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Relations of pain threshold and pain tolerance in cold water with scores on Maudsley Personality Inventory and Manifest Anxiety Scale.

Testing 56 Japanese undergraduates, the relationships between pain threshold and pain tolerance in cold water and personality factors were investigated. Significant negative correlations of moderate magnitude between the pain threshold and scores on Maudsley Neuroticism and the Manifest Anxiety Scale were found. On the contrary, significant positive, moderate correlations between pain tolerance and the Maudsley Extraversion were obtained.

Cold Temperature

Effect of electronic dental anesthesia on pain threshold and pain tolerance levels of human teeth subjected to stimulation with an electric pulp tester.

The effect of electronic dental anesthesia on pain threshold and pain tolerance levels of human teeth subjected to stimulation with an electric pulp tester was evaluated. Subjects (n = 120) were randomly assigned to one of four experimental groups (baseline, placebo, square wave, and postsynaptic wave). Symptom-free right-sided maxillary incisor teeth were tested for anesthesia with an electric pulp tester. Electrostimulation significantly increased the pain perception threshold and pain tolerance level with both the square wave and postsynaptic wave. The postsynaptic wave was more effective than the square wave. Presented at the Satellite Symposium on Advances in the Management of Acute and Chronic Facial Pain associated with the 6th World Congress on Pain, Melbourne, Australia, 1990.

Adolescent

Muscle and bone pressure pain threshold and pain tolerance in fibromyalgia patients and controls.

Pressure pain thresholds and pressure pain tolerances on non-trigger-point muscle and bone were measured with a dolorimeter in 46 female patients with primary fibromyalgia and in 50 healthy women of the same age. The pressure pain thresholds and the pressure pain tolerances on both muscle and bone were lower in the fibromyalgia patients than in the healthy controls. All the differences were statistically highly significant, though there was a certain degree of overlapping between the patients and the controls. It is concluded that patients with primary fibromyalgia have a generalized amplification of pain sensitivity, a sign that might be useful in the diagnosis of fibromyalgia.

Adult

Effect of acupuncture of pain threshold and pain tolerance determined by electrical stimulation of the skin: a controlled study.

The effect of needling traditional acupuncture loci (Ho-Ku, LI4; Nei-Kuan, EH-6) compared to arbitarily chosen points was measured in twelve healthy subjects. In a crossover blind study pain tolerance and pain threshold were measured by electrical stimulation of the skin in the thyroid area. Traditional acupuncture was found to be significantly more effective in elevating pain threshold than needling of arbitarily chosen points. Pain tolerance also rose more under "real" acupuncture, the difference, however, being statistically not significant. In one subject, threshold and tolerance increased more under needling of nonacupuncture loci, while two subjects did not show any changes under either procedure.

Acupuncture Therapy

Effects of the synthetic enkephalin analogue FK 33-824 on pain threshold and pain tolerance in man.

Natural enkephalins exert weak and transitory analgesic effects. The synthetic enkephalin, FK 33-824 (FK), is less susceptible to metabolic breakdown and produces long-lasting analgesia in animals. The present studies examined the effects of FK on threshold and tolerance of electrically evoked pain in man under double blind conditions. 1.0 mg FK given intramuscularly (saline control) increased tolerance significantly without affecting the pain threshold, but also produced vasodilatation and feelings of oppression and heaviness (study I). In study II, where 50 mg betazole was employed as "placebo" because of its vasodilatatory effects, 1.0 mg FK increased pain tolerance significantly more than 0.25 mg FK while the threshold remained unchanged. Self-ratings of activation and well-being decreased; those of oppression increased, as did reaction time, equally after 0.25 and 1.0 mg FK but were not altered by betazole. In conclusion, 1.0 mg FK i.m. increases tolerance but not perception of pain, thus mimicking the analgesic effects of morphine.

Adult

Modification of human pain threshold by specific tactile receptors.

The effects of conditioning vibrotactile stimulation of particular tactile receptor groups on thresholds to painful electric stimuli were studied in seven healthy adults. Preferentially Pacinian afferents were activated with conditioning sinusoidal vibration of 240 Hz at 20 and 200 micrometers amplitudes and preferentially non-Pacinian tactile fibers were activated with conditioning sinusoidal vibration of 20 Hz at 200 and 400 micrometers amplitudes. None of the subjects showed pain threshold elevation during activation of non-Pacinian tactile fibers. However, 6 of the 7 subjects showed significant pain threshold elevation with conditioning vibration stimulus of 240 Hz at 200 micrometers amplitude, and 4 subjects showed significantly elevated pain thresholds with conditioning stimulus of 240 Hz at 20 micrometers amplitude. It is concluded that the activation of Pacinian afferents causes inhibition of pain conducting pathways.

