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Karnishkina O.Yu.

Sechenov Institute of Evolutionary Physiology and Biochemistry

Bukhantseva D.S.

Almazov National Medical Research Centre;
Southern District Medical Center of the Federal Medical Biological Agency

Didur E.A.

Almazov National Medical Research Centre

Lytochkina S.V.

Mechnikov North-Western State Medical University

Deffo A.E.D.

Mechnikov North-Western State Medical University

Karelov A.E.

Mechnikov North-Western State Medical University

Babenko A.Yu.

Almazov National Medical Research Centre

Dobretsov M.G.

Sechenov Institute of Evolutionary Physiology and Biochemistry

Deep muscle pain threshold as a possible criterion for assessment of small fiber neuropathy

Authors:

Karnishkina O.Yu., Bukhantseva D.S., Didur E.A., Lytochkina S.V., Deffo A.E.D., Karelov A.E., Babenko A.Yu., Dobretsov M.G.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2025;(1): 76‑80

DOI: 10.17116/anaesthesiology202501176

Views: 431

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Table of contents

DEEP MUSCLE PAIN THRESHOLD AS A POSSIBLE CRITERION FOR ASSESSMENT OF SMALL FIBER NEUROPATHY
DEEP MUSCLE PAIN THRESHOLD AS A POSSIBLE CRITERION FOR ASSESSMENT OF SMALL FIBER NEUROPATHY

To cite this article:

Karnishkina OYu, Bukhantseva DS, Didur EA, et al. . Deep muscle pain threshold as a possible criterion for assessment of small fiber neuropathy. Russian Journal of Anesthesiology and Reanimatology. 2025;(1):76‑80. (In Russ.)
https://doi.org/10.17116/anaesthesiology202501176

Подписка 2025-2 (АиР)
МСФ на ЯМ
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Currently, diagnostic methods for early stages of small fiber neuropathy are limited.

OBJECTIVE

To determine reference values for assessing distal (dorsum of the foot) deep muscle pain pressure thresholds in apparently healthy individuals.

MATERIAL AND METHODS

Sixty-five apparently healthy individuals aged 18—60 years (42 women and 23 men) were studied. PPT was measured using manual mechanical algometer FDK5 (Wagner Instruments, USA) with semicircular smooth applicator. The testing site was dorsum of the foot approximately 0.5—1 cm below the arcuate artery between metatarsal bones of the 3rd and 4th toes.

RESULTS

Age of men and women was similar (28.4±2.2 and 26.4±1.6 years, respectively). Men were taller and had higher weight and body mass index (BMI). However, PPT of the right and left feet did not differ from each other and did not depend on BMI. Mean PPT was similar in men and women. In the entire sample (men and women), distribution of PPT was satisfactorily (R2=0.742) described by normal Gaussian curve with a peak at 1.76 kg/cm2 and standard deviation 0.49 kg/cm2.

CONCLUSIONS

The proposed method allows us to determine deep muscle pain thresholds of the dorsum of the foot with minimal activation of nociceptors of large blood vessels, periosteum or tendons. The method can be used for early diagnosis of muscle hyperalgesia as one of the signs of small fiber neuropathy.

Keywords:

small fiber neuropathy
algometer
deep muscle pain
pain detection threshold
reference values
screening method

Authors:

Karnishkina O.Yu.

Sechenov Institute of Evolutionary Physiology and Biochemistry

Bukhantseva D.S.

Almazov National Medical Research Centre;
Southern District Medical Center of the Federal Medical Biological Agency

Didur E.A.

Almazov National Medical Research Centre

Lytochkina S.V.

Mechnikov North-Western State Medical University

Deffo A.E.D.

Mechnikov North-Western State Medical University

Karelov A.E.

Mechnikov North-Western State Medical University

Babenko A.Yu.

Almazov National Medical Research Centre

Dobretsov M.G.

Sechenov Institute of Evolutionary Physiology and Biochemistry

Received:

04.07.2024

Accepted:

26.08.2024

List of references:

  1. Zhou L. Small Fiber Neuropathy. Seminars in Neurology. 2019;39(5):570-577.  https://doi.org/10.1055/s-0039-1688977
  2. Karelov AE. Modern concepts of pain mechanisms. Russian Journal of Anesthesiology and Reanimatology. 2020;6:88-95. (In Russ.). https://doi.org/10.17116/anaesthesiology202006188
  3. Chan ACY, Ong K, Ong JJY, Sharma VK, Wong HY, Vijayan J. Biomarkers in small fiber neuropathy. Exploration of Neuroprotective Therapy. 2022;2(6):264-283.  https://doi.org/10.37349/ent.2022.00033
  4. Basantsova NY, Zinchenko YS, Starshinova AA, Yablonskiy PK. Diagnostic evaluation of small-fiber neuropathies in various diseases (review). Pediatriya. 2018;9(6):101-110. (In Russ).
  5. Spasova AP, Barysheva OYu, Tikhova GP, Maltsev VV, Koryachkin VA. Thermal quantitative sensory testing in prediction of chronic pain in survivors of critical illness. Russian Journal of Anesthesiology and Reanimatology. 2021;6:43-51. (In Russ.). https://doi.org/10.17116/anaesthesiology202106143
  6. Gibbons CH. Small Fiber Neuropathies. Continuum. 2014;20(5):1398-1412. https://doi.org/10.1212/01.CON.0000455874.68556.02
  7. Suponeva NA, Belova NV, Zaitseva NI, Yusupova DG, Lagoda DY, Korepina OS, Piradov MA. Small fiber neuropathy. Annaly klinicheskoj i eksperimental’noj nevrologii. 2017;11(1): 73-79. (In Russ.).
  8. Rolke R, Baron R, Maier C, Tolle TR, Treede RD, Beyer A, Binder A, Birbaumer N, Birklein F, Botefur IC, Braune S, Flor H, Huge V, Klug R, Landwehrmeyer GB, Magerl W, Maihofner C, Rolko C, Schaub C, Scherens A, Sprenger T, Valet M, Wasserka B. Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values. Pain. 2006;123:231-243.  https://doi.org/10.1016/j.pain.2010.05.002
  9. Uceyler N, Zeller D, Kahn AK, Kewenig S, Kittel-Schneider S, Schmid A, Casanova-Molla J, Reiners K, Sommer C. Small fibre pathology in patients with fibromyalgia syndrome. Brain. 2013;136(6):1857-1867. https://doi.org/10.1093/brain/awt053
  10. Rolke R, Andrews CK, Magerl W, Treede RD. Deep pain thresholds in the distal limbs of healthy human subjects. European Journal of Pain. 2005;9:39-48.  https://doi.org/10.1016/j.ejpain.2004.04.001
  11. Graven-Nielsen T, Mense S, Arendt-Nielsen L. Painful and non-painful pressure sensations from human skeletal muscle. Experimental Brain Research. 2004;159:273-283.  https://doi.org/10.1007/s00221-004-1937-7
  12. Fischer AA. Pressure algometry over normal muscles. Standard values, validity and reproducibility of pressure threshold. Pain. 1987;30(1):115-126.  https://doi.org/10.1016/0304-3959(87)90089-3
  13. Giesbrecht RJ, Battie MC. A comparison of pressure pain detection thresholds in people with chronic low back pain and volunteers without pain. Physical Therapy. 2005; 85(10):1085-1092. https://doi.org/10.1093/ptj/85.10.1085
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