TY - JOUR
T1 - Endogenous pain modulation profiles among individuals with chronic pain
T2 - Relation to opioid use
AU - Martel, Marc O
AU - Petersen, Kristian
AU - Cornelius, Marise
AU - Arendt-Nielsen, Lars
AU - Edwards, Robert
N1 - DNRF121
Copyright © 2019. Published by Elsevier Inc.
PY - 2019/4
Y1 - 2019/4
N2 - It is generally assumed that individuals exhibiting high pain inhibition also tend to exhibit low pain facilitation, but little research has examined this association in individuals with pain. The aims of this cross-sectional study were 1) to examine the association between measures of conditioned pain modulation (CPM) and temporal summation (TS) in individuals with chronic pain, and 2) to examine whether this association was moderated by demographic (age, sex), psychological (depression, catastrophizing), or medication-related (opioid use) variables. Individuals (N= 190) with back or neck pain completed questionnaires and underwent a series of quantitative sensory testing procedures assessing CPM and TS. Results indicated that individuals with higher levels of CPM showed lower levels of TS, r = –.20, P <.01. Analyses, however, revealed that the magnitude of this association was substantially weaker among opioid users (r= –.08, NS) than nonusers (r= −.34, P <.01). None of the demographic or psychological variables included in our study influenced the association between CPM and TS. The magnitude of CPM was lower for opioid users than nonusers, suggesting that opioid use might dampen the functioning of endogenous pain-inhibitory systems and possibly contribute to a discordance between measures of pain inhibition and pain facilitation. Perspective: Results of the present study indicated that greater endogenous pain-inhibitory capacity is associated with lower levels of pain facilitation. This association, however, was not significant among opioid users, suggesting that opioids might compromise the functioning and interrelationship between endogenous pain modulatory systems.
AB - It is generally assumed that individuals exhibiting high pain inhibition also tend to exhibit low pain facilitation, but little research has examined this association in individuals with pain. The aims of this cross-sectional study were 1) to examine the association between measures of conditioned pain modulation (CPM) and temporal summation (TS) in individuals with chronic pain, and 2) to examine whether this association was moderated by demographic (age, sex), psychological (depression, catastrophizing), or medication-related (opioid use) variables. Individuals (N= 190) with back or neck pain completed questionnaires and underwent a series of quantitative sensory testing procedures assessing CPM and TS. Results indicated that individuals with higher levels of CPM showed lower levels of TS, r = –.20, P <.01. Analyses, however, revealed that the magnitude of this association was substantially weaker among opioid users (r= –.08, NS) than nonusers (r= −.34, P <.01). None of the demographic or psychological variables included in our study influenced the association between CPM and TS. The magnitude of CPM was lower for opioid users than nonusers, suggesting that opioid use might dampen the functioning of endogenous pain-inhibitory systems and possibly contribute to a discordance between measures of pain inhibition and pain facilitation. Perspective: Results of the present study indicated that greater endogenous pain-inhibitory capacity is associated with lower levels of pain facilitation. This association, however, was not significant among opioid users, suggesting that opioids might compromise the functioning and interrelationship between endogenous pain modulatory systems.
KW - Endogenous pain inhibition
KW - chronic pain
KW - opioids
KW - pain facilitation
UR - http://www.scopus.com/inward/record.url?scp=85057286733&partnerID=8YFLogxK
U2 - 10.1016/j.jpain.2018.10.004
DO - 10.1016/j.jpain.2018.10.004
M3 - Journal article
C2 - 30385319
SN - 1526-5900
VL - 20
SP - 462
EP - 471
JO - Journal of Pain
JF - Journal of Pain
IS - 4
ER -