Testing for Sensory Hypersensitivity or Central Hyperexcitability Associated With Cervical Spine Pain

BackgroundSensory hypersensitivity is a recently recognized yet common feature of some neck pain conditions, particularly those with higher levels of pain and disability. It is generally acknowledged that the presence of widespread sensory hypersensitivity provides indication of augmented central pain processing mechanisms or central hyperexcitability. Sensory hypersensitivity may be able to differentiate various neck pain conditions, provide an indication of prognosis after whiplash injury, and show potential to recognize poor responders to physical interventions.Special FeaturesVarious tests may be used to determine the presence of sensory hypersensitivity. This article outlines and discusses 3 tests that have been used in the investigation of processes underlying neck pain as follows: pressure pain thresholds (PPT); thermal pain thresholds, and the brachial plexus provocation test.SummaryAlthough there are some data available on the psychometric properties of these tests, particularly PPT, much more information is required before these tests can be comprehensively used in the clinical environment.