The Effect of Pressure Pain Sensitivity and Patient Factors on Self-Reported Pain-Disability in Patients with Chronic Neck Pain

Zakir Uddin*, 1, 5, 6, Joy C. MacDermid*, 1, 2, Linda J. Woodhouse3, John J. Triano1, 4, Victoria Galea1, Anita R. Gross1
1 School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
2 Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph’s Health Centre, London, Ontario, Canada
3 Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada

4 Research Division, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
5 Department of Rehabilitation Science, Bangladesh University of Health Sciences, Dhaka, Bangladesh
6 Department of Physical Therapy, College of Health and Welfare, Woosong University, Daejeon, South Korea

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© Uddin et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to these authors at the School of Rehabilitation Science, McMaster University, 1400 Main Street West IAHS (4th floor), Hamilton, Ontario L8S 1C7, Canada; Tel: 1-905-525-9140, Ext. 22524; Fax: 1-905-524-0069; E-mails:,,


The study was conducted to estimate the extent to which pressure pain sensitivity (PPS) and patient factors predict pain-related disability in patients with neck pain (NP), and to determine if PPS differs by gender. Forty-four participants with a moderate level of chronic NP were recruited for this cross sectional study. All participants were asked to complete self-reported assessments of pain, disability and comorbidity and then underwent PPS testing at 4-selected body locations. Pearson`s r w was computed to explore relationships between the PPS measures and the self-reported assessments. Regression models were built to identify predictors of pain and disability. An independent sample t-test was done to identify gender-related differences in PPS, pain-disability and comorbidity. In this study, greater PPS (threshold and tolerance) was significantly correlated to lower pain-disability (r = -.30 to -.53, p≤0.05). Age was not correlated with pain or disability but comorbidity was (r= 0.42-.43, p≤0.01). PPS at the 4-selected body locations was able to explain neck disability (R2=25-28%). Comorbidity was the strongest predictor of neck disability (R2 =30%) and pain (R2=25%). Significant mean differences for gender were found in PPS, disability and comorbidity, but not in pain intensity or rating. This study suggests that PPS may play a role in outcome measures of pain and disability but between-subject comparisons should consider gender and comorbidity issues.

Keywords: Comorbidity, gender, neck pain sensitivity, neck disability, pain threshold, pain tolerance..