Abstract
It is generally assumed that individuals exhibiting high pain inhibition also tend
to exhibit low pain facilitation, but little research has examined this association
in individuals with pain. The aims of this cross-sectional study were 1) to examine
the association between measures of conditioned pain modulation (CPM) and temporal
summation (TS) in individuals with chronic pain, and 2) to examine whether this association
was moderated by demographic (age, sex), psychological (depression, catastrophizing),
or medication-related (opioid use) variables. Individuals (N= 190) with back or neck pain completed questionnaires and underwent a series of quantitative
sensory testing procedures assessing CPM and TS. Results indicated that individuals
with higher levels of CPM showed lower levels of TS, r = –.20, P < .01. Analyses, however, revealed that the magnitude of this association
was substantially weaker among opioid users (r= –.08, NS) than nonusers (r= −.34, P < .01). None of the demographic or psychological variables included in our
study influenced the association between CPM and TS. The magnitude of CPM was lower
for opioid users than nonusers, suggesting that opioid use might dampen the functioning
of endogenous pain-inhibitory systems and possibly contribute to a discordance between
measures of pain inhibition and pain facilitation.
Perspective
Results of the present study indicated that greater endogenous pain-inhibitory capacity
is associated with lower levels of pain facilitation. This association, however, was
not significant among opioid users, suggesting that opioids might compromise the functioning
and interrelationship between endogenous pain modulatory systems.
Key words
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Article info
Publication history
Published online: October 29, 2018
Accepted:
October 15,
2018
Received in revised form:
September 28,
2018
Received:
July 17,
2018
Footnotes
This work was supported by grants R21DA041020 and R01AG034982 (R.R.E., P.I.) from the National Institutes of Health grants, a research collaborative grant from the International Association for the Study of Pain, and The Center for Neuroplasticity and Pain (CNAP) is supported by the Danish National Research Foundation (DNRF121). None of the funding sources were involved in the collection, analysis, or interpretation of data. Funding sources were also not involved in manuscript preparation or in the decision to submit the article for publication.
The authors have no conflicts of interest to declare.
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© 2018 by the American Pain Society
