Pain Perception Research Articles

Pain management In Total Knee Arthroplasty: Which helps in better post-operative outcomes?

Background: Individuals exhibit variations in pain perception and pain threshold, and these differences exist between the right and left limbs, resulting in biases related to inter-cerebral pain variability and inter-patient pain variability. Currently, there is limited available data comparing adductor canal block (ACB) with femoral nerve block (FNB) in individuals who have undergone bilateral total knee arthroplasty (TKA). Methods: We conducted a prospective, non-randomized, controlled study involving patients scheduled for bilateral total knee arthroplasty (TKA) under central neuraxial anesthesia. Following surgery, patients received intermittent 12-hourly boluses of 15 mL ropivacaine 0.5% through two distinct peripheral nerve blocks (adductor canal block - ACB and femoral nerve block - FNB) in either of the lower limbs. The primary objective was to evaluate the postoperative Visual Analog Scale (VAS) score, while the secondary outcomes included the assessment of quadriceps muscle strength and the degree of flexion at the knee joint. Results: Out of the 70 patients evaluated for eligibility, 63 were enrolled, and 60 were included in the final analysis. Visual Analog Scale (VAS) scores after both blocks during periods of rest at 30 minutes, 6 hours, 12 hours, and 48 hours post-operatively did not exhibit any significant differences. However, VAS scores during rest at 24 hours and during exercise at 24 hours and 48 hours demonstrated a notable disparity. Furthermore, there was a significant difference in favour of adductor canal block (ACB) over femoral nerve block (FNB) regarding quadriceps muscle strength and the degree of knee flexion at 24 hours and 48 hours post-operatively. Conclusions: Adductor canal block (ACB) delivers comparable pain relief to femoral nerve block (FNB) both at rest and during passive exercise for up to 48 hours after surgery. ACB notably maintains the motor strength of quadriceps muscles when contrasted with FNB, and this preservation comes without introducing any additional complications.

THE IMPACT OF DEPRESSION AMONG PATIENTS WITH CHRONIC LOW BACK PAIN

This scientific article has the objectives to examine the impact of depression on people experiencing chronic low back pain. Recognizing the bidirectional relationship between these conditions, the study aims to elucidate the various consequences of depressive symptoms on pain perception, functional impairment and overall quality of life among patients with chronic low back pain. Material and methods: A systematic review of the scientific literature was conducted to identify relevant studies, clinical trials and meta-analyses published between 1990 and 2023. The search included electronic databases such as PubMed, MEDLINE and PsycINFO. Results: Literature synthesis reveals that depression significantly amplifies the symptomatology of chronic low back pain, influencing various areas of a patient’s life. Key findings include decreased pain threshold by exacerbating the perception of pain intensity and duration, slowing the recovery and rehabilitation process, and decreasing health-related quality of life, highlighting the need for a multidisciplinary approach to both conditions. Conclusion: The article highlights the pervasive and interconnected nature of depression and chronic low back pain. The issues presented highlight the profound impact of depression on patients with chronic low back pain, highlighting the importance of integrated interventions that address both physical and mental health aspects of those affected. Keywords: depression, chronic low back pain, rehabilitation, pain threshold.

Pain perception during baroreceptor unloading by lower body negative pressure.

People with high blood pressure have reduced sensitivity to pain, known as blood pressure hypoalgesia. One proposed mechanism for this is altered baroreceptor sensitivity. In healthy volunteers, stimulating the carotid baroreceptors causes reduced sensitivity to acute pain; however, this effect may be confounded by a rise in blood pressure due to baroreflex stimulation. The present study tests whether baroreceptor unloading contributes to the physiological mechanism of blood pressure-related hypoalgesia. In the present study, pain perception to thermal stimulation of the forearm was studied in 20 healthy volunteers during baroreceptor unloading by lower body negative pressure (LBNP) at -5 and -20 mmHg. Blood pressure and heart rate were measured continuously throughout. To address issues relating to stimulation order, the sequence of LBNP stimulation was counterbalanced across participants. Increased heart rate was observed at a LBNP of -20 mmHg, but not -5 mmHg, but neither stimulus had an effect on blood pressure. There was no change in warm or cold sensory detection thresholds, heat or cold pain thresholds nor perceived pain from a 30s long thermal heat stimulus during LBNP. Therefore, baroreceptor unloading with maintained systemic blood pressure did not alter pain perception. The current study does not support the hypothesis that an altered baroreflex may underlie the physiological mechanism of blood pressure-related hypoalgesia. This work provides evidence that, when measured in normotensive healthy young adults, the baroreflex response to simulated hypovolaemia did not lead to reduced pain sensitivity (known as blood pressure hypoalgesia).