Adult

Alterations in electrical pain thresholds by use of acupuncture-like transcutaneous electrical nerve stimulation in pain-free subjects.

Acupuncture-like transcutaneous electrical nerve stimulation (ALTENS) was compared with a placebo treatment in altering acute electrical pain thresholds. Ten pain-free subjects underwent, on different days, an acclimatization session, an ALTENS treatment, and a placebo treatment in a cross-over design. Electrical sensation and pain thresholds were measured from the tip of the index finger bilaterally at 15-minute intervals twice before, once during, and three times after a 30-minute treatment session. The ALTENS treatment was given at 4 Hz at an intensity just below pain threshold delivered to acupuncture points in the hand and wrist. The placebo treatment was similarly delivered, except that the intensity of stimulation was just above sensation threshold. Neither the ALTENS treatment nor the placebo treatment produced a significant change in pain threshold. There was no correlation between initial pain threshold and change in pain threshold. Implications for the modulation of pain are discussed.

Adult

Relations between experimentally induced tooth pain threshold changes, psychometrics and clinical pain relief following TENS. A retrospective study in patients with long-lasting pain.

The present study investigates the relationships between clinical pain relief, physiological and psychological parameters. Out of 50 patients with long-lasting musculoskeletal neck- and shoulder-pain treated with transcutaneous electrical nerve stimulation (TENS), 21 were selected and classified as responders (n = 13) or non-responders (n = 8). Tooth pain thresholds (PT) were measured before and after an experimental TENS treatment and the relative change in PT following the stimulation was calculated. Three psychometric self-inventories were administered: Zung Depression Scale, Spielberger's Trait Anxiety Scale and the Multidimensional Health Locus of Control Scale. Responders (R) and non-responders (NR) differed significantly from each other in the PT measurements as well as on the psychometric scales. NR exhibited higher levels of anxiety and depression, a more pronounced powerful other orientation and no change or a decrease in PT following TENS compared to R. These findings indicate relationships and interactions between physiological and psychological factors in patients with long-lasting pain.

Adult

Experimental pain thresholds and plasma beta-endorphin levels during exercise.

Experimental pain thresholds (electrical intracutaneous finger and dental pulp stimulation) and plasma hormone levels (beta-endorphin, cortisol, and catecholamines) were measured in ten healthy sportive men before, during, and after progressively more strenuous physical exercise. In a double-blind study conducted on two different days, 20 mg of the opioid-antagonist naloxone or placebo was administered prior to exercise. A significant pain threshold elevation was found during exercise for finger (ANOVA, P less than 0.004) and dental pulp stimulation (P less than 0.01). Pain threshold elevation was most pronounced during maximal exertion, at which time the subjects reported the greatest subjective fatigue. Thresholds remained elevated 10-15 min after the end of exercise, and, 60 min after exercise, thresholds returned to baseline values. The subjective magnitude estimation of suprathreshold stimuli was significantly reduced (P less than 0.0001) 5-10 min after exercise. Plasma beta-endorphin, cortisol, and catecholamines increased significantly (P less than 0.0005, all values) during exercise. Plasma beta-endorphin levels did not correlate significantly with pain thresholds (r = -0.37, NS). Naloxone failed to affect pain thresholds, although beta-endorphin and cortisol increased significantly more (P less than 0.02) during exercise after naloxone. It is concluded that short-term, exhaustive physical exercise can evoke a transient elevation in pain thresholds. This exercise-induced elevation in pain threshold does not, however, appear to be directly related to plasma endorphin levels.

Adult

Cephalic muscle tenderness and pressure pain threshold in a general population.

Tenderness and pain thresholds in pericranial muscles were studied in a general population. A random sample of 1000 adults aged 25-64 years was drawn as part of the Glostrup Population Studies, and 740 adults were examined. This study was part of a multifacetted, epidemiological study of different headache disorders according to the new headache classification. Manual palpation and pressure pain threshold with an electronic pressure algometer were performed by observers blinded to other information such as the person's history of headache, previous illness and mental state. The muscles most commonly tender to manual palpation were the lateral pterygoid (55%), the trapezius (52%), and the sternocleido-mastoid muscles (51%). Females were more tender than men in all the muscles examined by manual palpation. In total, the young age group was more tender than the old age group (P = 0.03). Pressure pain thresholds on temporal muscles showed lower thresholds in women than in men (P less than 10(-3)), and in the total population thresholds increased with age (P less than 0.05). No side-to-side difference in tenderness by manual palpation was found, while the right side showed increased pain thresholds in right-handed individuals (P less than 10(-4)). No side-to-side difference was found in left-handed persons. This study provides data about the normal population and forms the necessary basis for evaluating the importance of muscle tenderness in headache subjects and other selected groups.

Adult

Cervicogenic headache, migraine, and tension-type headache. Pressure-pain threshold measurements.

