Pain
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Recent studies into the common complaint of chronic neck pain have focused on its anatomical origin, identifying especially the cervical zygapophysial joints. However the pathophysiology of chronic neck pain remains poorly understood. In this psychophysical study, responses to electrocutaneous stimulation in subjects with chronic neck pain were examined. ⋯ There was a small difference in detection threshold between the two groups: both pain threshold and pain tolerance were significantly lower in the pain group compared with pain free controls. These findings define hyperalgesia psychophysically and, taken together with the absence of tissue damage at the sites of testing. suggest that these painful cervical regions may be examples of secondary hyperalgesia which, in turn, implies central sensitisation of nociceptive pathways. These results are compatible with studies which identify potential anatomical origins of chronic neck pain but provide evidence that central sensitisation may be the relevant mechanism of pain production.