Negative affect and sensitization to pain

Abstract

Pain usually has a strong negative affective component, which is believed to modulate pain perception. After reviewing theories on the link between negative affect and pain, mechanisms are discussed by which negative affect may either increase or inhibit pain. Possible pain-inhibiting mechanisms are endogenous opioid release, blood pressure reactivity, and distraction of attention; possible pain-increasing mechanisms are autonomic and muscular reactivity, misattribution of arousal, hypervigilance to pain, worrying, and avoidance behavior. It is emphasized that each of these mechanisms can be very adaptive in acute pain situations to prevent injury and promote recovery. In chronic pain, however, ongoing physiological arousal and hypervigilance to pain, induced or magnified by negative affect, may cause sensitization to pain. Furthermore, worrying about pain and avoidance of pain-inducing activities may increase negative affect, ypervigilance, and functional disability. It is argued that, in the long run, pain-related negative affect has sensitizing and disabling effects.

Interventions for relieving pain associated with panretinal photocoagulation: a prospective randomized trial

“…A previous study has shown that anxiety increases pain sensation. 46 Unfortunately, diazepam or its combination with the nonopioids analgesics mentioned above failed to demonstrate the effectiveness against PRP-associated pain in our study. Of note, although our study has shown that oral or intramuscular NSAIDs are not effective for PRP-associated pain, topical NSAID has been reported to be effective in reducing PRP-induced pain.…”

“…Previous research has found that possible pain-inhibiting mechanisms that are endogenous opioid release, blood pressure reactivity, and distraction of attention; possible pain-increasing mechanisms are autonomic and muscular reactivity, misattribution of arousal, hypervigilance to pain, worrying, and avoidance behaviour. 46 Therefore, measures to promote paininhibiting mechanisms or decrease pain-increasing mechanisms may help reduce patients' painful sensation during PRP treatment. Use of some psychological interventions, such as positive emotion induction or relaxation procedures, was found useful for acute pain management.…”

Opioid-mediated pain sensitivity in mice bred for high voluntary wheel running

“…Thus, at the level of individual variation within lines, higher amounts of running tend to be weakly associated with shorter tailflick latencies (increased pain sensitivity). Note that this is contrary to the prediction that the acute effect of exercise decreases pain sensitivity [3][4][5][6][7].…”

“…[1,2]). In contrast, studies in both rodents and humans have demonstrated that exercise can also reduce pain [3][4][5][6][7]. The phenomenon in which pain perception is altered during exposure to various stressors has been referred to as stress-induced analgesia, or specifically as exercise-induced analgesia when physical activity is involved.…”

Negative affect, pain and sex: The role of endogenous opioids

“…Rhudy and Meagher (2001b) speculated that negative emotions of low to moderate intensity increase attention towards and amplify pain via neural circuits in the amygdala and periaqueductal grey that also modulate startle responses. Alternatively, an increase in the concentration of circulating catecholamines during psychological stress (Janssen et al, 1998), or selective attention or misattribution of arousal (Janssen, 2002), might heighten sensitivity to pain. Anger is generally associated with hyperalgesia (Bruehl et al, 2002;Janssen, Spinhoven, and Brosschot, 2001), possibly for similar reasons.…”