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C. Enriquez1, N. Rommer2, P. Hilden2, C. Tolerico2, M. Oniyide2
1Kean University, School of Physical Therapy, Union, United States, 2Saint Barnabas Medical Center, Physical Therapy, Livingston, United States
Background: Although it is generally recognized that pain etiology is multifactorial, evidence also points to the critical role of the central nervous system in individual pain perception and clinical pain outcomes(1,2,3). Quantitative Sensory Tests (QST) are direct methods of measuring individual pain processing mechanisms that reflect the CNS’s activity in processing pain input (1,3,4). The predictive value of these psychophysical paradigms is used to capture biomarkers of chronic pain (5,6,7,8) and prognostication of treatment outcomes (8,9,10). The purpose of this study was to investigate the association between demographic and psychosocial factors with QST in predicting pain outcomes.
Purpose: The purpose of this study was to investigate the association between demographic and psychosocial factors using QST to capture pain outcomes in healthy individuals.
Methods: Demographic and psychosocial profiles on anxiety, depression, and pain catastrophizing (PC) were collected from 37 males and 38 females between 18-65 years old. Pain outcomes from QST were Pressure Pain Threshold (PPT), Temporal Summation (TS), and Conditioned Pain Modulation (CPM). Mechanical pressure algometer was used for experimental pain applied on the right upper trapezius muscle. PPT score was the average of 3 pain threshold trials at 30-sec interstimulus interval (ISI). TS and CPM involved 10 pressure pulses applied at pain threshold level with 1-sec ISI, calculated as difference between pain rating after the 10th and the 1st pressure pulses.
Results: Univariate analysis showed men and those with depression scores ≥11 points had greater PPT values (p < 0.001, p=0.034 respectively). Although PPT values in men were 4.1 lbs. greater than women (95% CI [2.8,5.4], p < 0.001), joint multivariate model showed males with depression scores of ≥11 points had 3.8 lbs. higher PPT values than those with ≤10 points ([1.2,6.5], p = 0.004). Results also highlight a high correlation between anxiety and depression (r= 0.75, p < 0.001). Significant differences in TS among subjects with low-high PC behaviors were also seen (p=0.042), where those with PC scores >2 points had lower TS scores than those with 0-2 points.
Conclusion(s): Sex, depression, anxiety, and PC behaviors appear to play an important role in pain processing mechanisms that influence clinical pain outcomes in healthy individuals. These normative values provide quantifiable evidence on the collective role of specific demographic and psychosocial factors on individual pain processing mechanisms that significantly contribute to clinical pain outcomes. Future studies should include larger sample size to support these findings, including contrast populations to capture potentially unique predictors between groups.
Implications: Our study underscores the value of integrating specific risk factors in the critical evaluation of pain etiology and their contributions to pain outcomes in a clinical context. It also highlights the role of QST in capturing and quantifying the role of pain predictors in a group of healthy reference population that reflects normative pain responses. Integration of these risk factors is essential not only in the effective prevention of chronic pain but also in the classification, prognostication, and creation of effective interventional strategies in the painful, symptomatic population.
Funding, acknowledgements: None
Keywords: Pain Outcomes, Pain Predictors, Quantitative Sensory Tests
Topic: Pain & pain management
Did this work require ethics approval? Yes
Institution: Kean University and Saint Barnabas Medical Center
Committee: Trident University, and Saint Barnabas Medical Center
Ethics number: #2020.012/#1113
All authors, affiliations and abstracts have been published as submitted.
