Abnormal Pain Response to Visual Feedback During Cervical Movements in Chronic Whiplash: An Experimental Study

Margot De Kooning, Liesbeth Daenen, Sam Verhelpen, Sanneke Don, Lennard Voogt, Nathalie Roussel, Kelly Ickmans, Michel Van Loo, Patrick Cras, Jo Nijs

Research output: Contribution to journalArticle

6 Citations (Scopus)


BACKGROUND: Whiplash-associated disorders (WAD) are a debilitating condition. In chronic WAD, sensorimotor incongruence exacerbates symptoms. Sensorimotor incongruence occurs when somatosensory input and predicted motor output are in conflict, which can trigger pain. On the other hand, there is evidence that visual feedback can decrease pain in certain chronic pain conditions. Therefore, the aim of this study was to examine the effect of visual feedback and sensorimotor incongruence on pain thresholds in chronic WAD.

METHODS: Sixty-four participants (healthy controls and patients with chronic WAD) were subjected to six experimental conditions. Participants watched correct real-time or modified visual feedback of the neck or hand (without movement as well as during repetitive neck lateroflexion). Sensorimotor incongruence was induced by manipulating visual feedback. Pressure pain thresholds were measured at baseline and during each condition.

RESULTS: Marked between-group differences were observed. Visual feedback of the neck-correct or modified-did not influence pain thresholds in chronic WAD. In contrast, healthy controls had significantly higher pain thresholds when provided with the correct or modified visual feedback. When a movement of the neck was added during visual feedback, patients with chronic WAD showed no significant difference in pain thresholds, while an increase in pain thresholds was found in the healthy control group.

CONCLUSION: In contrast to the healthy controls, visual feedback and sensorimotor incongruence did not alter pain thresholds in patients with chronic WAD. These findings suggest an abnormal pain response to visual feedback and somatosensory incongruence as well as failing mechanisms of pain inhibition in chronic WAD.

Original languageEnglish
Pages (from-to)156-165
Number of pages10
JournalPain Practice
Issue number2
Publication statusPublished - Feb 2017


  • chronic whiplash-associated disorders
  • pain modulation
  • pressure pain threshold
  • sensorimotor incongruence
  • visual feedback
  • Movement
  • Humans
  • Middle Aged
  • Whiplash Injuries/physiopathology
  • Male
  • Hand
  • Chronic Pain/psychology
  • Cervical Vertebrae/physiopathology
  • Adult
  • Female
  • Pain Threshold
  • Neck
  • Pain Measurement
  • Feedback, Sensory

Fingerprint Dive into the research topics of 'Abnormal Pain Response to Visual Feedback During Cervical Movements in Chronic Whiplash: An Experimental Study'. Together they form a unique fingerprint.

Cite this