Production of Consistent Pain by Intermittent Infusion of Sterile 5% Hypertonic Saline, Followed by Decrease of Pain With Cryotherapy

in Journal of Sport Rehabilitation
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Context:

It is suggested that postinjury pain is difficult to examine; thus, investigators have developed experimental pain models. To minimize pain, cryotherapy (cryo) is applied, but reports on its effectiveness are limited.

Objective:

To investigate a pain model for the anterior knee and examine cryo in reducing the pain.

Design:

Controlled laboratory study.

Setting:

Therapeutic modality laboratory.

Participants:

30 physically active healthy male subjects who were free from any lower extremity orthopedic, neurological, cardiovascular, or endocrine pathologies.

Main Outcome Measures:

Perceived pain was measured every minute. Surface temperature was also assessed in the center of the patella and the popliteal fossa.

Results:

There was a significant interaction between group and time (F68,864 = 3.0, P = .0001). At the first minute, there was no difference in pain between the 3 groups (saline/cryo = 4.80 ± 4.87 mm, saline/sham = 2.80 ± 3.55 mm, no saline/cryo = 4.00 ± 3.33 mm). During the first 5 min, pain increased from 4.80 ± 4.87 to 45.90 ± 21.17 mm in the saline/cryo group and from 2.80 ± 3.55 to 31.10 ± 20.25 mm in the saline/sham group. Pain did not change within the no-saline/cryo group, 4.00 ± 3.33 to 1.70 ± 1.70 mm. Pain for the saline/sham group remained constant for 17 min. Cryo decreased pain for 16 min in the saline/cryo group. There was no difference in preapplication surface temperature between or within each group. No change in temperature occurred within the saline/sham. Cooling and rewarming were similar in both cryo groups. Ambient temperature fluctuated less than 1°C during data collection.

Conclusion:

Intermittent infusion of sterile 5% hypertonic saline may be a useful experimental pain model in establishing a constant level of pain in a controlled laboratory setting. Cryotherapy decreased the induced anterior knee pain for 16 min.

Long is with the Dept of Health and Human Performance, Oklahoma State University, Stillwater, OK. Knight, Hopkins, Parcell, and Feland are with the Dept of Exercise Sciences, Brigham Young University, Provo, UT.