Temporal summation of pressure pain during muscle hyperalgesia evoked by nerve growth factor and eccentric contractions

Nerve growth factor (NGF) has a key role in the generation and potentiation of pain. Its centrally sensitizing effects may facilitate pain responses to noxious stimulus. This study assessed (1) the influence of NGF on delayed onset muscle soreness (DOMS) in shoulder muscles; and (2) the temporal summation of pressure pain during hyperalgesia induced by NGF and DOMS. In a blinded design, 10 healthy subjects were injected with NGF in the trapezius muscle on one side and with isotonic saline on the contralateral side as control. The subjects undertook shoulder eccentric exercise to induce DOMS in the shoulder muscles 3 h after the injections. The soreness intensity to muscle contraction, pressure pain thresholds (PPT), and pain intensity to sequential stimuli (i.e. temporal summation at 1 and 30 s inter-stimulus interval (ISI)) were assessed before injections - 3, 24 h, and 4, 7, and 21 days after injections. The soreness intensity to muscle contraction significantly increased at 3 and 24 h in both shoulders (P < 0.05) and went back to baseline levels at day 7. The same development was seen in PPT as reduced thresholds (P < 0.05). The NGF injected side had higher pain ratings during temporal summation at 1 s ISI compared with the contralateral side 24 h after injections. Intramuscular administration of NGF intensified the DOMS responses, evoking facilitated temporal summation. Central as well as peripheral sensitization mechanisms may play a role in the facilitation.