title: Characteristics of sensitization associated with chronic pain conditions.
abstract: OBJECTIVE
  To describe and understand varieties and characteristics of sensitization contributing to hyperalgesia in participants with chronic pain conditions.
  
  
  METHODS
  Thermal stimulation was delivered to the face, forearm, and calf of pain-free participants and individuals with irritable bowel syndrome, temporomandibular pain disorder (TMD), and fibromyalgia syndrome (FM). Three-second contacts by a preheated thermode occurred at 30-second intervals in ascending and then in descending series (0.7°C steps).
  
  
  RESULTS
  Thermal pain ratings during ascending series were greater at each site in individuals diagnosed with chronic pain. Intense pain at the time of testing further enhanced the ratings at all sites, but mild or moderate clinical pain did not have this effect. Thermal pain in all participants was greater during descending series compared with the ascending series of arm and leg stimulation. The hypersensitivity during the descending series was comparable in pain-free, FM and TMD participants but was increased in duration for arm or leg stimulation of FM participants.
  
  
  CONCLUSIONS
  The widespread sensitization for irritable bowel syndrome and TMD participants does not rely on mechanisms of spatial and temporal summation often invoked to explain widespread hyperalgesia associated with chronic pain. Increased sensitivity during descending series of stimulation of an arm or leg but not the face indicates a propensity for sensitization of nociceptive input to the spinal cord. Abnormally prolonged sensitization for FM participants reveals a unique influence of widespread chronic pain referred to deep somatic tissues.
authors: Departments of ‡Behavioral Science †Prosthodontics, College of Dentistry Departments of §Community Health and Family Medicine *Neuroscience, College of Medicine, University of Florida, Gainesville, FL.
authors: Charles J
authors: CJ
authors: Vierck
authors: Fong
authors: F
authors: Wong
authors: Christopher D
authors: CD
authors: King
authors: Andre P
authors: AP
authors: Mauderli
authors: Siegfried
authors: S
authors: Schmidt
authors: Joseph L
authors: JL
authors: Riley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000503:physiopathology*; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology; D006358:Hot Temperature; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology / Q000523:psychology; D043183:Irritable Bowel Syndrome / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009619:Nociceptors / Q000502:physiology; D010147:Pain Measurement; D011601:Psychophysics; D013696:Temperature; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology; D055815:Young Adult
references: Pain. 2002 Sep;99(1-2):49-59
references: 12237183
references: Pain. 1998 May;76(1-2):71-81
references: 9696460
references: J Neurophysiol. 1997 Aug;78(2):992-1002
references: 9307129
references: Pain. 2006 Oct;124(3):242-263
references: 16842915
references: Pain. 2008 Oct 15;139(2):315-323
references: 18538477
references: J Appl Physiol (1985). 2001 Dec;91(6):2611-8
references: 11717226
references: J Orofac Pain. 2007 Fall;21(4):309-17
references: 18018992
references: Circulation. 2002 Jun 18;105(24):2817-20
references: 12070106
references: Exp Brain Res. 1999 Jun;126(4):482-94
references: 10422711
references: Pain. 1996 Aug;66(2-3):105-8
references: 8880830
references: Clin J Pain. 2012 Sep;28(7):595-601
references: 22699135
references: Clin Gastroenterol Hepatol. 2010 Feb;8(2):125-9; discussion 129-36
references: 20152787
references: Pain. 2010 Jan;148(1):49-58
references: 19889500
references: Pain. 2009 Jun;143(3):172-178
references: 19278784
references: J Pain. 2007 Nov;8(11):893-901
references: 17681887
references: Pain. 2003 Mar;102(1-2):87-95
references: 12620600
references: J Pain. 2011 Feb;12(2):297-303
references: 21146468
references: Pain Res Treat. 2012;2012:951354
references: 22110947
references: Pain Res Treat. 2012;2012:981565
references: 22110948
references: Cells Tissues Organs. 2005;180(1):69-75
references: 16088135
references: Pain. 2005 May;115(1-2):5-11
references: 15836964
references: J Physiol. 1984 Nov;356:443-58
references: 6520794
references: Pain. 2003 Jan;101(1-2):167-74
references: 12507711
references: Pain. 2010 Mar;148(3):454-461
references: 20074857
references: J Orofac Pain. 2009 Winter;23(1):54-64
references: 19264036
references: Pain. 2007 Dec 5;132(3):301-311
references: 17533117
references: Clin J Pain. 2007 May;23(4):323-30
references: 17449993
references: World J Gastroenterol. 2009 Jul 14;15(26):3254-60
references: 19598301
references: Brain Res. 2010 Aug 6;1347:58-64
references: 20537988
references: J Pain. 2005 May;6(5):323-32
references: 15890634
references: Pain Res Treat. 2010;2010:912513
references: 22110917
references: Pain. 2004 Aug;110(3):689-696
references: 15288410
references: J Rheumatol Suppl. 2005 Aug;75:22-8
references: 16078357
references: J Pain. 2009 May;10(5):542-52
references: 19411061
references: J Orofac Pain. 2004 Winter;18(1):41-55
references: 15029872
references: Eur J Pain. 2010 Jan;14(1):11-6
references: 19261494
references: Pain. 1995 Dec;63(3):341-351
references: 8719535
references: J Dent Res. 2007 Dec;86(12):1187-92
references: 18037653
references: Ann Behav Med. 2001 Summer;23(3):215-26
references: 11495222
references: Pain. 2001 Mar;91(1-2):165-75
references: 11240089
references: J Pain. 2006 Aug;7(8):529-35
references: 16885007
references: J Appl Physiol (1985). 2010 Dec;109(6):1880-6
references: 20884834
references: Pain Res Treat. 2010;2010:949027
references: 22110918
references: Exp Brain Res. 2006 Apr;170(2):182-90
references: 16328284
references: J Neurosci Methods. 2010 Apr 30;188(1):83-8
references: 20149824