Conditioned pain modulation and pressure pain sensitivity in the adult Danish general population: the DanFunD study

Increased pressure pain sensitivity and impaired descending pain control have been associated with chronic pain, but knowledge on the variability in the adult general population is lacking. Pressure pain thresholds (PPTs) and descending pain control as assessed by conditioning pain modulation (CPM) were recorded in a randomly selected sample (n=2199, 53% females) of the Danish adult general population aged 18-70 years. PPTs were recorded over the tibialis anterior muscle and the upper trapezius muscle. CPM was defined as the difference between PPT assessments before and during conditioning with cold pressor pain (hand) for 2 min. Conditioning pain intensity was assessed on a visual analogue scale (VAS) and questionnaire data was collected. Female sex (P<0.001) and younger age (P≤0.02) was associated with lower PPTs at both body sites. For the trapezius muscle, high perceived stress were associated with lower PPTs (P<0.02), whereas an interaction was found between body mass index and sex. CPM potency was lower in females compared with males (P≤0.003) whereas no association with age was found. Higher education (P≤0.05), premature withdrawal from the cold pressor test (P≤0.02) and high VAS score (P≤0.02) were associated with a larger CPM response.

PERSPECTIVES: Data from this large population-based study provides new insight into the gender and age variation in pain sensitivity and CPM response. Decreased CPM potency and increased pain sensitivity in females were found, emphasizing the need to improve the understanding of its clinical consequences.