Highlights
- •Prevalence of chronic pain rises with age.
- •Age-related changes in the descending modulatory pathways could be a possible mechanism.
- •We experimentally explored endogenous pain modulation in younger compared with older adults.
- •Older adults show preserved capacity for endogenous pain modulation.
- •In the future, nonpharmacological analgesic treatment strategies could be enhanced in the elderly.
Abstract
The prevalence of chronic pain rises with increasing age. It has been suggested that
the mechanisms responsible for the development of chronic pain overlap with mechanisms
involved in aging, potentially implicating age-related changes in descending modulatory
pathways. This observation raises the question whether other forms of endogenous pain
modulation, in particular placebo analgesia, become compromised with age. Because
of the known contribution of placebo effects to analgesic treatment outcomes this
question is of important clinical relevance. In this study, we compared the response
to thermal painful stimuli and the capacity for endogenous pain modulation between
younger and older adults using a well established placebo analgesia paradigm involving
expectancy and conditioning components. We recruited 30 younger (age 23–40 years,
mean = 27.04, standard error of the mean ± .61) and 24 older adults (60–80 years,
mean = 69.3, standard error of the mean ± .89). We observed increased heat pain thresholds
and higher pain intensity ratings (in response to physically identical heat stimulation)
in the older compared with the younger group. However, the placebo analgesic response
was comparable between both age groups of healthy participants. The preserved capacity
for placebo analgesia in our sample of older participants highlights the potential
to use nonpharmacological analgesic treatment strategies in this age group and to
exploit placebo mechanisms as an add-on to existing analgesic (pharmacological) treatment
strategies.
Perspective
In contrast to the commonly shared view that endogenous pain modulation declines with
age we found a comparable capacity for placebo analgesia in a group of healthy older
and younger adults.
Key words
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Article info
Publication history
Published online: September 08, 2016
Accepted:
August 30,
2016
Received in revised form:
August 29,
2016
Received:
April 4,
2016
Footnotes
This work was supported by grants from the German Research Foundation (FOR-1328, BI 789/2-1) and the German Federal Ministry of Education and Research (FK 01GQ0808).
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2016 by the American Pain Society
