Stress-induced allodynia--evidence of increased pain sensitivity in healthy humans and patients with chronic pain after experimentally induced psychosocial stress.
BACKGROUND
Experimental stress has been shown to have analgesic as well as allodynic effect in animals. Despite the obvious negative influence of stress in clinical pain conditions, stress-induced alteration of pain sensitivity has not been tested in humans so far. Therefore, we tested changes of pain sensitivity using an experimental stressor in ten female healthy subjects and 13 female patients with fibromyalgia.


METHODS
Multiple sensory aspects of pain were evaluated in all participants with the help of the quantitative sensory testing protocol before (60 min) and after (10 and 90 min) inducing psychological stress with a standardized psychosocial stress test ("Trier Social Stress Test").


RESULTS
Both healthy subjects and patients with fibromyalgia showed stress-induced enhancement of pain sensitivity in response to thermal stimuli. However, only patients showed increased sensitivity in response to pressure pain.


CONCLUSIONS
Our results provide evidence for stress-induced allodynia/hyperalgesia in humans for the first time and suggest differential underlying mechanisms determining response to stressors in healthy subjects and patients suffering from chronic pain. Possible mechanisms of the interplay of stress and mediating factors (e.g. cytokines, cortisol) on pain sensitivity are mentioned. Future studies should help understand better how stress impacts on chronic pain conditions.
Department of Psychosomatics and Psychotherapy, University Hospital Münster, Münster, Germany.
Benjamin
B
Crettaz
Martin
M
Marziniak
Peter
P
Willeke
Peter
P
Young
Dirk
D
Hellhammer
Astrid
A
Stumpf
Markus
M
Burgmer
D000328:Adult; D059350:Chronic Pain / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology; D006801:Humans; D006930:Hyperalgesia / Q000209:etiology / Q000503:physiopathology*; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology*; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold / Q000502:physiology; D011594:Psychometrics; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology*; D055815:Young Adult