Differential physiological effects during tonic painful hand immersion tests using hot and ice water

Abstract

a b s t r a c tThe cold pressor test (CPT) is an empirically validated test commonly used in research on stress, pain and cardiovascular reactivity. Surprisingly, the equivalent test with water heated to noxious temperatures (hot water immersion test, HIT) has not been thoroughly investigated. The aim of the present study was to characterize the physiological effects and psychophysics of both tests and to analyze whether the autonomic responses are mainly induced by baroreflexes or a consequence of the pain experience itself. The study consisted of a single session including one CPT (4 ± 0.2°C) and one HIT (47 ± 0.5°C; cut-off point 5 min) trial performed on 30 healthy drug free volunteers aged 19-57 (median 24) yrs. The sequence of both trials was alternated and participants were randomly assigned to sequence order and parallelized with respect to gender. Physiological parameters (cardiovascular, respiratory and electrodermal activity) and subjective pain intensity were continuously monitored. In addition, pain detection and tolerance thresholds as well as pain unpleasantness were assessed. Both tests were comparable with regard to the time course and intensity of subjective pain. However, a significantly higher increase of blood pressure could be observed during the CPT when compared to the HIT. The HIT appears less confounded with thermoregulatory baroreflex activity and therefore seems to be a more appropriate model for tonic pain.

Cold pressor stress affects cardiac attenuation of startle

“…The observed effects of stress on the CMS may be specific for the CP intervention. The CP test elicits vascular constriction, which is specific for cold water exposure (Streff et al, 2010) and is also indicated in our data by the reduction of pulse transit time. Venous pooling caused by the CP test (Brod et al, 1979) and, therefore, increased central venous pressure, may play a key role in the observed early effect on the CMS.…”

An Evaluation of Central Sensitization in Patients With Sickle Cell Disease

“…This task is similar to cold pressor testing in terms of eliciting a pain response. Hot water was chosen to avoid the possibility of prompting a vaso-occlusive crisis and avoids baroreflex activation [48]. Participants immersed the dominant hand in a circulating water bath maintained at a tailored temperature designed to be moderately painful.…”

Interpersonal Touch Buffers Pain Sensitivity in Romantic Relationships but Heightens Sensitivity between Strangers and Friends

“…Some studies expose the skin to radiant heat [16], heated water [17], or extreme cold (e.g., the cold pressor test) [18]. Other studies generate ischemic pain by obstructing blood flow in an extremity, as occurs when a blood pressure cuff is inflated [19].…”