Pressure-pain threshold (PPT) measurements were performed with a pressure algometer, at 22 specified points in the head in patients with cervicogenic headache (n = 32), migraine (with and without aura) (n = 26) and tension-type headache (n = 17). Comparisons were made with a group of healthy controls (n = 20). The average PPT differed significantly between the groups (ANOVA, F = 9.5, P < 0.0005), largely caused by the low threshold in cervicogenic headache patients. There were no significant differences between controls and the 2 other headache groups. In the cervicogenic headache group, the lowest PPT was found in the occipital part of the head on the side with pain predominance. The ratio between the dominant and non-dominant sides (all 11 points on each side) was 0.85 in cervicogenic headache, whereas it was 0.99 in migraine patients with side preponderance of the pain. The present results support the view that the pathogenesis of cervicogenic headache differs from that of migraine and tension-type headache. The results may further support the theory that fibres from the C2 level (innervating the occipital part of the head) may be included in the pathogenetic mechanism in cervicogenic headache.

Adult

[A study of the regularity of pain threshold changes after trauma and the effect of electroacupuncture].

Pain threshold of rats was measured by the latent period of tail flick and limb withdrawal elicited by radiant heat. 52 male SD rats were used and trauma was produced by aseptic amputation just beneath the right ankle joint. The effect of nerve block and electroacupuncture (EA) was studied and non-traumatic groups were arranged as control. The pain threshold was reduced right after trauma and the lowest level appeared on the 3rd day and then recovered gradually up to the 7th day after trauma. Nerve block and EA markedly raised the pain threshold. Particularly, EA elevated pain threshold of traumatic rats more marked and long-lasted than the effect of nerve block. This may be resulted by mobilizing the functions of the endogenous analgesic systems.

Acupuncture Analgesia

Pain thresholds in rats during recovery from REM sleep deprivation.

Using 30 Sprague-Dawley female rats, threshold to pain was measured over the course of recovery from REM sleep deprivation. Relative to the untreated controls and to their own pretreatment thresholds, the REM-deprived animals showed significantly reduced pain thresholds which were still evident 96 hours after the termination of the REM deprivation. Possible implications of these data for research with analgesic drugs were noted.

Animals

Cephalic and extracephalic pressure pain thresholds in chronic tension-type headache.

Pressure pain thresholds were assessed with an algometer (Somedic Inc.), over the forehead, temple and suboccipital region as well as over the Achilles tendon. A group of 32 patients suffering from chronic tension-type headache was compared to 20 healthy controls and to 10 migraineurs without aura. Although individual values were widely scattered, pressure pain thresholds were on average significantly lower in chronic tension-type headache, not only at pericranial sites but also over the Achilles tendon. Only 50% of these patients had one or more pericranial thresholds 1.5 S.D. below the mean of controls. After muscular biofeedback therapy, all pain thresholds were on average increased. Along with results obtained previously, the present data support the hypothesis that diffuse disruption of central pain-modulating systems, possibly due to a modified limbic input to the brain-stem, is pivotal in the pathophysiology of chronic tension-type headache.

Adult

[On circadian variations of the placebo effect on the pain threshold of healthy teeth: Contribution to a physiology of placebo effects (author's transl)].

Placebo doses can influence the pain threshold of healthy teeth according to the label. Systematic longitudinal researches over the day with measuring the utilization time of cold stimulus on healthy front teeth demonstrate that the placebo effect is subject to significant circadian variations. During daytime a pseudo-analgesic causes a stronger and steeper onset of increase of the tooth pain threshold than during the night, when the pain threshold is influenced only minimal or even inverse. The placebo effect can come up to 40% of the pain threshold increase caused by a usual analgesic; this portion, however, is as well subject to high circadian variations. The extent of the placebo effect corresponds to the order of magnitude of the spontaneous circadian variations of pain threshold and correlates positively to it. These correlations are considered as indicating that those vegetative mechanisms causing the circadian variations of the pain threshold are equally involved in affecting the placebo actions.

Circadian Rhythm

Glycemic control of pain threshold in diabetic and control rats.

Pain threshold was assessed via tail flick latency in alloxan-diabetic, streptozotocin-diabetic, BB/W-diabetic, and control laboratory rats. In addition, tail flick latency was determined under conditions of both euglycemia (60-120 mg/dl) and hyperglycemia (greater than 250 mg/dl). Conditions of hyperglycemia resulted in a significant decrease in tail flick latency in both diabetic and control animals. More interestingly, tail flick latency was returned to control values in diabetic rats following normalization of blood glucose levels. It is concluded that elevated blood glucose levels result in a decrease in pain threshold in both diabetic and control rats. In addition, a permanent state of painful symptoms may be avoided in clinical diabetes by improvement of diabetic control.

Animals