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

Farbu, Elisabeth; Rypdal, Martin; Skandfer, Morten; Steingrímsdóttir, Ólöf Anna; Brenn, Tormod; Stubhaug, Audun; Nielsen, Christopher Sivert; Höper, Anje Christina

doi:10.1097/j.pain.0000000000002437

Cited by 8 publications

(10 citation statements)

References 42 publications

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“…Thus, the subjective experience of the environment might be an important marker for the cold exposures’ effect on the body, but a poor marker of the thermal environment. On the other side, the experience of pain and the environment, as well as having pain, could very well be closely connected ( Sundstrup et al, 2015 ; Farbu et al, 2021b ). The central sensitization associated with pain could increase the risk of feeling cold or cooling, and the likelihood of reporting a cold environment.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, many report that their pain condition is aggravated by weather ( Timmermans et al, 2014 ) and that cold temperature causes pain. Further, the findings that weather affects pain tolerance indicates that the climatic environment can be of importance for how and when we feel pain ( Farbu et al, 2021b ).…”

Section: Discussionmentioning

confidence: 99%

“…Pain is one of the most prominent symptoms of musculoskeletal conditions, and pain is an experience and a feeling, it is subjective in nature, and it seems to vary over time ( Glette et al, 2020 ; Farbu et al, 2021b ). Measuring it is therefore inherently difficult.…”

Section: Discussionmentioning

confidence: 99%

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Cold exposure and musculoskeletal conditions; A scoping review

Farbu

Höper²,

Reierth³

et al. 2022

Front. Physiol.

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Background: Musculoskeletal conditions are major contributors to years lived with disability. Cold exposure can be a risk factor, but any conclusion is obscure.Aim: The aim of the present scoping review was to identify the existing evidence of an association between cold exposure and musculoskeletal conditions. The aim also included to consider pain in different regions and their assessment, as well as different measures of cold exposure, effect sizes, and to assess the feasibility of future systematic reviews and meta-analyses.Eligibility criteria: The studies must have: an epidemiological design, defined cold exposure to come prior to the health outcome, defined exposure and outcome(s), existence of effect estimate(s) or data that made it possible to calculate such an estimate. Further, studies were required to be in English language and published in peer-reviewed journals. Studies that had a specific goal of studying cold exposure as an aggravator of already existing health problems were excluded.Sources: We searched Ovid MEDLINE(R) and Epub Ahead of Print, In-Process and Other Non-Indexed Citations, Daily and Versions(R), and Embase Classic + Embase for original studies.Charting method: The included studies were reviewed for study population, measurement of exposure and outcome, and effect size. Each publication was assessed for risk of bias.Results: The included studies were heterogeneous in populations, measures of cold exposure and musculoskeletal conditions. Most studies used self-reported data. They were mostly cross-sectional studies, only two were prospective and one was a case-control study. Associations were found for different cold exposures and regional musculoskeletal conditions, but the heterogeneity and lack of studies impeded valid synthesis of risk magnitude, or meta-analyses.Conclusion: The studies identified in this review indicate that cold exposure increases the risk of musculoskeletal conditions. However, there is a need for studies that better assess temporality between exposure and outcome. Future studies should also include better exposure assessment, including both objective measurements and measures of subjective experience of cold exposure. The heterogeneity in measurement of exposure and outcome impeded any meta-analysis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cold exposure and musculoskeletal conditions; A scoping review

Farbu

Höper²,

Reierth³

et al. 2022

Front. Physiol.

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“…9,11,46,49 Accordingly, in the large-scale Tromsø study, cold weather acclimatization matched cold pain tolerance. 25 Although these mechanisms may play a role, they do not explain our findings because peripheral vascular responding was not correlated and thus likely not causally related to perceived cold-pressor–induced pain. Previous studies found that direct microneurographically recorded human cutaneous sympathetic activity during a cold-pressor test was weak, inconsistent, and not correlated to pain.…”

Section: Discussionmentioning

confidence: 74%

Interindividual variability in cold-pressor pain sensitivity is not explained by peripheral vascular responding and generalizes to a C-nociceptor–specific pain phenotype

