title: The influence of repeated pain stimulation on the emotional aspect of pain: a preliminary study in healthy volunteers.
abstract: OBJECTIVE
  Pain is a multidimensional experience with sensory-discriminative, cognitive-evaluative, and affective-motivational components. Emotional factors, such as unpleasantness or anxiety, are known to have influence on pain in humans. Repeated painful stimulation has been reported to reduce subjective pain intensity. Nevertheless, there is little evidence of the influence of such stimulation on the emotional factors of pain. The aim of this study was to evaluate the influence of repeated painful stimulation on the experience of unpleasantness and anxiety.
  
  
  METHODS
  Eight subjects (six females, two males) volunteered to participate in this study. Subjects received repeated painful stimulation for 3 consecutive days each instance lasting 6 seconds, 60 times per day, on the medial side of the forearm of the nondominant hand. We examined the following items to evaluate changes of responses to painful stimulation: pain thresholds, pain tolerance levels, pain intensities, unpleasantness, and anxiety. Furthermore, pain thresholds and pain tolerance levels were compared between different sites on the ipsilateral and contralateral forearms.
  
  
  RESULTS
  No immediate or chronological changes in pain thresholds or pain tolerance levels were observed. Pain intensities were reduced significantly over the 3-day experimental period (P<0.05). On the other hand, there was no great change in unpleasantness during the 3-day period. Anxiety was increased significantly after the painful stimulation compared with that without the painful stimulation and before day 1 of the stimulation (P<0.05).
  
  
  CONCLUSIONS
  These results suggest that repeated painful stimulation may result in habituation to pain intensities but not habituation to emotional factors.
authors.affiliation: Department of Physical Therapy, Faculty of Health Science, Kio University, Koryo-cho, Kitakatsuragi-gun, Nara, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maeoka
authors.affiliation: Department of Physical Therapy, Faculty of Health Science, Kio University, Koryo-cho, Kitakatsuragi-gun, Nara, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Hiyamizu
authors.affiliation: Department of Physical Therapy, Faculty of Health Science, Kio University, Koryo-cho, Kitakatsuragi-gun, Nara, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Matsuo
authors.affiliation: Department of Physical Therapy, Faculty of Health Science, Kio University, Koryo-cho, Kitakatsuragi-gun, Nara, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Morioka
keywords: anxiety; habituation; pain intensity; unpleasantness