Highlights
- •Older adults showed reduced offset analgesia compared with younger adults.
- •No sex differences in offset analgesia were evident in any age group.
- •A reduction stimuli as small as .4°C resulted in significant offset analgesia.
- •Reduced offset analgesia was associated with pain in daily life for all age groups.
Abstract
An age-related decline in endogenous pain inhibitory processes likely places older
adults at an increased risk for chronic pain. Limited research indicates that older
adults may be characterized by deficient offset analgesia, an inhibitory temporal
sharpening mechanism that increases the detectability of minor decreases in noxious
stimulus intensity. The primary purpose of the study was to examine age differences
in offset analgesia in community-dwelling younger, middle-aged, and older adults.
An additional aim of the study was to determine whether the magnitude of offset analgesia
predicted self-reported bodily pain. Eighty-seven younger adults, 42 middle-aged adults,
and 60 older adults completed 4 offset analgesia trials and 3 constant temperature
trials in which a noxious heat stimulus was applied to the volar forearm for 40 seconds.
The offset trials consisted of 3 continuous phases: an initial 10-second painful stimulus,
either a 1.0°C or .4°C increase in temperature from the initial 10-second painful
stimulus for 10 seconds, and either a 1.0°C or .4°C decrease back to the initial testing
temperature for 20 seconds. During each trial, subjects rated pain intensity continuously
using an electronic visual analog scale (0–100). All subjects also completed the Short-Form
Health Survey-36 including the Bodily Pain subscale. The results indicated that older
and middle-aged adults showed reduced offset analgesia compared with younger adults
in the 1.0°C and .4°C offset trials. Furthermore, the magnitude of offset analgesia
predicted self-reported bodily pain, with those exhibiting reduced offset analgesia
reporting greater bodily pain. Dysfunction of this endogenous inhibitory system could
increase the risk of developing chronic pain for middle-aged and older adults.
Perspective
Older and middle-aged adults showed reduced offset analgesia compared with younger
adults. The significant association between reduced offset analgesia and pain in daily
life supports the notion that pain modulatory deficits are associated with not just
a chronic pain condition but with the experience of pain in general.
Key words
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Article info
Publication history
Published online: August 25, 2017
Accepted:
August 2,
2017
Received in revised form:
August 2,
2017
Received:
January 6,
2017
Footnotes
Disclosures
This research was supported by National Institutes of Health-National Institute on Aging grant R01AG039659. Dr. Fillingim has received consulting fees, speaking fees, and/or honoraria from WebMD and Algynomics (<$10,000 each) and owns stock or stock options in Algynomics. The other authors have no conflicts of interest.
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© 2017 by the American Pain Society
