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Palmitoylethanolamide and stearoylethanolamide levels in the interstitium of the trapezius muscle of women with chronic widespread pain and chronic neck-shoulder pain correlate with pain intensity and sensitivity.

Abstract
Chronic widespread pain (CWP) is a complex condition characterized by central hyperexcitability and altered descending control of nociception. However, nociceptive input from deep tissues is suggested to be an important drive. N-Acylethanolamines (NAEs) are endogenous lipid mediators involved in regulation of inflammation and pain. Previously we have reported elevated levels of the 2 NAEs, the peroxisome proliferator-activated receptor type-α ligand N-palmitoylethanolamine (PEA) and N-stearoylethanolamine (SEA) in chronic neck/shoulder pain (CNSP). In the present study, the levels of PEA and SEA in women with CWP (n=18), CNSP (n=34) and healthy controls (CON, n=24) were investigated. All subjects went through clinical examination, pressure pain threshold measurements and induction of experimental pain in the tibialis anterior muscle. Microdialysis dialysate of the trapezius was collected before and after subjects performed a repetitive low-force exercise and analyzed by mass spectrometry. The levels of PEA and SEA in CNSP were significantly higher post exercise compared with CWP, and both pre and post exercise compared with CON. Levels of both NAEs decreased significantly pre to post exercise in CWP. Intercorrelations existed between aspects of pain intensity and sensitivity and the level of the 2 NAEs in CWP and CNSP. This is the first study demonstrating that CNSP and CWP differ in levels of NAEs in response to a low-force exercise which induces pain. Increases in pain intensity as a consequence of low-force exercise were associated with low levels of PEA and SEA in CNSP and CWP. These results indicate that PEA and SEA have antinociceptive roles in humans.
AuthorsNazdar Ghafouri, Bijar Ghafouri, Britt Larsson, Niclas Stensson, Christopher J Fowler, Björn Gerdle
JournalPain (Pain) Vol. 154 Issue 9 Pg. 1649-1658 (Sep 2013) ISSN: 1872-6623 [Electronic] United States
PMID23707281 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
Chemical References
  • Amides
  • Endocannabinoids
  • Ethanolamines
  • Palmitic Acids
  • Saline Solution, Hypertonic
  • Stearic Acids
  • stearoylethanolamide
  • palmidrol
Topics
  • Adult
  • Aged
  • Amides
  • Chronic Pain (pathology)
  • Endocannabinoids (metabolism)
  • Ethanolamines (metabolism)
  • Exercise
  • Female
  • Humans
  • Microdialysis
  • Middle Aged
  • Muscle, Skeletal (metabolism)
  • Neck Pain (pathology)
  • Pain Measurement
  • Pain Threshold (physiology)
  • Palmitic Acids (metabolism)
  • Pressure
  • Regression Analysis
  • Saline Solution, Hypertonic (adverse effects)
  • Shoulder Pain (pathology)
  • Stearic Acids (metabolism)
  • Surveys and Questionnaires
  • Time Factors
  • Young Adult

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