Pain Adaptability in Individuals With Chronic Musculoskeletal Pain Is Not Associated With Conditioned Pain Modulation

Wong Lit Wan, D, Arendt-Nielsen, L, Wang, K, Xue, C, Wang, Y and Zheng, Z 2018, 'Pain Adaptability in Individuals With Chronic Musculoskeletal Pain Is Not Associated With Conditioned Pain Modulation', Journal of Pain, vol. 19, no. 8, pp. 897-909.


Document type: Journal Article
Collection: Journal Articles

Title Pain Adaptability in Individuals With Chronic Musculoskeletal Pain Is Not Associated With Conditioned Pain Modulation
Author(s) Wong Lit Wan, D
Arendt-Nielsen, L
Wang, K
Xue, C
Wang, Y
Zheng, Z
Year 2018
Journal name Journal of Pain
Volume number 19
Issue number 8
Start page 897
End page 909
Total pages 13
Publisher Churchill Livingstone
Abstract Healthy humans can be divided into the pain adaptive (PA) and the pain nonadaptive (PNA) groups; PA showed a greater decrease in pain rating to a cold pressor test (CPT) than PNA. This study examined if the dichotomy of pain adaptability existed in individuals with chronic musculoskeletal pain. CPTs at 2°C and 7°C were used to assess the status of pain adaptability in participants with either chronic nonspecific low back pain or knee osteoarthritis. The participants potency of conditioned pain modulation (CPM) and local inhibition were measured. The strengths of pain adaptability at both CPTs were highly correlated. PA and PNA did not differ in their demographic characteristics, pain thresholds from thermal and pressure stimuli, or potency of local inhibition or CPM. PA reached their maximum pain faster than PNA (t41 = -2.76, P <.01), and had a gradual reduction of pain unpleasantness over 7 days whereas PNA did not (F6,246 = 3.01, P =.01). The dichotomy of pain adaptability exists in musculoskeletal pain patients. Consistent with the healthy human study, the strength of pain adaptability and potency of CPM are not related. Pain adaptability could be another form of endogenous pain inhibition of which clinical implication is yet to be understood. Perspective: The dichotomy of pain adaptability was identified in healthy humans. The current study confirms that this dichotomy also exists in individuals with chronic musculoskeletal pain, and could be reliably assessed with CPTs at 2°C and 7°C. Similar to the healthy human study, pain adaptability is not associated with CPM, and may reflect the temporal aspect of pain inhibition.
Subject Rheumatology and Arthritis
Anaesthesiology
Sensory Systems
Keyword(s) Cold pressor test
conditioned pain modulation
musculoskeletal pain
pain adaptability
pressure pain threshold
DOI - identifier 10.1016/j.jpain.2018.03.002
Copyright notice © 2018 The American Pain Society
ISSN 1526-5900
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