Advancements in alveolar bone grafting and ridge preservation: a narrative review on materials, techniques, and clinical outcomes.

This narrative review systematically explores the progression of materials and techniques in alveolar ridge preservation (ARP). We commence by delineating the evolution from traditional ARP methods to cutting-edge alternatives, including platelet-rich fibrin, injectable bone repair materials, and hydrogel systems. Critical examination of various studies reveals these innovative approaches not only accelerate bone healing but also significantly improve patient-reported outcomes, such as satisfaction, pain perception, and overall quality of life. Emphasis is placed on the correlation between advanced ARP techniques and enhanced patient comfort and clinical efficacy, underscoring their transformative potential in dental implantology. Highlighting the effectiveness of ARP, the implant survival rate over a span of 5 to 7years was high, showcasing the reliability and success of these methods. Further, patients expressed high aesthetic satisfaction with the soft tissue outcome, evidenced by an average visual analog scale (VAS) score of 94. This positive aesthetic appraisal is linked to the clinical health of implants, potentially due to the employment of tooth-supported surgical guides. The economic analysis reveals a varied cost range for bone graft substitutes ($46.2 to $140) and socket sealing materials ($12 to $189), with a noteworthy correlation between the investment in barrier membranes and the diminished horizontal and vertical ridge resorption. This suggests that membrane usage significantly contributes to preserving ridge dimensions, offering a cost-effective strategy for enhancing ARP outcomes. In conclusion, this review illuminates the significant advancements in ARP, highlighting the shift towards innovative materials and techniques that not only promise enhanced bone regeneration and reduced healing times but also improve patient satisfaction and aesthetic outcomes. The documented high implant survival rate and the beneficial economic implications of membrane use further validate the effectiveness of contemporary ARP strategies, paving the way for their broader adoption in dental implantology.

Overview of Brown-Sequard Syndrome.

A neurologic syndrome called Brown-Séquard syndrome is brought on by spinal cord hemisection. On the side of the body, ipsilateral to the lesion, it presents as weakness or paralysis, proprioceptive abnormalities, and loss of pain and temperature perception. Brown-Séquard syndrome is an incomplete spinal cord syndrome with a range of severity in its clinical presentation.
      One of the most intricate and fascinating areas of the nervous system to study is the spinal cord. Its overwhelming clinical presentation, development problems, lesions, and intricate connections call for a deeper comprehension of its anatomical and physiological makeup.
      Like the brain, the extremely fragile and sensitive spinal cord is well-protected by the robust bony cage comprising the vertebral arch and vertebral bodies. Together, they create the spinal hollow, or long spinal column, which houses the spinal cord. Millions of neurons reside in the spinal cord, and their bundled fibers run as ascending or descending tracts. Thirty-one pairs of spinal nerves, primarily supplying the trunk and limbs, emerge from the spinal cord. These are mixed spinal nerves with a motor component that assists in controlling the trunk and voluntary muscles in all limbs. Additionally, they have a sensory component that aids in taking in the sensory data from these regions. Therefore, for a better understanding of the clinical presentation and its pathology in any spinal cord lesion, it is imperative to grasp the fundamentals of anatomy.
       In this short review, we have discussed the symptoms, management, and prevention of brown syndrome.

Whose Pain Matters? Racial Differences in Perceptions of Emotional Pain After Fatal Police Shootings

Whose Pain Matters? Racial Differences in Perceptions of Emotional Pain After Fatal Police Shootings

Efficacy of Preemptive Analgesia on Pain Perception After Simple Tooth Extraction: A Prospective Study

Efficacy of Preemptive Analgesia on Pain Perception After Simple Tooth Extraction: A Prospective Study

Sens-ocular model: Cell-based assay to evaluate eye stinging potential of chemicals and baby cosmetic formulations.

The TRPV1 receptor, which is known to contribute significantly to pain perception, has recently been identified as a useful tool for predicting eye stinging potential in cosmetics. In this study, HEK-293 cells with high TRPV1 expression were utilized to evaluate calcium influx related to receptor activation triggered by chemicals and cosmetic formulations. The cells were exposed to increasing concentrations of substances to cause or not some aggression to the eye, and TRPV1 activity was assessed by measuring intracellular FURA-2 AM fluorescence signal. To confirm TRPV1 channel activation, capsazepine, a capsaicin antagonist, was employed in addition to using capsaicin as a positive control. The study's results indicate that this novel model can identify compounds known to cause some aggression to the eye, such as stinging, considering a cut-off value of 60% of Ca2+ influx exposed to the lowest evaluated concentration (0.00032%). When applied to the cosmetic baby formulation, although the presented model exhibited higher sensitivity by classifying as stinging formulations that had previously undergone clinical testing and were deemed non-stinging, the assay could serve as a valuable in vitro tool for predicting human eye stinging sensation and can be used as a tier 1 in an integrated testing strategy.

Structural alterations and pain perception at the ankle joint in patients with haemophilia.

Patients with haemophilia (PwH) suffer from chronic pain due to joint alterations induced by recurring haemorrhage. This study aimed to investigate the relationship between structural alterations and pain perception at the ankle joint in PwH. Ankle joints of 79 PwH and 57 healthy controls (Con) underwent ultrasound examination (US) and assessment of pain sensitivity via pressure pain thresholds (PPT). US discriminated between joint activity (synovitis) and joint damage (cartilage and/or bone degeneration) applying the HEAD-US protocol. Based on US-findings, five subgroups were built: PwH with activity/damage, PwH with activity/no damage, PwH with no activity/no damage, controls with activity/no damage and controls with no activity/no damage. Joint activity and joint damage were significantly increased in ankles of PwH compared to Con (p ≤.001). Subgroup analysis revealed that structural alterations negatively impact pain perception. This is particularly evident when comparing PwH with both activity/damage to PwH with no activity/no damage at the tibiotalar joint (p=.001). At the fibulotalar joint, no significant differences were observed between PwH subgroups. Further analysis showed that both joint activity and joint damage result in an increase in pain sensitivity (p ≤.001). The data suggest a relation between joint activity, joint damage and pain perception in PwH. Even minor changes due to synovitis appear to affect pain perception, with the effect not intensifying at higher levels of inflammation. In terms of joint damage, severe degeneration leads to a sensitised pain state most robustly, whereas initial changes do not seem to significantly affect pain perception.

Intraoperative Patient Warming Instead of Gas on the Management of Postoperative Pain in Laparoscopic Colectomy and Cholecystectomy: A Randomized Controlled Trial.

Blurred lines remain in details of the association between patient warming with postoperative pain and a proper analgesic requirement. Therefore, the present study proposes to observe the effects of intraoperative patient warming and carbon dioxide insufflation duration in laparoscopic colectomy (LCol) andlaparoscopic cholecystectomy (LChol) procedures on postoperative pain, analgesic requirements, and hemodynamics. The present study involved 80 cases aged 18-80 years with the American Society of Anesthesiologists I-III classification, possessing two initial groups primarily, one for LCol and one for LChol. Subsequently, each was divided into two through randomization for intraoperative warming. Postoperatively, pain perception, per se, was evaluated using the visual analog scale (VAS) score at the 30 minutes, 1st, 6th, 12th, and 24th hours, along with the impact of pain on hemodynamic parameters and side effects such as nausea/vomiting and the dosage of analgesics used. Groups actively heated with warm air-blowing devices detected significantly higher intraoperative core and skin temperature measurements, and postoperative early pain perception was significantly lower in the warmed ones. Furthermore, a significant decrease in the VAS scores and the analgesic at the 12th and 24th hours compared to the first six hours was recognized between them. Consequently, herewith, we postulate that so-called patient warming positively affects the VAS scores.

The effect of interventions in vaginal birth on fear of childbirth: A multicentre study.

This cross-sectional multicentre study aimed to determine the effect of interventions during vaginal birth for fear of childbirth. In this cross-sectional and analytical study, 852 women who had a vaginal birth between 2019 and 2020 were enrolled. Data were collected using the Descriptive Questionnaire and Wijma Birth Expectation/Experience Scale Version B. The mean total Wijma Birth Expectation/Experience Scale Version B score of the women was 97.00 ± 24.24, indicating severe and clinical levels of fear of childbirth. Moreover, 69.4% of the women had clinical, 18.6% had severe and 12% had moderate levels of fear of childbirth. During birth, women who had close supporters, who were allowed to move and who did not undergo amniotomy, enema, perineal shaving and electronic foetal monitoring had a low level of fear of childbirth. As the number of pregnant women in the labour room, frequency of vaginal examinations, duration of delivery/hour, severity of labour pain and negative perception of the approach of health professionals increased, the women's fear of childbirth increased. Fear of childbirth decreased as the frequency of antenatal follow-ups, number of births and satisfaction levels of the women increased (p < 0.05). Low income perception, irregular prenatal follow-up, severe labour pain and a long duration of labour were strong predictors of increased fear of childbirth. Increasing number of births, high birth satisfaction level and positive perception of the approach of health professionals were strong predictors of reduced fear of childbirth. The reduction of interventions in vaginal delivery and support from health care providers during delivery can be effective in reducing fear of childbirth.

Experiences of patients with advanced cancer coping with chronic pain: a qualitative analysis

ObjectivesTo gain insight into the perceptions, and beliefs of patients with advanced cancer coping with chronic pain and to identify their attitudes and demands on pain management.MethodsFrom July to September 2022, 17 patients with advanced cancer living with chronic pain were recruited from a tertiary cancer hospital in Hunan Province, China. Qualitative and semi-structured interviews were conducted individually, with 30-45 minutes for each. The Colaizzi 7-step analysis method in phenomenological research was used for data analysis.ResultsThe experience of pain acceptance by advanced cancer patients with chronic pain was summarized into four themes: pain catastrophizing (unable to ignore the pain, try various methods to relieve the pain, exaggerating pain perception, and lack of knowledge about proper pain management), rumination (compulsive rumination and worrying rumination), avoidance coping (situational avoidance and repressive avoidance) and constructive action (setting clear value goal and taking reciprocal action).ConclusionMost patients with advanced cancer had low pain acceptance and negative attitudes. Feeling helpless in the face of pain and suffering alone were their norm. Long-term negative emotions could lead to gradual depression and loss of hope for treatment, resulting in pain catastrophizing and persistent rumination. Nevertheless, a few patients accepted pain with positive attitudes. Medical professionals should pay more attention to the psychological status of advanced cancer patients with chronic pain, and employ alternative therapies, for example, cognitive behavioral therapy. More efforts are needed to reduce patients’ pain catastrophizing, and promote their pain acceptance by a better understanding of pain through health education.

The Perception of Pain and Suffering of the Weak, the Innocent and the Marginalized from Evolution and from Christian Theology

The topic of pain and suffering is complex and requires a holistic vision. This article begins by clarifying concepts to understand pain as a biological, psychological, and social phenomenon that has an evolutionary history whose maximum expression arises in humans. Established this common ground, it explores altruism and animal cooperation as incipient phenomena of care for the other, though contextual. Then it points out that the difference with humans is that they perceive caring for the weak, innocent, and marginalized as a moral duty and a path of personal flourishing. Finally, in the face of human weakness and from Christian theology, God shows with deeds a path of care for the weak by making himself weak, suffering and remaining innocent.

The Relationship Between Disordered Sleep and Pain Perception in Patients with Peripheral Neuropathy (P10-9.010)

The Relationship Between Disordered Sleep and Pain Perception in Patients with Peripheral Neuropathy (P10-9.010)

Time-course of pain and salivary opiorphin release in response to oral capsaicin differ in burning mouth syndrome patients, temporomandibular disorders patients and control subjects.

Opiorphin is an analgesic peptide released by salivary glands and capsaicin an agonist of TRPV1 receptors eliciting burning sensations. The primary objective of this study was to assess opiorphin release after stimulation of the tongue by capsaicin (STC). The secondary objectives were to compare opiorphin release after STC in 3 groups of subjects [healthy (CTRL), Burning Mouth Syndrome (BMS), painful Temporomandibular disorders (TMDp)] and pain evoked by STC in these 3 groups. Salivary opiorphin was assessed with high-performance liquid chromatography at 3 different time points (baseline, after 5min and 20min of STC). Pain was self-reported on a (0-10) numeric rating scale. Three groups (N = 16) of adults were recruited at the Clinical Hospital Centre and School of Dental Medicine in Zagreb. Opiorphin levels were higher (1) in TMDp compared to CTRL in 1st (2.23 ± 1.72 pg/ul vs. 0.67 ± 0.44pg/ul, p = 0.002) and 3rd sampling (2.44 ± 2.01 pg/ul vs. 0.74 ± 0.52 pg/ul, p = 0.020) and (2) within BMS group at 3rd sampling vs. baseline (p < 0.025). Pain scores were higher in BMS compared to TMDp (p < 0.025) and CTRL (p < 0.025). This study evidenced (1) a differential basal amount of opiorphin in two pain conditions and control subjects (2) a differential kinetic of release of opiorphin after STC in CTRL, BMS and TMDp (3) a differential pain perception after STC in BMS and TMDp vs. CTRL, which can provide a readout for animal models. The specific regulation of opiorphin release in patients with orofacial painful conditions provides valuable insights for clinicians and researchers in physiology and pathology and encourages further research in this area. ClinicalTrials.gov NCT04694274. Registered on 01/05/2021.

Results of routine thoracic radiographic examinations rarely impact the plan to proceed with anesthetic procedures in dogs with presumed acute intervertebral disc herniation

IntroductionAcute thoracolumbar intervertebral disc herniation (IVDH) constitutes an emergency because associated neurological clinical signs can be progressive, with prognosis dependent on preoperative presence of deep pain perception. Pre-anesthetic thoracic radiographs are routinely performed to evaluate for potential pathology that could result in increased risk or change in overall prognosis. However, due to the emergent nature of this disease, the weight of thoracic radiographic findings on treatment plans for these dogs in unknown. The objective of this study was to investigate the clinical benefit of thoracic radiographs prior to advanced spinal imaging and surgery for acute non-ambulatory dogs with suspected T3-L3 myelopathy.MethodsConsecutive dogs presented with presumed acute IVDH between July 2020-July 2022 were identified, and medical records were reviewed retrospectively. Age, body weight, and alteration of treatment plan were compared between the dogs with positive thoracic pathology identified on thoracic radiographs and those with negative thoracic pathology.ResultsOnly 2/105 dogs had their diagnostic and treatment plans changed due to thoracic radiographic findings. Dogs with radiographic pathology diagnosed (2/16) were more likely to have their treatment plans changed than dogs with no radiographic pathology (0/89) (p = 0.014). The odds of radiographic thoracic pathology were 4.6 times higher in dogs aged 12 years or older [OR 4.6 (95%CI 1.2–17, p = 0.026].DiscussionPerforming routine thoracic radiography prior to advanced (anesthetized) diagnostic spinal imaging in presumed IVDH cases rarely resulted in a change to the treatment plan, thought eh practice may be clinically relevant in dogs 12 years of age or older.

The role of Cannabinoid receptors in visceral pain sensation of rat: an interventional study

Visceral pain, originating from internal organs, represents a challenging aspect of pain management due to its intricate mechanisms and often debilitating nature. Understanding the underlying pathways involved in visceral pain perception is crucial for developing effective therapeutic strategies. The current study aimed to delve into recent advancements in the understanding of cannabinergic modulation of visceral pain perception, focusing on findings from interventional studies utilizing animal models, particularly rats. A total of 30 male rats aged 3 months, with an average weight of 220 g were randomly divided into 3 groups. The groups contained the control group which received intraperitoneal injection of normal saline, the second group received an intraperitoneal injection of anandamide (2 mg/kg), and the third group received an intraperitoneal injection of tramadol (20 mg/kg). The pain in all groups assessed by acetic acid test. The data obtained from the intraperitoneal injection of anandamide to the rats of the experimental group showed a significant decrease in the amount of perceived visceral pain compared to control group. In addition, the results showed that tramadol injection significantly decreased visceral pain in experimental group 2 compared to the control group. In conclusion, the current study provides an evidence for the involvement of cannabinoid receptors in the modulation of visceral pain sensation in rats.        

Add-on Vitamin E in Improving Treatment Outcomes in Diabetic Peripheral Neuropathy: A Prospective Interventional Study

Background: Neuropathy is one of the most common long-standing complications of diabetes, affecting over 50% of the diabetic individuals. Managing DPN and its complications involves comprehensive care and a multidisciplinary approach. Besides pharmacological treatments, botanicals and dietary supplements that have also been found to improve symptoms of DPN without affecting glucose control. The possible role of vitamin E in the management of DPN have been postulated in various studies. The present study thus aimed to prospectively assess whether add-on treatment with vitamin E can improve treatment outcomes in diabetic peripheral neuropathy.Methods: The study included newly diagnosed patients with diabetic peripheral neuropathy for a period of initial two months. Patients were randomly allocated to either standard treatment Group (Group A) or the interventionGroup (Group B). As a part of intervention, patients received vitamin E 400mg once daily in addition to thestandard of care. Efficacy Parameters measured at baseline, 6 months and 12 months included changes in visual analog scoring, mean pain score, brief pain inventory and patient’s global impression of change. Treatment safety, quality of life and treatment adherence was assessed. Data was statistically analysed.Result: The study included a total of 100 patients, 50 patients in each Group. Significantly higher decrease of glycaemic measures was noted for Group B compared to Group A in terms of PPPG and serum creatinine, however, there was comparable change in HbA1c and FPG for both Groups. There was comparable significant reduction in mean VAS scoring at 6 and 12 months for Group B. Considering all the efficacy measures, there was highest reduction for the pain interference in the intervention arm (Group B), in comparison to Group A. (p&lt;0.001). Quality of life measures and mean adherence scoring significantly increased for treatment group B as compared to A at both 6 months and 12 months of study assessments. No major safety concerns were reported during the study period.Conclusion: Our study noted that addition of vitamin E as an added supplementation to the standard of careshowed benefits in terms of patient reported reduced pain interference and pain perception, which also significantly improved overall quality of life in these patients.

EFFICACY OF SUBLINGUAL VERSUS ORAL PIROXICAM IN MANAGEMENT OF POST-SURGICAL PAIN, SWELLING AND TRISMUS AFTER LOWER 3RD MOLAR SURGERY- A RANDOMIZED CONTROL CLINICAL TRIAL

Background of the study: Third molar surgical removal is a common procedure in oral and maxillofacial surgery, causing moderate to severe pain, swelling, and trismus. Postoperative pain control improves patient recovery and oral function, with commonly used analgesics including Ibuprofen, Aceclofenac, Ketorolac, Tramadol, Paracetamol, Nalbuphine, Nimusulide, and Buprenorphine. Aim and Objective: The study compares oral and sub-lingual Piroxicam for managing post-surgical pain after extraction of impacted third molars, focusing on analgesia onset, pain intensity, swelling, and trismus degree. Materials and method: A randomized control trial was conducted on 30 patients who underwent surgical removal of mandibular impacted third molars. The patients were divided into two groups: Group I (Study) and Group II (Control). All patients underwent the procedure by a single surgeon. Post-operative medications were prescribed according to the study design, with Piroxicam 20mg administered sub-lingually (Group I) and 20mg orally (Group II). The parameters were assessed and measured for both groups, and the results and statistical analysis were compared. Result: The results revealed that the inter-group difference for the post-operative symptoms evaluated using a t-test for Equality of means by comparing the pre-op, POD 2, POD 7 values was statistically significant. Mean onset time taken and pain perception by Group I (Sub-lingual) in the first dose was 32.3 minutes and for Group II was 51.21 minutes which was established to be significantly (P&lt;0.05) low for the sub-lingual group by statistical analysis. Conclusion: The study found that the sublingual route of administering Piroxicam had a faster onset of action and better analgesia postoperatively compared to the oral route. This is crucial for patients and surgeons to improve compliance and comfort post-operatively after impaction surgery, as potent analgesics are essential for effective pain management.

Investigating mortality salience as a potential causal influence and moderator of responses to laboratory pain.

Because pain can have profound ramifications for quality of life and daily functioning, understanding nuances in the interplay of psychosocial experiences with pain perception is vital for effective pain management. In separate lines of research, pain resilience and mortality salience have emerged as potentially important psychological correlates of reduced pain severity and increased tolerance of pain. However, to date, there has been a paucity of research examining potentially interactive effects of these factors on pain perception. To address this gap, the present experiment investigated mortality salience as a causal influence on tolerance of laboratory pain and a moderator of associations between pain resilience and pain tolerance within a Chinese sample. Participants were healthy young Chinese adults (86 women, 84 men) who first completed a brief initial cold pressor test (CPT) followed by measures of demographics and pain resilience. Subsequently, participants randomly assigned to a mortality salience (MS) condition completed two open-ended essay questions in which they wrote about their death as well as a death anxiety scale while those randomly assigned to a control condition completed analogous tasks about watching television. Finally, all participants engaged in a delay task and a second CPT designed to measure post-manipulation pain tolerance and subjective pain intensity levels. MS condition cohorts showed greater pain tolerance than controls on the post-manipulation CPT, though pain intensity levels did not differ between groups. Moderator analyses indicated that the relationship between the behavior perseverance facet of pain resilience and pain tolerance was significantly stronger among MS condition participants than controls. This experiment is the first to document potential causal effects of MS on pain tolerance and Ms as a moderator of the association between self-reported behavior perseverance and behavioral pain tolerance. Findings provide foundations for extensions within clinical pain samples.