Pain Modulatory Profiles in Massage for Individuals With Neck Pain
Pain Modulatory Profiles in Massage for Individuals With Neck Pain
One in ten adults experience widespread pain. Neck pain, for example, is a prevalent
 condition with a high rate of recurrence that affects between 10.4% and 21.3% of the
 population annually.

 Massage is a common manual therapy intervention for individuals with musculoskeletal pain.
 However, the mechanisms of massage are not well established. Also, the conditioned pain
 modulation (CPM) paradigm is a dynamic quantitative sensory testing measure of a pain
 inhibitory process in which pain sensitivity is lessened in response to a remotely applied
 painful stimulus.

 This study will evaluate the association between pain inducing massage and the conditioned
 pain modulation paradigm in participants with a history of neck pain.
Conditioned pain modulation (CPM) is the physical manifestation of the diffuse noxious
 inhibitory control (DNIC), an endogenous pain inhibitory pathway in which pain inhibits pain.
 Conditioned pain modulation is less efficient in individuals with chronic pain conditions and
 it is a predictor for the development of chronic pain.

 Massage is a common manual therapy intervention for individuals with musculoskeletal pain.
 Greater changes in pain sensitivity occur following pain inducing massage suggesting a
 mechanism dependent upon the efficiency of the conditioned pain modulation response. Previous
 research has indicated pain inducing massage is more effective than pain free massage
 suggesting a mechanism dependent upon conditioned pain modulation.

 The study team will evaluate the association between pain inducing massage and the
 conditioned pain modulation paradigm. Participants with neck pain will be randomly assigned
 to receive a pain inducing massage, pain free massage, or a coldpressor task. Pre-and post
 intervention pain will be assessed. The study team will determine if analgesia induced by
 pain inducing massage is similar to the conditioned pain modulation paradigm and if baseline
 conditioned pain modulation predicts responders to pain inducing massage and short term
 clinical outcomes in patients with a history of neck pain.
Inclusion Criteria:

 -  currently experiencing neck pain with or without arm pain

 -  neck pain symptom intensity rated as 4/10 or higher during the last 24 hours

 -  neck pain for greater than or equal to 3 months

 Exclusion Criteria:

 -  non-English speaking

 -  systemic medical conditions known to affect sensation (e.g. diabetes, hypertension)

 -  history of neck surgery or fracture within the past 6 months

 -  current history of chronic pain condition other than neck pain

 -  diagnosis of cervical radiculopathy or cervical myelopathy

 -  history of whiplash; g) currently using blood thinning medication

 -  any blood clotting disorder such as hemophilia

 -  any contraindication to application of ice, such as: uncontrolled hypertension, cold
 urticaria, cryoglobulinemia, paroxysmal cold hemoglobinuria, and circulatory
 compromise.