Pain catastrophizing may moderate the association between pain and secondary hyperalgesia

Abstract

Catastrophizing, a persistent negative mental set characterized by helplessness, rumination, and magnification of pain sensations, has a potent effect on pain report and clinical outcomes. Previous studies have documented an association between cognitive factors and central sensitization.The current analysis sought to test the potential modulating effect of pain catastrophizing on the association between capsaicin pain and the region of secondary hyperalgesia. Thirty-eight healthy individuals (50% women, mean age = 25.7, SD = 5.3) completed the Pain Catastrophizing Scale (PCS), then underwent topical application of 10% capsaicin, which was covered by a thermode maintained at 40°C for 90-min. Following removal of the capsaicin, the region of secondary hyperalgesia was determined. Hayes' PROCESS macro was employed to examine catastrophizing's potential moderating effect, which did not reveal a significant association between capsaicin pain ratings and the region of secondary hyperalgesia (β = 15.1, p = .06). Though PCS was not associated with area of secondary hyperalgesia (β = 23.9, p = .29), a significant interaction was present between PCS and capsaicin pain ratings (β = 3.7, p = .0004). Specifically, those endorsing higher catastrophizing levels and higher pain ratings experienced the greatest areas of secondary hyperalgesia. The Johnson-Neyman technique was used to determine the regional effect of the moderation, which indicated that

Even mild catastrophic thinking is related to pain intensity in individuals with painful temporomandibular disorders

“…43 In an experimental pain setting, Pressman and co-workers found that in healthy individuals, relatively low levels of catastrophising (PCS 10.6) moderated the association between pain and such secondary hyperalgesia. 44 Therefore, in samples with similar subclinical levels of pain catastrophising such as ours, mild catastrophic thinking may be an early predictor of pain chronification, a notion that warrants further research.…”

“…The pain attention behaviour embedded in catastrophic thinking could, however, be a significant mediator in the transition from acute to chronic pain condition; a hyperalgesic state often associated with widespread pain 43 . In an experimental pain setting, Pressman and co‐workers found that in healthy individuals, relatively low levels of catastrophising (PCS 10.6) moderated the association between pain and such secondary hyperalgesia 44 …”