Highlights
- •The dichotomy of pain adaptability existed in chronic musculoskeletal pain patients.
- •Pain adaptability was dissociated with the potency of conditioned pain modulation.
- •Pain adaptability could reflect the temporal aspect of pain inhibition.
Abstract
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 (t41 = −2.76, P < .01), and had a gradual reduction of pain unpleasantness over 7 days whereas PNA
did not (F6,246 = 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.
Key words
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Article info
Publication history
Published online: March 26, 2018
Accepted:
March 3,
2018
Received in revised form:
September 3,
2017
Received:
April 2,
2017
Footnotes
The authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2018 by the American Pain Society
