Associations among four modalities of experimental pain in women
Open accessAbstract
Unlabelled The aim of this study was to investigate the associations among 4 measures of pain induction procedures in 244 healthy women. The procedures were (1) pressure pain threshold assessed over the temporalis muscles, masseter muscles, temporomandibular joints, and the wrists; (2) C fiber-mediated heat pain threshold/tolerance assessed on the skin over the forearm, cheek, and dorsal aspect of the foot; (3) temporal summation of C fiber-mediated heat pain; and (4) ischemic pain threshold/tolerance. Strong associations among pressure pain thresholds at the 4 sites examined (rho = 0.7 to 0.8, P values < or = .001) and among heat pain threshold/tolerance values at the 3 sites examined (rho = 0.6 to 0.9, P values < or = .001) were observed. Pressure pain threshold was moderately correlated with each of the heat pain threshold/tolerance values (rho = 0.2 to 0.4, P values < or = .001). Ischemic pain threshold/tolerance was moderately associated with each of the pressure and heat pain measures (rho = 0.2 to 0.3, P values < or = .05 to .001). Derived measures of the temporal summation of heat pain did not correlate strongly with threshold or tolerance measures of pressure, ischemic, or heat pain. We concluded (1) that for a specific pain modality, the correlation between threshold and tolerance values across anatomic sites is high, and (2) that measures of pressure, ischemic, and thermal pain threshold/tolerance are significantly correlated, although the strength of these associations is moderate. These findings demonstrate that a battery of pain-assessing procedures is required to determine an individual's pain sensitivity profile or phenotype.Perspective By investigating the relationship between pain sensitivity produced by different forms of stimuli, this study demonstrates that a battery of tests should be used to assess an individual's pain sensitivity and one should be careful in making inferences about an individual's sensitivity to pain by using only one pain modality.
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“It has been recommended that pain sensitivity assessment should comprise tests from different modalities because of sometimes low intermodality correlations.(5,31,35) Assessment of cold pain should therefore be part of a comprehensive pain sensitivity testing.”
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“Correlations between measures may be low (25,26), and the techniques require specialized equipment, trained staff and associated expense.”
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“Supporting this, meaures of pain sensitivity correlate poorly with measures of pain odulation (Bhalang et al., 2005), despite the fact that individual ifferences in both appear to be associated with chronic pain risk Edwards, 2005; Nielsen et al., 2009).”
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Self-citationQuantitative Changes in Regional Cerebral Blood Flow Induced by Cold, Heat and Ischemic Pain
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“Despite this finding, it should be emphasized that other investigators have observed considerable variability in patient self-report of pain sensitivity and pain threshold or tolerance [103, 104].”
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“However, Bhalang et al.29 investigated the relation between pain sensitivity induced by different forms of stimuli commonly used in human pain research and showed that measures of mechanical, heat, and ischemic pain are significantly correlated in healthy women.”
BackgroundHummel, T. R., Springborn, M., Croy, I., Kaiser, J., & Lötsch, J. (2011) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2011.01.012 · Cited by 17 · see citing works
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“However, measures of experimental pain have been shown to correlate only moderately across stimulus modalities [1, 10–13].”
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Test-Retest Reliability of Thermal Temporal Summation Using an Individualized Protocol
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Appraisals of pain from controlled stimuli: Relevance to quantitative sensory testing
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SCLERAL BUCKLING SURGERY AND EYE PAIN
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Long-term alterations in somatosensory functioning in survivors of childhood cancer
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“Past research suggests that such corrections are considered to be overly conservative in cases in which outcome variables are correlated,(53) as is the case among QST parameters.(6) Thus, correctionswere notmade in the current study.”
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“Previous investigators have used slope (fitted to discrete pain ratings of each pulse) to define TS because it closely approximates the sensitization to identical series of stimuli.(7,11,13,17,41) However, the choices of the starting and ending points for the slope vary.”
MethodColman, M., Syx, D., Wandele, I. D., Rombaut, L., Wille, D., Malfait, Z., Meeus, M., Malfait, A., Oosterwijck, J. V., & Malfait, F. (2023) · Journal of Pain · doi:10.1016/j.jpain.2023.06.015 · Cited by 8 · see citing works
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“For instance, Bhalang et al. (2005) reported significant correlations between PPT at the temporalis muscle, the masseter muscle and temporoman-dibular joint ( r = 0.66–0.70).”
InfluentialWhat Can We Sense? Interoceptive Accuracy
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Adverse life events, sensitization of spinal nociception, and chronic pain risk
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Pain threshold - measure of pain sensitivity or social behavior?
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Development of safety limits for load carriage in adults
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“While pain tolerance and threshold are correlated with one another (Bhalang et al., 2005), pain tolerance and threshold have been shown to be distinct sub-domains of pain perception (Gelfand, 1964; Lacourt et al., 2012; Vaegter et al., 2017).”
BackgroundIndividual differences in pain sensitivity : measurement and causation
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“Despite some research demonstrating high levels of interindividual correlations across pain modalities and anatomic sites (44), other studies suggest that pain intensity ratings may systematically vary across pain stimuli due to activation of different pain pathways (e.g., heat and cold stimulate…”
Sensory processing and neurophysiological evaluation in children
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Ethnicity and pain: psychosocial stress and stress Responses
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Mapeamento da distribuição corporal da dor na fibromialgia
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“Multiple somatosensory effects induced by stimuli based on different fibers could be related to pain threshold variation [38].”
- Authors
- Bhalang, K., Sigurdsson, A., Slade, G. D., & Maixner, W.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Bhalang, Kanokporn
- ORCID
- Bhalang, Kanokporn
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2005-09
- Volume
- 6
- Issue
- 9
- Pages
- 604-611
- ISSN
- 1526-5900 (ISSN-L)
- OpenAlex
- W1969555549
- Cited by
- 89
- References
- 40
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 5 · 2022: 2 · 2021: 5 · 2020: 2 · 2019: 5 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 1 · 2014: 5 · 2013: 11 · 2012: 11
- FWCI
- 3.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- experimental pain, pain sensitivity, pressure pain threshold, thermal pain threshold, pain tolerance, ischemic pain, temporal summation, women, pain phenotypes, temporomandibular joint pain, wrist pain
- MeSH terms
- Adolescent, Adult, Afferent Pathways, Female, Hot Temperature, Humans, Hyperalgesia, Ischemia, Nociceptors, Pain, Pain Measurement, Physical Stimulation, Pressure, Sensory Receptor Cells, Observer Variation, Pain Threshold, Nerve Fibers, Unmyelinated
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