On the absence of correlation between responses to noxious heat, cold, electrical and ischemie stimulation

Abstract

Is a person's response to one noxious stimulus similar to his/her responses to other noxious stimuli? This long-investigated topic in pain research has provided inconclusive results. In the present study, 2 samples were studied: one using 60 healthy volunteers and the other using 29 patients with coronary artery disease. Results showed near-zero correlations between measures of heat, cold, ischemic, and electrical laboratory pains, as well as between these laboratory pains and an idiopathic pain, the latency to exercise-induced angina in the patients. Power analyses showed that the sample sizes were sufficient to detect a correlation of 0.50 or greater at the 0.05 level 99% of the time in the healthy volunteers, and between 80 and 85% of the time in the patients. Reliability analyses indicated retest correlations on the order of 0.60 for these measures, indicating that the lack of correlation between modalities was not due to unreliability within a measure. These studies fail to demonstrate alternate-forms reliability among these tests, and also fail to support the notion that a person can be characterized as generally stoical or generally complaining to any painful stimulus. In practice, this implies that a battery of tests should generally be used to assess pain sensitivity and also that assessments of one pain modality are not generally useful for making inferences about another.

Reliability and validity of a simple and clinically applicable pain stimulus: sustained mechanical pressure with a spring-clamp

“…No correlation was found to CPT tolerance. In other words, clamp pain intensity correlated to other QST to varying degrees, which is in line with the literature which suggests, that different methods of QST measure different aspects of pain sensitivity and modulation [6,7,18,19].…”

Anxiety sensitivity and pain: Generalisability across noxious stimuli

“…However, as Janal et al (1994) note, findings obtained using a specific pain modality have not always generalised to other pain modalities. Indeed, pain ratings compared across noxious stimuli such as cold pressor, heat, electrical and pressure pain responses have often demonstrated weak or even no correlation (Davidson and McDougall, 1969;Lynn and Perl, 1977;Janal et al, 1994). Furthermore, Riley et al (1998) found that while sex differences in pain tolerance were large for pressure pain, they were often small to moderate for noxious heat stimuli.…”

Thermal and Pressure Pain Sensitivity in Patients with Unilateral Shoulder Pain: Comparison of Involved and Uninvolved Sides

“…5,50,51 This is not a new finding, as there is low to moderate correlation across different pain stimuli when examined on the same individual. 34,36 However, this is important to recognize, as many prior studies 15,17,18,[20][21][22]31 that have reported on side-to-side comparisons utilized only a single type of stimulus. It is possible that individuals exhibit different patterns of experimental pain sensitivity, based on the stimuli used for testing.…”