Psychophysical and Electrophysiological Approaches to the Pain-Relieving Effects of Heterotopic Nociceptive Stimuli

Willer, Jean Claude; Roby, A.; Bars, D. Le

doi:10.1093/brain/107.4.1095

Cited by 371 publications

(197 citation statements)

References 27 publications

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“…Similarly, as noted above and illustrated in Figure 2, offspring of hypertensive persons exhibit an elevated nociceptive flexion reflex threshold compared with offspring of normotensive individuals~Page & France, 1997!. Because the nociceptive flexion reflex can be elevated by stimulation of descending pain modulation systems~De Broucker, Cesaro, Willer, & Le Bars, 1990;Roby-Brami, Bussel, Willer, & Le Bars, 1987;Willer, Boureau, & Albe-Fessard, 1979;Willer, Roby, & Le Bars, 1984!, our findings provide additional support for the notion of enhanced activation of central pain modulation systems in individuals at risk for hypertension.…”

Section: Descending Pain Modulationmentioning

confidence: 73%

Decreased pain perception and risk for hypertension: Considering a common physiological mechanism

France

1999

Psychophysiol.

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For almost two decades, researchers have demonstrated that hypertension is reliably associated with decreased perception of pain. More recently, a growing body of evidence has begun to suggest that hypoalgesia is not a consequence of high blood pressure, as the phenomenon precedes the onset of hypertension in individuals at risk for the disorder. This article provides a review of empirical evidence of decreased pain perception in normotensive persons with a family history of hypertension, elevated resting blood pressure, or exaggerated cardiovascular reactivity to stress. Based on the existing evidence, hypoalgesia is argued to be a correlate of dysregulation of central nervous system structures involved in both pain control and cardiovascular regulation in individuals who are genetically predisposed to develop high blood pressure. As such, hypoalgesia may serve as a valuable method of identifying individuals at greatest risk for hypertension. Descriptors: Pain, Hypoalgesia, Risk for hypertensionHypertension is often referred to as a "silent" killer because it is typically believed that individuals with high blood pressure rarely experience subjective symptoms of their disorder. In fact, two decades of research has demonstrated convincingly that hypertension is reliably associated with at least one subjective symptomhypoalgesia, or decreased perception of pain. The following article will briefly review the existing literature on the association between hypoalgesia and high blood pressure, and will present evidence to suggest that this relationship may have important clinical and theoretical implications. In particular, evidence of hypoalgesia in normotensive individuals at increased risk for hypertension will be offered in support of the notion that hypertension and decreased pain perception may result from a common physiological dysfunction. Specifically, central opioid hyposensitivity is hypothesized as a mechanism of both hypoalgesia and exaggerated autonomic and neuroendocrine responses to stress in individuals at risk for hypertension. Finally, it will be argued that if hypoalgesia and hypertension share a common pathophysiology, then decreased pain perception might serve as a behavioral marker of risk for hypertension long before the onset of high blood pressure levels.

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Section: Descending Pain Modulationmentioning

confidence: 73%

Decreased pain perception and risk for hypertension: Considering a common physiological mechanism

France

1999

Psychophysiol.

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“…25 [ fig 2A]; MVCs, P=.77 [ fig 3A]). Similarly, pain ratings did not change for any of the exercise sessions (trial effect: 25FAIL, P=.92 [ fig 1B]; 25TIME, P=.40 [ fig 2B]; MVCs, P=.28 [ fig 3B]).…”

