The language of chronic pain. Disabil Rehabil 2019:1–8. doi: 10.1080/09638288.2019.1624842.
doi: 10.1080/09638288.2019.1624842
Namer B, Handwerker HO. Translational nociceptor research as guide to human pain perceptions and pathophysiology. Exp Brain Res 2009;196:163–72.
North RY, Li Y, Ray P, Rhines LD, Tatsui CE, Rao G, Johansson CA, Zhang H, Kim YH, Zhang B, Dussor G, Kim TH, Price TJ, Dougherty PM. Electrophysiological and transcriptomic correlates of neuropathic pain in human dorsal root ganglion neurons. Brain 2019;142:1215–26.
Olmarker K, Storkson R, Berge OG. Pathogenesis of sciatic pain: a study of spontaneous behavior in rats exposed to experimental disc herniation. Spine 2002;27:1312–17.
Orstavik K, Jorum E. Microneurographic findings of relevance to pain in patients with erythromelalgia and patients with diabetic neuropathy. Neurosci Lett 2010;470:180–4.
Pauli J, Starkweather A, Robins JL. Screening tools to predict the development of chronic low back pain: an integrative review of the literature. Pain Med 2019;9:1651–77.
Pei YC, Bensmaia SJ. The neural basis of tactile motion perception. J Neurophysiol 2014;112:3023–32.
Penfield W, Rasmussen T. The Cerebral Cortex of Man. New York: MacMillan, 1955.
Pietrobon D, Moskowitz MA. Chaos and commotion in the wake of cortical spreading depression and spreading depolarizations. Nat Rev Neurosci 2014;15:379–93.
Ruscheweyh R, Sandkuhler J. Long-range oscillatory Ca2+ waves in rat spinal dorsal horn. Eur J Neurosci 2005;22:1967–76.
Sanzarello I, Merlini L, Rosa MA, Perrone M, Frugiuele J, Borghi R, Faldini C. Central sensitization in chronic low back pain: a narrative review. J Back Musculoskelet Rehabil 2016;29:625–33.
Schirmer CM, Shils JL, Arle JE, Cosgrove GR, Dempsey PK, Tarlov E, Kim S, Martin CJ, Feltz C, Moul M, Magge S. Heuristic map of myotomal innervation in humans using direct intraoperative nerve root stimulation. J Neurosurg Spine 2011;15:64–70.
Stynes S, Konstantinou K, Ogollah R, Hay EM, Dunn KM. Novel approach to characterising individuals with low back-related leg pain: cluster identification with latent class analysis and 12-month follow-up. PAIN 2018;159:728–38.
Suadicani SO, Cherkas PS, Zuckerman J, Smith DN, Spray DC, Hanani M. Bidirectional calcium signaling between satellite glial cells and neurons in cultured mouse trigeminal ganglia. Neuron Glia Biol 2010;6:43–51.
Truini A, Garcia-Larrea L, Cruccu G. Reappraising neuropathic pain in humans--how symptoms help disclose mechanisms. Nat Rev Neurol 2013;9:572–82.
Vaegter HB, Palsson TS, Graven-Nielsen T. Facilitated pronociceptive pain mechanisms in radiating back pain compared with localized back pain. J Pain 2017;18:973–83.
Vaso A, Adahan HM, Gjika A, Zahaj S, Zhurda T, Vyshka G, Devor M. Peripheral nervous system origin of phantom limb pain. PAIN 2014;155:1384–91.
Warren S, Hamalainen HA, Gardner EP. Objective classification of motion- and direction-sensitive neurons in primary somatosensory cortex of awake monkeys. J Neurophysiol 1986;56:598–622.
Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. PAIN 2011;152(3 suppl):S2–15.
Yatziv SL, Devor M. Suppression of neuropathic pain by selective silencing of DRG ectopia using non-blocking concentrations of lidocaine. PAIN 2019;160:2105–14.