Determining A Valid Model of Experimental Shoulder Pain

Abstract

This thesis investigated whether experimental pain, with a particular focus on experimental shoulder pain, validly replicated the clinical experience of pain. One systematic review and one experimental study were conducted as part of the research program. The introduction chapter summarised the literature regarding prognosis and management of shoulder pain. A lack of reliable information regarding the muscle response to shoulder pain was identified as a potential cause of suboptimal management. Experimental pain was identified as the best option for determining the muscle response to pain due to the short-comings of other options, however, research has not been conducted to validate current models of experimental pain as a viable model for clinical shoulder pain. A systematic review of appendicular experimental pain models identified that investigated models of experimental pain reproduced pain in a similar distribution to clinical pain but largely did not reproduce the same emotional response. A low number of studies had comprehensively investigated experimental pain response to provocation. The experimental study established that experimental shoulder pain induced by hypertonic saline injection reproduced a similar distribution of pain but did not reproduce the emotional distress seen in clinical populations. Most subjects had a decrease or no change in pain in response to provocation. A valid model of experimental model of shoulder pain has not been established. The discussion chapter outlined to implications of the previous two chapters on previously conducted research involving motor response to experimental pain and the direction of future research.