Section: Pain Perception Experimental Painmentioning

confidence: 99%

“…Thus, exercise would act as a counterirritant (ie, activation of nociceptors produce an endogenous analgesic response), resulting in greater pain relief for these persons after exercise compared with those who experienced less baseline pain. 25 Another predictor for exercise-induced changes in pain was the change in fibromyalgia pain intensity. Those subjects who had the greatest experimental pain relief also had the greatest decrease in fibromyalgia pain intensity.…”

mentioning

confidence: 99%

Pain Perception After Isometric Exercise in Women With Fibromyalgia

Bement¹,

Weyer²,

Hartley³

et al. 2011

Archives of Physical Medicine and Rehabilitation

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“…Endogenous pain inhibition has typically been assessed by a "pain inhibits pain" model termed conditioned pain modulation (CPM) or a model called offset analgesia (offset). CPM is the central inhibition of pain in a local area by a second pain that can be experienced anywhere in the body (38). Offset is an inhibitory temporal sharpening mechanism characterized by a pronounced reduction in perceived pain intensity evoked by slight decreases in noxious temperatures compared to those of equal magnitude increases (16).…”

mentioning

confidence: 99%

Self-reported physical activity predicts pain inhibitory and facilitatory function

Naugle

Riley

2013

The Journal of Pain

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Considerable evidence suggests regular physical activity can reduce chronic pain symptoms. Dysfunction of endogenous facilitatory and inhibitory systems has been implicated in multiple chronic pain conditions. However, few studies have investigated the relationship between levels of physical activity and descending pain modulatory function.Purpose-This study's purpose was to determine whether self-reported levels of physical activity in healthy adults predicted 1) pain sensitivity to heat and cold stimuli, 2) pain facilitatory function as tested by temporal summation of pain (TS), and 3) pain inhibitory function as tested by conditioned pain modulation (CPM) and offset analgesia.Methods-Forty-eight healthy adults (age range 18-76) completed the International Physical Activity Questionnaire (IPAQ) and the following pain tests: heat pain thresholds (HPT), heat pain suprathresholds, cold pressor pain (CPP), temporal summation of heat pain, conditioned pain modulation, and offset analgesia. The IPAQ measured levels of walking, moderate, vigorous and total physical activity over the past seven days. Hierarchical linear regressions were conducted to determine the relationship between each pain test and self-reported levels of physical activity, while controlling for age, sex and psychological variables.Results-Self-reported total and vigorous physical activity predicted TS and CPM (p's <.05). Individuals who self-reported more vigorous and total physical activity exhibited reduced temporal summation of pain and greater CPM. The IPAQ measures did not predict any of the other pain measures.Conclusion-Thus, these results suggest that healthy older and younger adults who self-report greater levels of vigorous and total physical activity exhibit enhanced descending pain modulatory function. Improved descending pain modulation may be a mechanism through which exercise reduces or prevents chronic pain symptoms. KeywordsVigorous; Pain modulation; Temporal Summation; Conditioned Pain Modulation; ExerciseThe prevalence estimates of chronic pain among adults in the United States may be as high as 40%, affecting approximately 100 million adults (15). Pain increases physical disability (32), reduces quality of life, and is costly to both the individual experiencing pain and the Copyright © 2013 American College of Sports MedicineCorresponding Author: Kelly M. Naugle, College of Dentistry, University of Florida, 1329 SW 16 th Street, Rm 5180, Gainesville, FL 32608, Phone: 352-273-5975, Fax: 352-273-5985, knaugle@dental.ufl.edu. Conflict of InterestThere are not actual or potential conflicts of interest for any of the authors. The results of the present study do not constitute endorsement by ACSM. nation (15). Alarmingly, a recent study reported that the national cost of pain exceeds the cost of the nation's priority health conditions (e.g., cardiovascular disease, neoplasms, endocrine, nutritional and metabolic diseases), with costs ranging from $560 to $635 billion annually (15). Clearly, a need exists for effective meth...

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Psychophysical and Electrophysiological Approaches to the Pain-Relieving Effects of Heterotopic Nociceptive Stimuli

Cited by 371 publications

References 27 publications

Decreased pain perception and risk for hypertension: Considering a common physiological mechanism

Decreased pain perception and risk for hypertension: Considering a common physiological mechanism

Pain Perception After Isometric Exercise in Women With Fibromyalgia

Self-reported physical activity predicts pain inhibitory and facilitatory function

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