title: Demographic Predictors of Pain Sensitivity: Results From the OPPERA Study.
abstract: The demographic factors of sex, age, and race/ethnicity are well recognized as relevant to pain sensitivity and clinical pain expression. Of these, sex differences have been the most frequently studied, and most of the literature describes greater pain sensitivity for women. The other 2 factors have been less frequently evaluated, and current literature is not definitive. Taking advantage of the large Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study cohort, we evaluated the association of sex, age, and self-reported race with 34 measures of pressure, mechanical, and thermal pain sensitivity encompassing threshold and suprathreshold perception. Women were significantly more pain-sensitive than men for 29 of 34 measures. Age effects were small, and only significant for 7 of 34 measures, however, the age range was limited (18-44 years of age). Race/ethnicity differences varied across groups and pain assessment type. Non-Hispanic white individuals were less pain-sensitive than African-American (for 21 of 34 measures), Hispanic (19 of 34), and Asian (6 of 34) individuals. No pain threshold measure showed significant racial differences, whereas several suprathreshold pain measures did. This suggests that racial differences are not related to tissue characteristics or inherent nociceptor sensitivity. Rather, the differences observed for suprathreshold pain ratings or tolerance are more likely related to differences in central nociceptive processing, including modulation imposed by cognitive, psychological, and/or affective factors.
  
  
  
  The influence of sex, age, and race/ethnicity on various aspects of pain sensitivity, encompassing threshold and suprathreshold measures and multiple stimulus modalities, allows for a more complete evaluation of the relevance of these demographic factors to acute pain perception.
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Cara
authors.initials: C
authors.lastname: Ostrom
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Center for Pain Research and Innovation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Endodontics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Eric
authors.initials: E
authors.lastname: Bair
authors.affiliation: Center for Pain Research and Innovation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Endodontics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: William
authors.initials: W
authors.lastname: Maixner
authors.affiliation: Department of Neural and Pain Sciences, and Brotman Facial Pain Clinic, University of Maryland School of Dentistry, Baltimore, Maryland.
authors.forename: Ronald
authors.initials: R
authors.lastname: Dubner
authors.affiliation: Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida.
authors.forename: Roger B
authors.initials: RB
authors.lastname: Fillingim
authors.affiliation: Department of Oral Diagnostic Services, University at Buffalo, Buffalo, New York.
authors.forename: Richard
authors.initials: R
authors.lastname: Ohrbach
authors.affiliation: Center for Pain Research and Innovation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Gary D
authors.initials: GD
authors.lastname: Slade
authors.affiliation: Department of Neural and Pain Sciences, and Brotman Facial Pain Clinic, University of Maryland School of Dentistry, Baltimore, Maryland. Electronic address: jgreenspan@umaryland.edu.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Greenspan
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000523:psychology*; D016022:Case-Control Studies; D015331:Cohort Studies; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005157:Facial Pain / Q000208:ethnology* / Q000523:psychology*; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology; D008297:Male; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold / Q000523:psychology*; D010812:Physical Stimulation / Q000009:adverse effects; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012727:Sex Characteristics; D014481:United States; D055815:Young Adult
keywords: Quantitative sensory testing; ethnic differences; heat pain; pain sensitivity; pressure pain; racial differences; sex differences