Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Mar 6;23(3):571-579.
doi: 10.1515/sjpain-2022-0084. Print 2023 Jul 26.

Temporal stability and responsiveness of a conditioned pain modulation test

Anders Galaasen Bakken  1 , Iben Axén  1 , Andreas Eklund  1 , Anna Warnqvist  2 , Søren O'Neill  3
Affiliations
Randomized Controlled Trial

Temporal stability and responsiveness of a conditioned pain modulation test

Anders Galaasen Bakken et al. Scand J Pain. .

Abstract

Objectives: Conditioned pain modulation is a commonly used quantitative sensory test, measuring endogenous pain control. The temporal stability of the test is questioned, and there is a lack of agreement on the effect of different pain conditions on the conditioned pain modulation response. Thus, an investigation of the temporal stability of a conditioned pain modulation test among patients suffering from persistent or recurrent neck pain is warranted. Further, an investigation into the difference between patients experiencing a clinically important improvement in pain and those not experiencing such an improvement will aid the understanding between changes in pain and the stability of the conditioned pain modulation test.

Methods: This study is based on a randomized controlled trial investigating the effect of home stretching exercises and spinal manipulative therapy vs. home stretching exercises alone. As no difference was found between the interventions, all participants were studied as a prospective cohort in this study, investigating the temporal stability of a conditioned pain modulation test. The cohort was also divided into responders with a minimally clinically important improvement in pain and those not experiencing such an improvement.

Results: Stable measurements of conditioned pain modulation were observed for all independent variables, with a mean change in individual CPM responses of 0.22 from baseline to one week with a standard deviation of 1.34, and -0.15 from the first to the second week with a standard deviation of 1.23. An Intraclass Correlation Coefficient (ICC3 - single, fixed rater) for CPM across the three time points yielded a coefficient of 0.54 (p<0.001).

Conclusions: Patients with persistent or recurrent neck pain had stable CPM responses over a 2 week course of treatment irrespective of clinical response.

Keywords: conditioned pain modulation; manual therapy; neck pain; quantitative sensory testing.

PubMed Disclaimer

References

    1. Nir, R-R, Yarnitsky, D. Conditioned pain modulation. Curr Opin Support Palliat Care 2015;9:131–7. https://doi.org/10.1097/SPC.0000000000000126 . - DOI
    1. Le Bars, D, Dickenson, AH, Besson, J-M. Diffuse noxious inhibitory controls (DNIC). I. Effects on dorsal horn convergent neurones in the rat. Pain 1979;6:283–304. https://doi.org/10.1016/0304-3959(79)90049-6 . - DOI
    1. Bars, DL, Dickenson, AH, Besson, J. Diffuse noxious inhibitory controls (DNIC). II. Lack of effect on non-convergent neurones, supraspinal involvement and theoretical implications. Pain 1979;6:305–27. https://doi.org/10.1016/0304-3959(79)90050-2 . - DOI
    1. Le Bars, D, Willer, J-C. Pain modulation triggered by high-intensity stimulation: implication for acupuncture analgesia? Int Congr 2002;1238:11–29. https://doi.org/10.1016/S0531-5131(02)00412-0 . - DOI
    1. Gerhardt, A, Eich, W, Treede, R-D, Tesarz, J. Conditioned pain modulation in patients with nonspecific chronic back pain with chronic local pain, chronic widespread pain, and fibromyalgia. Pain 2017;158:430–9. https://doi.org/10.1097/j.pain.0000000000000777 . - DOI

Publication types

LinkOut - more resources