Advanced search
1 file | 400.63 KB

Does acetaminophen activate endogenous pain inhibition in chronic fatigue syndrome/fibromyalgia and rheumatoid arthritis? : a double-blind randomized controlled cross-over trial

(2013) PAIN PHYSICIAN. 16(2). p.E61-E70
Author
Organization
Abstract
Background: Although enhanced temporal summation (TS) and conditioned pain modulation (CPM), as characteristic for central sensitization, has been proved to be impaired in different chronic pain populations, the exact nature is still unknown. Objectives: We examined differences in TS and CPM in 2 chronic pain populations, patients with both chronic fatigue syndrome (CFS) and comorbid fibromyalgia (FM) and patients with rheumatoid arthritis (RA), and in sedentary, healthy controls, and evaluated whether activation of serotonergic descending pathways by acetaminophen improves central pain processing. Study Design: Double-blind randomized controlled trial with cross-over design. Methods: Fifty-three women (19 CFS/FM patients, 16 RA patients, and 18 healthy women) were randomly allocated to the experimental group (1 g acetaminophen) or the placebo group (1 g dextrose). Participants underwent an assessment of endogenous pain inhibition, consisting of an evaluation of temporal summation with and without conditioned pain modulation (CPM). Seven days later groups were crossed-over. Patients and assessors were blinded for the allocation. Results: After intake of acetaminophen, pain thresholds increased slightly in CFS/FM patients, and decreased in the RA and the control group. Temporal summation was reduced in the 3 groups and CPM at the shoulder was better overall, however only statistically significant for the RA group. Healthy controls showed improved CPM for both finger and shoulder after acetaminophen, although not significant. Limitations: The influence of acetaminophen on pain processing is inconsistent, especially in the patient groups examined. Conclusion: This is the first study comparing the influence of acetaminophen on central pain processing in healthy controls and patients with CFS/FM and RA. It seems that CFS/ FM patients present more central pain processing abnormalities than RA patients, and that acetaminophen may have a limited positive effect on central pain inhibition, but other contributors have to be identified and evaluated.
Keywords
central sensitization, rheumatoid arthritis, chronic pain, exercise induced analgesia, chronic fatigue syndrome, pain inhibition, fibromyalgia, TEMPORAL SUMMATION, FIBROMYALGIA SYNDROME, EVOKED PAIN, 2ND PAIN, THRESHOLD, HYPERSENSITIVITY, SENSITIZATION, POLYMORPHISM, ASSOCIATION, DEFINITION

Downloads

  • Meeus et al 2013.pdf
    • full text
    • |
    • open access
    • |
    • PDF
    • |
    • 400.63 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Meeus, Mira, Kelly Ickmans, Filip Struyf, Linda Hermans, Kevin Van Noesel, Jorinde Oderkerk, Luc De Clerck, et al. 2013. “Does Acetaminophen Activate Endogenous Pain Inhibition in Chronic Fatigue Syndrome/fibromyalgia and Rheumatoid Arthritis? : a Double-blind Randomized Controlled Cross-over Trial.” Pain Physician 16 (2): E61–E70.
APA
Meeus, M., Ickmans, K., Struyf, F., Hermans, L., Van Noesel, K., Oderkerk, J., De Clerck, L., et al. (2013). Does acetaminophen activate endogenous pain inhibition in chronic fatigue syndrome/fibromyalgia and rheumatoid arthritis? : a double-blind randomized controlled cross-over trial. PAIN PHYSICIAN, 16(2), E61–E70.
Vancouver
1.
Meeus M, Ickmans K, Struyf F, Hermans L, Van Noesel K, Oderkerk J, et al. Does acetaminophen activate endogenous pain inhibition in chronic fatigue syndrome/fibromyalgia and rheumatoid arthritis? : a double-blind randomized controlled cross-over trial. PAIN PHYSICIAN. 2013;16(2):E61–E70.
MLA
Meeus, Mira, Kelly Ickmans, Filip Struyf, et al. “Does Acetaminophen Activate Endogenous Pain Inhibition in Chronic Fatigue Syndrome/fibromyalgia and Rheumatoid Arthritis? : a Double-blind Randomized Controlled Cross-over Trial.” PAIN PHYSICIAN 16.2 (2013): E61–E70. Print.
@article{3175704,
  abstract     = {Background: Although enhanced temporal summation (TS) and conditioned pain modulation (CPM), as characteristic for central sensitization, has been proved to be impaired in different chronic pain populations, the exact nature is still unknown. 
Objectives: We examined differences in TS and CPM in 2 chronic pain populations, patients with both chronic fatigue syndrome (CFS) and comorbid fibromyalgia (FM) and patients with rheumatoid arthritis (RA), and in sedentary, healthy controls, and evaluated whether activation of serotonergic descending pathways by acetaminophen improves central pain processing. 
Study Design: Double-blind randomized controlled trial with cross-over design. 
Methods: Fifty-three women (19 CFS/FM patients, 16 RA patients, and 18 healthy women) were randomly allocated to the experimental group (1 g acetaminophen) or the placebo group (1 g dextrose). Participants underwent an assessment of endogenous pain inhibition, consisting of an evaluation of temporal summation with and without conditioned pain modulation (CPM). Seven days later groups were crossed-over. Patients and assessors were blinded for the allocation. 
Results: After intake of acetaminophen, pain thresholds increased slightly in CFS/FM patients, and decreased in the RA and the control group. Temporal summation was reduced in the 3 groups and CPM at the shoulder was better overall, however only statistically significant for the RA group. Healthy controls showed improved CPM for both finger and shoulder after acetaminophen, although not significant. 
Limitations: The influence of acetaminophen on pain processing is inconsistent, especially in the patient groups examined. 
Conclusion: This is the first study comparing the influence of acetaminophen on central pain processing in healthy controls and patients with CFS/FM and RA. It seems that CFS/ FM patients present more central pain processing abnormalities than RA patients, and that acetaminophen may have a limited positive effect on central pain inhibition, but other contributors have to be identified and evaluated.},
  author       = {Meeus, Mira and Ickmans, Kelly and Struyf, Filip and Hermans, Linda and Van Noesel, Kevin and Oderkerk, Jorinde and De Clerck, Luc and Moorkens, Greta and Hans, Guy and Grosemans, Sofie and Nijs, Jo },
  issn         = {1533-3159},
  journal      = {PAIN PHYSICIAN},
  keywords     = {central sensitization,rheumatoid arthritis,chronic pain,exercise induced analgesia,chronic fatigue syndrome,pain inhibition,fibromyalgia,TEMPORAL SUMMATION,FIBROMYALGIA SYNDROME,EVOKED PAIN,2ND PAIN,THRESHOLD,HYPERSENSITIVITY,SENSITIZATION,POLYMORPHISM,ASSOCIATION,DEFINITION},
  language     = {eng},
  number       = {2},
  pages        = {E61--E70},
  title        = {Does acetaminophen activate endogenous pain inhibition in chronic fatigue syndrome/fibromyalgia and rheumatoid arthritis? : a double-blind randomized controlled cross-over trial},
  volume       = {16},
  year         = {2013},
}

Web of Science
Times cited: