Pressure Pain Tolerance Research Articles

Changes in sex hormones and their interactions are related to pain perception between different menstrual subphases.

Background Whether sex hormones are related to pain perception across the menstrual cycle is unclear. We examined changes in experimental pain perception in healthy young females between the early-to mid-follicular subphase (emF) and the mid-luteal subphase (mL) and explored the role of sex hormones. Methods 66 participants were finally involved in the study. We tested pressure pain, cold pain, ischemic pain and needle pain meanwhile measured sex hormones levels in two menstrual subphases. Results Only the right ulna pressure test showed a significant reduction in pain threshold (PPTh3) during the mL. The absolute change of PPTh3 (PPTh3mL -PPTh3emF) was related to the absolute change of prolactin. The relative change of the range of pain tolerance for pressure pain of the right ulna (RPT3rc) was related to the relative change of progesterone (Prc) and estradiol(E2rc) levels, and the interaction effects showed that at Prc≤30, E2rc was positively correlated with RPT3rc. The same, the relative change of pressure pain tolerance of the pulp of the middle finger on the right hand (PPTo4rc) was related to E2rc and Prc, and the results of the interaction between E2rc and Prcsuggest that when E2rc is ≤0.8, Prc is positively correlated with PPTo4rc. Conclusions Two different formulas were applied in this study and showed inconsistent results. Most pain tests showed no difference between two subphases of menstrual cycle. Only the relative changes of the PPTo4 and RPT3 are related to the E2rc and Prc respectively between menstrual subphase in an interactive way in healthy young women.

The Effect of Kinesio Taping Tension on the Pressure-Pain Threshold and Pain Tolerance: A Randomized, Controlled, Doubled-blinded Trial

Purpose: To our knowledge, no study has demonstrated the effects of Kinesio Taping (KT) tension on pressure-pain threshold and tolerance. The aim of the study was to investigate the effect of KT tension tensions on pressure pain threshold and tolerance.
 Methods: A double-blind, randomized controlled study was conducted with 90 healthy male subjects with an average age of 21.04 ± 2.0 years. The subjects were randomized into four groups: 0% tension placebo (n=23), 50% tension (n= 24), 75% tension (n=22) and 100% tension groups (n=21). The KT was applied from distal to proximal, exposing the lateral epicondyle region on the dominant side. Pressure pain threshold and pain tolerance were measured using digital algometer over the lateral epicondyle. Measurements were carried out, before, immediate after and 30 minutes after KT.
 Results: There was no statistically significant difference between the groups in terms of PP threshold, pain tolerance and intensity (p>0.05). There was a significant in-group difference only in the 100% Tension Group in terms of PP threshold (p

Long-term consistency of clinical sensory testing measures for pain assessment.

Understanding the stability of quantitative sensory tests (QSTs) over time is important to aid clinicians in selecting a battery of tests for assessing and monitoring patients. This study evaluated the short- and long-term reliability of selected QSTs. Twenty healthy women participated in three experimental sessions: Baseline, 2 weeks, and 6 months. Measurements included pressure pain thresholds (PPT) in the neck, upper back, and leg; Pressure-cuff pain tolerance around the upper-arm; conditioned pain modulation during a pressure-cuff stimulus; and referred pain following a suprathreshold pressure stimulation. Intraclass correlation coefficients (ICC) and minimum detectable change (MDC) were calculated. Reliability for PPT was excellent for all sites at 2 weeks (ICC, 0.96-0.99; MDC, 22-55 kPa) and from good to excellent at 6 months (ICC, 0.88-0.95; MDC, 47-91 kPa). ICC for pressure-cuff pain tolerance indicated excellent reliability at both times (0.91-0.97). For conditioned pain modulation, reliability was moderate for all sites at 2 weeks (ICC, 0.57-0.74; MDC, 24%-35%), while it was moderate at the neck (ICC, 0.54; MDC, 27%) and poor at the upper back and leg at 6 months. ICC for referred pain areas was excellent at 2 weeks (0.90) and good at 6 months (0.86). PPT, pressure pain tolerance, and pressure-induced referred pain should be considered reliable procedures to assess the pain-sensory profile over time. In contrast, conditioned pain modulation was shown to be unstable. Future studies prospectively analyzing the pain-sensory profile will be able to better calculate appropriate sample sizes.

A Cross-sectional Study to Associate BMI with Pressure Pain Threshold and Pain Tolerance Among Healthy Young Individuals

Background: Although pain is common for everyone, it is a subjective sensation influenced by different variables. One factor that influences pain threshold and perception is body mass index (BMI). This study investigates the connection between BMI and pain by assessing the pressure pain threshold and tolerance on the median and ulnar nerves in the palms. Methods: The PPT and PT of 120 participants were measured with a digital pressure algometer (FPIX50; Wagner Instruments). Measurement sessions consisted of consecutive PPT and PT readings on the thenar and hypothenar eminence of the dominant and non-dominant hand. In addition, the PPT and PT were compared between BMI, thenar and hypothenar, dominant and non-dominant hand, and sexes. Results: The results have shown that the PPT and PT increased with BMI. However, only three out of the eight readings were significant (p = <0.05). When comparing the thenar and hypothenar, the results revealed significantly higher PPT and PT levels in the hypothenar (p = < 0.001). The results comparing the PPT and PT between the dominant and non-dominant hand revealed a significantly higher PPT in the non-dominant hand reflected across the thenar and hypothenar (t= -6.197, p= <0.01) (t= -2.550, p= 0.012), respectively. In addition, males had higher PPT and PT values (p = <0.05). Conclusion: The results suggest that individuals with higher BMI can tolerate more pain. They also indicate that the hypothenar eminence could withstand higher pain levels than the thenar eminence. In addition, our assessment also revealed a higher pain threshold observed in participants' nondominant hands, but the same could not be deduced for the pressure pain tolerance. Furthermore, the results have shown that males could tolerate more pain than females.

The Impact of Varied Music Applications on Pain Perception and Situational Pain Catastrophizing

We evaluated how pain processing and situational pain catastrophizing differed between 2 music interventions (Unwind and favorite music) and a control condition (white noise). Healthy adults (n = 70) completed quantitative sensory testing (QST) measuring pressure pain threshold (PPTh) and tolerance (PPTol), heat pain threshold (HPTh), offset analgesia (OA), temporal summation of pain (TSP), and conditioned pain modulation (CPM). Participants completed 3 QST rounds with the presence of white noise (control condition), a relaxing music app (Unwind), and their favorite music, which were presented in a randomized order. The Situational Pain Catastrophizing Scale was completed after each round. Friedman tests and post hoc Wilcoxon signed-rank tests were used to compare pain processing and catastrophizing across the 3 conditions. Participants’ PPTh, PPTol, and HPTh were significantly higher during the favorite music condition compared to the other 2 conditions, indicating lower pain sensitivity when listening to favorite music. In contrast, OA was lower in the favorite music condition. Although TSP and CPM were induced by the QST paradigm, these did not differ across the 3 conditions. Situational pain catastrophizing was also significantly lower during the favorite music condition. Several measures of pain sensitivity and situational pain catastrophizing were lower when listening to favorite music compared to relaxing music or white noise. More research is necessary to determine the mechanism(s) by which music modulates pain processing. PerspectiveThis article presents evidence that participant-chosen favorite music can alter several aspects of nociceptive processing, including catastrophic thinking about pain, compared to white noise or relaxing music. Employing an individual's favorite music during episodic or procedural pain might represent a cost effective adjunctive analgesic strategy.

Effect of stress on contextual pain sensitivity in the preoperative period- A proof of concept study.

The importance of non-noxious contextual inputs in the interplay of pain with neurophysiologic and behavioral factors is gaining recognition. Stress of impending surgery can act as a negative context, leading to a decrease in pain threshold in patients. This study was conducted to assess the influence of stress conferred by the imminent and other contextual inputs such as anxiety, socioeconomic status, prior painful experience, and the effect of gender on modulation of pain perception in patients undergoing elective surgery. In total, 120 patients aged between 18 and 60 years of either gender posted for elective gastrointestinal surgery under general anesthesia were recruited. Data were collected on preoperative anxiety level, socioeconomic status, education, and any prior painful experience. A pressure algometer was used to measure the pressure pain thresholds and pain tolerance on the day before surgery and on the morning of surgery in the preoperative suite. There was a statistically significant decrease in both pain threshold (P < 0.0001) and pain tolerance in the immediate preoperative period in comparison to the baseline readings taken the day before surgery (P = 0.048). The magnitude of change in pain scalars was greater in females (P < 0.001), those with a high anxiety score, and a history of severe painful experience in the past. Preoperative surgical stress lowers the pain threshold and pain tolerance. Contextual modulation of pain by factors such as anxiety and memory of prior painful experience, especially in the female gender, could influence postoperative patient outcomes and warrants further research.

Individual Characteristics and Pain Sensitivity during Pregnancy-A Cross-Sectional Study in Pregnant and Non-Pregnant Women.

The aim of the study was to describe the characteristics and factors related to pain perception in pregnant women, such as optimism, personality traits, and fear of developing COVID-19 consequences. Sixty-six pregnant women aged 23 to 42 years participated in the study, and the comparison group consisted of n = 59 non-pregnant female students aged 19 to 23 years. Pressure pain threshold and pain tolerance were measured with an algometer. To assess psychological characteristics, the Life-Orientation Test-Revised was used to assess optimism, the Fear of COVID-19 Scale was used to assess COVID-19 anxiety, and the Ten-Item Personality Inventory was applied to assess personality traits in a five-factor model. The main results of the study showed that pain tolerance was significantly lower in both dominant and non-dominant hand pregnant women than in the comparison group. The studied pregnant women had higher scores for conscientiousness, fear of COVID-19, and optimism compared with the non-pregnant women. Regression analysis showed that the variability in pain perception among pregnant women could not be explained by individual differences in personality traits, optimism, and fear of COVID-19.

Influence of genetic variants on remifentanil sensitivity in Chinese women.

Significant individual differences have been observed in pain sensitivity and analgesic effect of opioids. Previous studies have shown that genetic factors contributed to analgesics requirement obviously. Therefore, we investigated the role of genetic polymorphisms in the sensitivity to the analgesic effect of remifentanil in this study. One hundred thirty-seven patients undergoing gynaecological surgery were observed. Before procedures, we measured the basal pain threshold of each patient, including the pressure pain threshold and pressure pain tolerance threshold. Subsequently, patients received a continuous remifentanil infusion for 15 min at a constant rate of 0.2μg/(kg min). The pain thresholds were measured again after the remifentanil infusion. Moreover, respiratory depression was estimated using oxygen saturation during infusion. DNA was extracted from peripheral venous blood and genotyped using SNaPshot technology. Polymorphisms were found in genes associated with the individual variation in analgesia. Participants carrying OPRM1 rs9397685 AA, ADRB1 rs1801253 CC, and GCH1 rs8007267 CC polymorphisms showed higher sensitivity to analgesic effect induced by remifentanil, and the participants carrying the OPRD1 rs2234918 TT showed lower sensitivity to remifentanil-related respiratory depression. Moreover, individual susceptibility to remifentanil increases with age. Gene variation in OPRM1 rs9397685 AA, ADRB1 rs1801253 CC, GCH1 rs8007267 CC, and OPRD1 rs2234918 TT were related to the conspicuous interindividual differences in the analgesia and respiratory depression of remifentanil, mainly by affecting the target protein receptors and relative metabolic enzymes.

The Effect of Palmitoylethanolamide on Pain Intensity, Central and Peripheral Sensitization, and Pain Modulation in Healthy Volunteers-A Randomized, Double-Blinded, Placebo-Controlled Crossover Trial.

Palmitoylethanolamide (PEA) is marketed as a “dietary food for special medical purposes”. Its broad-spectrum analgesic, anti-inflammatory, and neuroprotective effects make PEA an interesting substance in pain management. However, the underlying analgetic mechanisms have not yet been investigated in humans. The aim of our study is to provide a deeper understanding of the involved mechanisms, which is essential for differentiating therapeutic approaches and the establishment of mechanism-based therapeutic approaches. In this randomized, placebo-controlled, double-blinded crossover trial, 14 healthy volunteers were included. PEA (3 × 400 mg per day) or placebo were taken for 4 weeks. Our study investigated the mode of action of PEA using an established pain model, “Repetitive phasic heat application”, which is well-suited to investigate analgesic and anti-hyperalgesic effects in healthy volunteers. Parameters for peripheral and central sensitization as well as for pain modulation were assessed. Repetitive heat pain was significantly decreased, and the cold pain tolerance was significantly prolonged after the PEA treatment. The pressure pain tolerance and the conditioned pain modulation were increased after the PEA treatment. The wind-up ratio and the average distance of allodynia were significantly decreased after the PEA treatment. The heat pain tolerance was significantly higher after the PEA treatment. The present study has demonstrated that PEA has clinically relevant analgesic properties, acting on both peripheral and central mechanisms as well as in pain modulation.

Is Physical Activity an Effective Factor for Modulating Pressure Pain Threshold and Pain Tolerance after Cardiovascular Incidents?

The purpose of this study was to investigate whether regular physical activity can alter the pressure pain threshold, pain tolerance, and subjective pain perception in individuals who have experienced a cardiovascular event. The study involved 85 individuals aged 37 to 84 years (M = 65.36) who qualified for outpatient cardiac rehabilitation, which consisted of 24 physical training sessions. The patients were all tested twice: on the first and last day of the outpatient cardiac rehabilitation program. Assessments of the pressure pain threshold and pain tolerance were performed with an algometer. To assess the pain coping strategies, the Pain Coping Strategies Questionnaire (CSQ) and parenting styles were measured retrospectively with subjective survey questions. The main results of the study showed that patients achieved significantly higher pressure pain thresholds after a physical training cycle (ps < 0.05, η2 = 0.05–0.14), but found no differences in the pain tolerance (ps > 0.05). A lower preference for the better pain coping strategy explanation (ß = −0.42, p = 0.013) and growing up in a family with a less neglectful atmosphere (ß = −0.35, p = 0.008) were associated with increased pressure pain threshold after physical training. The results suggest that physical activity is an important factor in modulating the pressure pain threshold.

Pain Tolerance in Chronic Pain Patients Seems to be More Associated with Physical Activity than with Depression and Anxiety

ObjectiveTo explore the associations between habitual self-reported physical activity, pain sensitivity and patient-reported outcomes (including pain intensity) in patients with chronic pain.DesignCross-sectional, experimental study.SubjectsPatients (n = 78), age range 18–65 years, with different chronic pain conditions (> 3 months) were compared with age- and sex-matched healthy controls (n = 98).MethodsMultivariate correlations between self-reported physical activity, pressure pain sensitivity, and patient-reported outcome measures were assessed.ResultsLower perceived health status (p < 0.001, Cohen’s d = 2.34), higher levels of depression (p < 0.001, Cohen’s d = 1.77), and lower pain tolerance threshold (p < 0.001, Cohen’s d = 1.66) were the most prominent variables discriminating patients from controls. In patients, bivariate and multivariate analyses showed that higher pressure pain tolerance was associated with male sex, lower pain intensity and fewer painful regions, higher self-efficacy and more self-reported physical activity, but not with lower levels of anxiety and depression.ConclusionPain tolerance thresholds, as well as degree of depression and perceived health status discriminated between patients and controls, and there was an association between pain tolerance thresholds and level of self-reported physical activity in patients. This study highlights the importance of further research into how increased physical activity may improve pain sensitivity in patients with chronic pain.LAY ABSTRACTPatients with chronic pain and healthy controls were included in this study of the relationships between self-reported physical activity, measurements of sensitivity to pressure pain, and questionnaire data. Pressure pain sensitivity was one of the most important factors discriminating between patients and controls, and there was a significant correlation between pain tolerance threshold and level of self-reported physical activity in patients (i.e. the lower pain thresholds the less physical activity). These results are relevant, as there are only a few previous studies examining the relationship between physical activity in patients with chronic pain and their sensitivity to pressure pain. More research is needed to explore how daily physical activity may improve chronic pain by, for example, increasing patient’s tolerance to pain.

Body image dissatisfaction and experimental pressure pain sensitivity in a cohort of 13-year-old adolescents

ObjectiveWe aimed to quantify the associations between body image (dis)satisfaction and pressure pain thresholds in adolescents, using data from Generation XXI, a population-based cohort study in Portugal. MethodsWe assessed 1785 13-year old adolescents cross-sectionally. Body image satisfaction was measured using the Children's Figure Rating Scale. Pain detection and tolerance thresholds were assessed using cuff pressure algometry. We quantified the associations between body image categories (satisfied, prefers slightly thinner, prefers much thinner, and prefers heavier) and pain detection and tolerance thresholds using linear and logistic regression for continuous and binary (odds of achieving the highest distribution quarter) outcomes, respectively. Models were adjusted to pubertal stage and body mass index. ResultsAdolescents who desired a heavier silhouette had lower pressure pain tolerance thresholds when compared to those who were satisfied (linear regression coefficient: −3.95; 95% confidence interval: −6.68, −1.21), which was more precise in boys (−3.51; −7.17, −0.08). Those adolescents also had lower odds of achieving the highest quarter of pressure pain tolerance threshold (odds ratio: 0.66; 0.48, 0.90), especially girls (0.58; 0.35, 0.98). Adolescents who desired much thinner silhouettes had lower odds of achieving the highest quarter of pressure pain tolerance (0.68; 0.46, 1.00), and this was clearer in girls (0.66; 0.48, 0.90). Pain detection thresholds did not show robust associations with body image dissatisfaction. ConclusionOur study suggests an association between satisfaction with one's silhouette and pain tolerance in adolescents from the general population, arguing for an integrated approach to the assessment of body image and pain sensitivity.

The Diurnal Profile of Human Basal Pain Sensitivity and Skin Sympathetic Nerve Activity: A Healthy Volunteer Study.

ObjectiveThe diurnal rhythm profile of human basal pain sensitivity and its association with sympathetic nerve activity are not fully understood. This study aimed to examine rhythmic changes in experimental pain sensitivity and skin sympathetic nerve activity in healthy volunteers.MethodsThirty healthy volunteers were included in the study. Experimental pain sensitivity, including pressure pain threshold and tolerance, cold pain threshold (CPT) and tolerance, skin sympathetic nerve activity, and cardiovascular parameters (including heart rate, cardiac output, and peripheral vascular resistance) at six time points throughout the day (08:00, 12:00, 16:00, 20:00, 00:00, and 04:00) were sequentially measured. Circadian rhythm analysis was performed on the mean values of the different measurements and individual subjects.ResultsSignificant differences were found in experimental pain sensitivity, skin sympathetic nerve activity, and non-invasive cardiovascular parameters at different time points (P < 0.05). The minimum measured values of all four types of experimental pain sensitivity were consistently observed at 04:00. Rhythmical analysis showed that the mean values of pressure pain threshold (meta2d P = 0.016) and skin sympathetic nerve activity (meta2d P = 0.039) were significant. Significant diurnal rhythms in pain sensitivity and skin sympathetic nerve activity existed in some individuals but not in others. No significant correlation between experimental pain sensitivity and skin sympathetic nerve activity was found at any time point (P > 0.05).ConclusionSignificant diurnal fluctuations were observed in different pain sensitivities and skin sympathetic nerve activity. No significant correlation between experimental pain sensitivity and sympathetic excitability at different times was found; the reasons for these phenomena remain to be further studied.Clinical Trial Registration[www.ClinicalTrials.gov], identifier [ChiCTR2000039709].

Low-Volume High-Intensity Interval Training Sessions With Different Work–Recovery Durations and Muscle Damage in Trained Men

ABSTRACT Purpose: This study compared the effect of low-volume high-intensity training (LV-HIIT) sessions with different work-recovery durations on muscle damage markers.Methods: Twenty-four trained adult males (22.3 ± 2.9 years; 24.6 ± 2.7 kg∙m-2) performed two LV-HIIT sessions (10 x 60 s and 20 x 30 s at 100% of maximal aerobic speed on treadmill (Vmax) interspersed with equal time passive recovery, respectively) in a randomized, counter-balanced order, separated by a 1-week interval. Delayed onset muscle soreness (DOMS) and countermovement vertical jump height (CVJH) performance were assessed before, and 24-h and 48-h post sessions.Results: Pressure-pain threshold (PPT), pressure-pain tolerance (PPTol) and perceived pain intensity (PPI) using pressure algometry assessed DOMS in the rectus rectus femoris, biceps femoris and gastroctemius. A non-significant session by time interaction for PPT, PPTol and PPI in all muscles analyzed was observed (all P > 0.260). Additionally, a non-significant session by time interaction was observed for CVJH performance (P = 0.836).Conclusion: LV-HIIT sessions with different work-recovery durations elicited non-significant changes on muscle damage markers following 24- and 48-h in trained males.

The impact of gender of the examiner on orofacial pain perception and pain reporting among healthy volunteers

ObjectivesPain on palpation of jaw muscles is a commonly used diagnostic criterion when examining patients with orofacial pain. It is not known, however, if pain reports are affected by the gender of the examiner. Our aim was to investigate if pressure pain threshold (PPT), pressure pain tolerance (PTol), and pain intensity assessed over the masseter muscles in healthy individuals are affected by the gender of the examiner.Materials and methodsHealthy, pain-free individuals were recruited on a voluntary basis. PPT and PTol were assessed using pressure algometry. At the PTol level, participants also rated pain intensity on a 0–10 numeric rating scale. Assessments of PPT and PTol were conducted with six repeated measurements performed twice, separately by one female and one male examiner, on each participant.ResultsIn total, 84 participants (43 women; median age 24, IQR 6) were included. With a female examiner, women reported higher pain intensity than men (Mann Whitney U, p = 0.005). In the multivariable analysis, significantly higher PTol was predicted by male examiner. Also, a higher ratio between PTol and reported pain intensity was predicted by male examiner.ConclusionsThe gender of the examiner influences pain reporting and perception in an experimental setting. This effect on pain perception related to gender of the examiner is probably related to normative gender behaviors rather than to biological alterations within the examined individual.Clinical relevanceIn clinical and experimental settings, gender of the examiner may affect not only pain perception but also pain reporting, with potential implications for diagnostics in patients with pain.

Sensitivity and pain in focal dystonia of the hand

IntroductionA growing body of evidence highlights the importance of understanding both the sensory and the motor pathophysiology of focal dystonia in order to improve its treatment. This study aims to evaluate somatosensory afferences in patients with focal or segmental dystonia affecting the upper limbs, to analyse whether the dominant limb is more frequently affected, to analyse pain tolerance, and to examine the potential association with pain perception in patients with hand dystonia. MethodsWe recruited 24 participants: 12 patients with focal hand dystonia and 12 individuals without dystonia. All participants were evaluated with a digital algometer (Somedic SenseLab AB®, Farsta, Sweden), a Semmes-Weinstein monofilament test, and the visual analogue scale for pain. ResultsAccording to our data, patients showed greater impairment in surface sensitivity than controls, both in the dominant and the non-dominant hands, as well as greater presence of pain (P > .001). Furthermore, the dystonia group showed a negative correlation between perceived pain and pressure pain tolerance threshold (rho = −0.83; P < .001). ConclusionsPatients with focal hand dystonia presented alterations in sensitivity and more severe perceived pain than individuals without dystonia. Future studies with larger samples should aim to analyse the clinical implications and everyday impact of both objective and subjective pain.

Pain, numbness, or both? Distinguishing the longitudinal course and predictors of positive, painful neuropathic features vs numbness after breast cancer surgery.

Both positive (burning, stabbing, and allodynia) and negative (numbness) neuropathic symptoms may arise after surgery but likely contribute differently to patients' postoperative pain experience. Numbness has been identified as divergent from positive neuropathic symptoms and therefore excluded from some neuropathic assessment tools (Neuropathic Pain Scale for PostSurgical patients [NeuPPS]). In this prospective longitudinal study of patients undergoing breast surgery, we aimed to delineate the time course of numbness and its coincidence with NeuPPS and to contrast the association of surgical, psychosocial, and psychophysical predictors with the development of negative vs positive neuropathic symptoms. Patients reported surgical area sensory disturbances at 2 weeks and 3, 6, and 12 months postoperatively. Association of baseline demographic, surgical, psychosocial, and psychophysical factors with NeuPPS and numbness across time was investigated using generalized estimating equation linear and logistic regression. Numbness was consistently reported by 65% of patients; positive neuropathic symptoms were less common, often decreasing over time. Neuropathic Pain scale for PostSurgical patients and numbness co-occurred in half of patients and were both associated with greater clinical pain severity and impact, younger age, axillary surgery, and psychosocial factors. More extensive surgery and chemotherapy were only associated with numbness. Conversely, other chronic pain, lower physical activity, perioperative opioid use, negative affect, and lower baseline pressure pain threshold and tolerance were only associated with NeuPPS. Patients reporting numbness alone did not endorse substantial clinical pain. Differentiation of predictors, prevalence, and time course of numbness vs NeuPPS in breast surgical patients revealed important distinctions, suggesting that their independent assessment is worthwhile in future studies of postsurgical pain.