Martel,

Papafragou,

Weigand

et al. 2024

Pain

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Pain sensitivity of healthy subjects in the cold-pressor (CP) test was proposed to be dichotomously distributed and to represent a pain sensitivity trait. Still, it has not been systematically explored which factors influence this pain sensitivity readout. The aim of this study was to distinguish potential contributions of local tissue-related factors such as perfusion and thermoregulation or gain settings in nociceptive systems. Cold-pressor–sensitive and CP-insensitive students screened from a medical student laboratory course were recruited for a CP retest with additional cardiovascular and bilateral local vascular monitoring. In addition, comprehensive quantitative sensory testing according to Deutscher Forschungsverbund Neuropathischer Schmerz standards and a sustained pinch test were performed. Cold pressor was reproducible across sessions (Cohen kappa 0.61 ± 0.14, P < 0.005). At 30 seconds in ice water, CP-sensitive subjects exhibited not only more pain (78.6 ± 26.3 vs 29.5 ± 17.5, P < 0.0001) but also significantly stronger increases in mean arterial blood pressure (12.6 ± 9.3 vs 5.6 ± 8.1 mm Hg, P < 0.05) and heart rate (15.0 ± 8.2 vs 7.1 ± 6.2 bpm, P < 0.005), and lower baroreflex sensitivity, but not local or vasoconstrictor reflex–mediated microcirculatory responses. Cold-pressor–sensitive subjects exhibited significantly lower pain thresholds also for cold, heat, and blunt pressure, and enhanced pain summation, but no significant differences in Aδ-nociceptor–mediated punctate mechanical pain. In conclusion, differences in nociceptive signal processing drove systemic cardiovascular responses. Baroreceptor activation suppressed pain and cardiovascular responses more efficiently in CP-insensitive subjects. Cold-pressor sensitivity generalized to a pain trait of C-fiber–mediated nociceptive channels, which was independent of local thermal and vascular changes in the ice-water–exposed hand. Thus, the C-fiber pain trait reflects gain setting of the nociceptive system.

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“…It is a common belief is that the weather affects pain. Pressure pain tolerance and cold pain tolerance correlate with meteorological variables, and these findings suggest that weather has a causal and dynamic effect on pain tolerance [ 20 ]. Alterations in barometric pressure (BMP) have also been associated with triggering tension-type headaches but multiple studies have been performed with inconsistent results [ 21 ].…”

Section: Reviewmentioning

confidence: 99%

Intrafasciomembranal Fluid Pressure: A Novel Approach to the Etiology of Myalgias, Part II

Hopen¹

2023

Cureus

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The fascia forms a hierarchy of spaces (small and large compartments) that contain and enclose muscle fibers, fiber bundles, skeletal muscles, and compartments of several skeletal muscles. Solid fascia serves as a membrane that enables an increased volume and fluid pressure within such a fasciomembrane, an intrafasciomembrial fluid pressure (IFMFP). Increased IFMFP provides a theoretical model and a common explanation for the etiology of the myalgias: trigger point (TrP), chronic exertional compartment syndrome (CECS), overtraining syndrome (OTS), and delayed onset muscle soreness (DOMS). Many myalgias and their symptoms are poorly understood, and this review aims to provide an extension to this theoretical model and novel approach. This review suggests that the swelling from elevated IFMFP also likely leads to a longitudinal shortening of the same affected tissue. This model of swelling and shortening provides additional explanations for the changes in the lines of force through the body that can lead to changes in the body's posture and, thus, to compensatory movements. This new approximation also provides a biomechanical explanation for the thickening of the fascia and referred pain, and also suggests that IFMFP is a factor in weather-related pain.

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

Abstract: Supplemental Digital Content is Available in the Text. The temporal nonrandom variation in pain tolerance and the associations with meteorological variables suggest that weather has a causal and dynamic effect on pain tolerance

Cited by 8 publications

References 42 publications

Cold exposure and musculoskeletal conditions; A scoping review

Cold exposure and musculoskeletal conditions; A scoping review

Interindividual variability in cold-pressor pain sensitivity is not explained by peripheral vascular responding and generalizes to a C-nociceptor–specific pain phenotype

Intrafasciomembranal Fluid Pressure: A Novel Approach to the Etiology of Myalgias, Part II

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