Pressure-pain sensitivity and natural pain-blocking after a cold hand immersion in people with and without tennis elbow
Assessment of Pressure Pain Threshold (PPT) and Conditioned Pain Modulation (CPM) After Effect in Patients With and Without Tennis Elbow (TE)
This will test whether people with tennis elbow feel pressure pain differently and whether their body's natural pain‑blocking response changes before, during, and after a cold hand immersion compared with people without elbow pain.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 38 (estimated) |
| Ages | N/A to 60 Years |
| Sex | All |
| Sponsor | The Hashemite University Academic / other |
| Locations | 1 site (Zarqa, Zarqa Governorate) |
| Trial ID | NCT07178288 on ClinicalTrials.gov |
What this trial studies
Researchers will measure pressure pain thresholds (PPT) at standardized sites near the elbow and wrist using a digital algometer and will use a cold‑pressor task (hand in ice water) to trigger conditioned pain modulation (CPM). PPT will be recorded at set time points before, during, and after the cold stimulus to map how pain sensitivity changes and how long any pain‑inhibiting effect lasts. The study will also examine PPT measurement reliability using intraclass correlation coefficients (ICC), standard error of measurement (SEM), and smallest detectable change (SDC). Testing takes place in the university physiotherapy clinic with coded data stored on institutional systems and repeated measures following a predefined protocol.
Who should consider this trial
Good fit: Adults with unilateral tennis elbow lasting more than six weeks confirmed by the investigator and able to tolerate cold‑pressor testing without contraindications are ideal candidates.
Not a fit: People with chronic widespread pain conditions, neurological or sensory dysfunction, diabetes or Raynaud's (contraindications to cold), or those on long‑term pain medications or antidepressants are excluded and unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, this could provide clearer, objective measures of pain sensitivity and the duration of natural pain inhibition, which may help clinicians tailor treatments for tennis elbow.
How similar studies have performed: PPT and CPM are established research measures and prior studies often report altered pain modulation in chronic musculoskeletal conditions, but the detailed time course of CPM after‑effects in tennis elbow is less well characterized.
Eligibility criteria
Show full inclusion / exclusion criteria
TE Group Inclusion Criteria: Patients with Tennis Elbow confirmed at initial assessment by the Primary Investigator (PI) Unilateral elbow pain \> 6 weeks duration reproduced on at least two of the following tests: * Palpation of the lateral epicondyle * Isometric testing of the wrist extensors * Middle finger extension test * Passive stretch of wrist extensors * Resisted hand gripping using a dynamometer * Upper limb neurodynamic test-radial nerve bias (ULNDT-RN) Exclusion Criteria: * History of chronic pain conditions (e.g. fibromyalgia, irritable bowel * syndrome, temporomandibular dysfunction, migraines) * Neurological or sensory dysfunction (especially in the upper limbs) * History of chronic musculoskeletal pain (e.g. arthritis, chronic low back * pain) * Contraindications to cold application (i.e. Reynaud's disease, diabetes) * Current or long-term use of pain medication or anti-depressants Healthy Group The asymptomatic group included adults (18-65 years) without pain (acute or chronic) at least 3 months before the experimental sessions.
Where this trial is running
Zarqa, Zarqa Governorate
- The Hashemite University, Department of Physical Therapy; Community Rehabilitation Center Clinics — Zarqa, Zarqa Governorate, Jordan (Recruiting)
Study contacts
- Principal investigator: Ahmad Muhsen — The Hashemite University
- Study coordinator: Ahmad Muhsen, PhD
- Email: muhsen_a@hu.edu.jo
- Phone: +962788654656
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.