The association of dispositional optimism and handedness with pressure pain: A cross-sectional study in the general population

This study aimed to investigate the association between dispositional optimism, handedness and pressure pain perception in general population and under experimental conditions. We included 2500 community-dwelling adults of both sexes from Croatia in a cross-sectional study. We measured pressure pain threshold, pressure pain tolerance, and pressure pain interval using a hand-held algometer. A detailed questionnaire was used to collect data on sociodemographic and psychological characteristics. The association between optimism and pain measures was assessed using multiple linear regression analysis, controlling for sex, age, and a number of socioeconomic and psychological confounding factors. Additionally, we tested whether handedness was associated with pain perception. Dispositional optimism was significantly and positively associated with pressure pain tolerance and interval on both hands, but not with pain threshold. Pressure pain perception did not differ substantially according to handedness, and only right-handed subjects displayed higher pain threshold, tolerance and pain interval on their dominant hand. These findings suggest that optimists can tolerate acute pressure pain better, but they are equally sensitive to pain. Further studies are needed to demonstrate causality between optimism and pain tolerance, and possibly even to translate these findings into supplementary, non-pharmaceutical optimism-based clinical pain management.

To tolerate weather and to tolerate pain: two sides of the same coin? The Tromsø Study 7.

It is a common belief that weather affects pain. Therefore, we hypothesized that weather can affect pain tolerance. This study used data from over 18,000 subjects aged 40 years or older from the general population, who participated in the Tromsø Study 7. They underwent a one-time assessment of cuff algometry pressure pain tolerance (PPT) and cold pain tolerance (CPT), tested with a cold pressor test. The results showed a clear seasonal variation in CPT. The rate of withdrawal in the cold pressor test was up to 75% higher in months in the warmer parts of the year compared with January 2016. There was no seasonal variation in PPT. The study not only found a nonrandom short-term variation in PPT but also indications of such a variation in CPT. The intrinsic timescale of this short-term variation in PPT was 5.1 days (95% % confidence interval 4.0-7.2), which is similar to the observed timescales of meteorological variables. Pressure pain tolerance and CPT correlated with meteorological variables, and these correlations changed over time. Finally, temperature and barometric pressure predicted future values of PPT. These findings suggest that weather has a causal and dynamic effect on pain tolerance, which supports the common belief that weather affects pain.

Effectiveness of ischemic compression pressure versus spray and stretch technique in the management of active myofascial trigger points of trapezius muscle.

Background: Now, a days myofascial trigger points are tremendously occurring and become a stressful part of nearly any person at any time in a lifetime. This study compares the effects of ischemic compression pressure with spray and stretch technique to treat active myofascial trigger points of the trapezius muscle in patients with neck pain.&#x0D; Methodology: A comparative interventional study was conducted at Dow University of Health Sciences from December 2016 and May 2017. Seventy patients (35 in each group) with active myofascial trigger points of trapezius were randomly assigned to group A (ischemic compression pressure) and group B (vapocoolant spray and stretch technique). Baseline and last session assessment of pain intensity, pain pressure tolerance, cervical range of motion and functional disability were measured through numerical pain-rating scale, algometer, goniometer and neck disability index, respectively.&#x0D; Results: Both groups showed significant improvement in all dependent variables of study which were neck pain, cervical range of motion and pain pressure tolerance (p-value&lt;0.05). Group A showed greater improvement in pain intensity (p-value 0.015), pressure pain threshold (p-value 0.000) and cervical range of motion flexion, left side flexion and right-side flexion (p-value 0.002, 0.000 &amp; 0.004) than group B.&#x0D; Conclusion: Both ischemic compression pressure &amp; spray and stretch technique deactivated trigger points of upper fibers trapezius muscle in patients with neck pain, but the ischemic compression pressure was superior to the spray and stretch technique.