TY - JOUR
T1 - Pain adaptability in individuals with chronic musculoskeletal pain is not associated with conditioned pain modulation
AU - Wan, Dawn Wong Lit
AU - Arendt-Nielsen, Lars
AU - Wang, Kelun
AU - Xue, Charlie Changli
AU - Wang, Yanyi
AU - Zheng, Zhen
N1 - Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - 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 (t
41 = −2.76, P <.01), and had a gradual reduction of pain unpleasantness over 7 days whereas PNA did not (F
6,246 = 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.
AB - 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 (t
41 = −2.76, P <.01), and had a gradual reduction of pain unpleasantness over 7 days whereas PNA did not (F
6,246 = 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.
KW - Cold pressor test
KW - conditioned pain modulation
KW - musculoskeletal pain
KW - pain adaptability
KW - pressure pain threshold
UR - http://www.scopus.com/inward/record.url?scp=85046114124&partnerID=8YFLogxK
U2 - 10.1016/j.jpain.2018.03.002
DO - 10.1016/j.jpain.2018.03.002
M3 - Journal article
C2 - 29597084
SN - 1526-5900
VL - 19
SP - 897
EP - 909
JO - Journal of Pain
JF - Journal of Pain
IS - 8
ER -