Psychological and pain profiles in persons with patellofemoral pain as the primary symptom

Review written by Ben Cormack info

Key Points

  1. Patellofemoral pain (PFP) sufferers had altered thermal and pressure pain thresholds that fit nociplastic pain profiles.
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Patellofemoral pain (PFP) is a common musculoskeletal problem often not associated with obvious tissue damage. The predominant mechanisms (1) behind the main symptom (pain) are also unclear with PFP, with pain often not simply fitting a nociceptive profile as defined by the International Association for the Study of Pain (IASP). Both nociceptive and nociplastic (altered nociceptive mechanisms) elements may be present in those with PFP, and the overall pain profile may also include elements of central sensitization.

IASP definitions

  • Nociceptive pain - pain that arises from actual or threatened damage to non-neural tissue and is due to the activation of nociception.
  • Nociplastic pain - pain that arises from altered nociception despite no clear evidence of actual or threatened tissue damage causing the activation of peripheral nociceptors.

The primary aim of this study was to look at using quantitative sensory tests (QST) to assess somatosensory function and potential changes within nociceptive mechanisms and signs of central sensitization between PFP sufferers and pain-free controls.

No previous study of PFP had also looked at a wide range of psychological factors, and this study looked to correlate psychological profiles with somatosensory function measured via QSTs as a secondary aim. The link between psychological factors and central sensitization has been proposed in pain classification systems (2).

Patellofemoral pain is a common musculoskeletal problem often not associated with obvious tissue damage.
Kinesiophobia is highly prevalent in PFP and should be addressed when working with patients with PFP.


The study recruited 150 participants with PFP as the major complaint and 61 controls. Pain in other body areas was allowed as long as PFP was the primary condition. 89% reported a duration of PFP pain of more than one

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