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The influence of sex and pain catastrophizing on conditioned pain modulation in athletes

Title:

The influence of sex and pain catastrophizing on conditioned pain modulation in athletes

Patlan, Ilana (2023) The influence of sex and pain catastrophizing on conditioned pain modulation in athletes. Masters thesis, Concordia University.

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Abstract

Context: Recent findings suggests that athletes have enhance pain modulatory systems compared to non-athletes, despite being constantly subjected to painful stimuli through training and competition. Measurements such as conditioned pain modulation (CPM) is one test that we can use to compare modulatory pain processes. CPM has been shown to be different in non-athlete males and females, but to our knowledge, no study has examined the sex differences in CPM in athletes. In addition, psychological factors, including pain catastrophizing, may explain why athletes perceive and express pain differently. Objective: To compare the sex differences in pain ratings, pressure pain threshold (PPT), and cardiovascular variables in athletes during a CPM protocol; and to determine influence of pain catastrophizing and other psychological factors with pain and cardiovascular variables recorded during a CPM protocol. Design: Cross-sectional design. Setting: Laboratory. Participants: 120 athletes (60 females) from various sports participated in this study. Main Outcome Measures: We measured catastrophizing using the Pain Catastrophizing Scale and pain using an 11-point numeric pain rating scale. CPM was measured using pressure pain threshold (PPT), which was measured on the thenar eminence and tibialis anterior before and after a cold pressor test (CPT). Results: During the CPT, participants experienced increases in subjective pain ratings, but pain intensity did not differ between males and females. We observed increases in PPT measures following the CPT in males and females, but males displayed higher PPT measures than females at pre- and post-CPT. In addition, we did not identify a relationship between any psychological factors and subjective pain ratings during the CPT. Conclusions: Our results suggest that psychological factors do not influence pain perception during a CPT and that male athletes present greater PPT measures than female athletes.

Divisions:Concordia University > Faculty of Arts and Science > Health, Kinesiology and Applied Physiology
Item Type:Thesis (Masters)
Authors:Patlan, Ilana
Institution:Concordia University
Degree Name:M. Sc.
Program:Health and Exercise Science
Date:29 March 2023
Thesis Supervisor(s):Dover, Geoffrey
Keywords:Conditioned pain modulation, athletes, pain catastrophizing, pressure pain threshold, cold pressor test, cardiovascular measures
ID Code:992036
Deposited By: Ilana Patlan
Deposited On:21 Jun 2023 14:53
Last Modified:21 Jun 2023 14:53

References:

1. Yarnitsky D. Role of endogenous pain modulation in chronic pain mechanisms and treatment. Pain. 2015;156:S24-S31.
2. Yarnitsky D, Arendt-Nielsen L, Bouhassira D, et al. Recommendations on terminology and practice of psychophysical DNIC testing. Eur J Pain. 2010;14(4):339.
3. Pud D, Granovsky Y, Yarnitsky D. The methodology of experimentally induced diffuse noxious inhibitory control (DNIC)-like effect in humans. Pain. 2009;144(1-2):16-19.
4. Kennedy DL, Kemp HI, Ridout D, Yarnitsky D, Rice ASC. Reliability of conditioned pain modulation: a systematic review. Pain. 2016;157(11):2410-2419.
5. Lewis GN, Rice DA, McNair PJ. Conditioned pain modulation in populations with chronic pain: a systematic review and meta-analysis. J Pain. 2012;13(10):936-944.
6. Lewis GN, Heales L, Rice DA, Rome K, McNair PJ. Reliability of the conditioned pain modulation paradigm to assess endogenous inhibitory pain pathways. Pain Res Manag. 2012;17(2):98-102.
7. Le Bars D, Dickenson AH, Besson J. Diffuse noxious inhibitory controls (DNIC). I. Effects on dorsal horn convergent neurones in the rat. Pain. 1979;6(3):283-304.
8. Le Bars D, Dickenson AH, Besson J. Diffuse noxious inhibitory controls (DNIC). II. Lack of effect on non-convergent neurones, supraspinal involvement and theoretical implications. Pain. 1979;6(3):305-327.
9. Staud R. The important role of CNS facilitation and inhibition for chronic pain. Int J Clin Rheumtol. 2013;8(6):639-646.
10. Yarnitsky D, Bouhassira D, Drewes AM, et al. Recommendations on practice of conditioned pain modulation (CPM) testing. Eur J Pain. 2015;19(6):805-806.
11. Mitchell LA, MacDonald RAR, Brodie EE. Temperature and the cold pressor test. The Journal of Pain. 2004;5(4):233-237.
12. McDougall J, Jutzeler CR, Scott A, Crocker PRE, Kramer JLK. Conditioned pain modulation in elite athletes: a systematic review and meta-analysis. Scand J Pain. 2020;20(3):429-438.
13. Etherton J, Lawson M, Graham R. Individual and gender differences in subjective and objective indices of pain: gender, fear of pain, pain catastrophizing and cardiovascular reactivity. Appl Psychophysiol Biofeedback. 2014;39(2):89-97.
14. Lentini M, Scalia J, Lebel FB, et al. Association Between Pain Catastrophizing and Pain and Cardiovascular Changes During a Cold-Pressor Test in Athletes. Journal of Athletic Training. 2021;56(5):473-483.
15. Granot M, Weissman-Fogel I, Crispel Y, et al. Determinants of endogenous analgesia magnitude in a diffuse noxious inhibitory control (DNIC) paradigm: do conditioning stimulus painfulness, gender and personality variables matter? Pain. 2008;136(1-2):142-149.
16. Park G, Kim CW, Park SB, Kim MJ, Jang SH. Reliability and usefulness of the pressure pain threshold measurement in patients with myofascial pain. Ann Rehabil Med. 2011;35(3):412-417.
17. Olesen SS, van Goor H, Bouwense SAW, Wilder-Smith OHG, Drewes AM. Reliability of Static and Dynamic Quantitative Sensory Testing in Patients With Painful Chronic Pancreatitis. Regional Anesthesia & Pain Medicine. 2012;37(5):530-536.
18. Nuwailati R, Bobos P, Drangsholt M, Curatolo M. Reliability of conditioned pain modulation in healthy individuals and chronic pain patients: a systematic review and meta-analysis. Scand J Pain. 2022;22(2):262-278.
19. Oono Y, Nie H, Matos RL, Wang K, Arendt-Nielsen L. The inter- and intra-individual variance in descending pain modulation evoked by different conditioning stimuli in healthy men. Scand J Pain. 2011;2(4):162-169.
20. Miranda J, Lamana SMS, Dias EV, Athie M, Parada CA, Tambeli CH. Effect of pain chronification and chronic pain on an endogenous pain modulation circuit in rats. Neuroscience. 2015;286:37-44.
21. Ossipov MH, Dussor GO, Porreca F. Central modulation of pain. The Journal of Clinical Investigation. 2010;120(11):3779-3787.
22. Tesarz J, Schuster AK, Hartmann M, Gerhardt A, Eich W. Pain perception in athletes compared to normally active controls: A systematic review with meta-analysis. Pain. 2012;153(6):1253-1262.
23. Sullivan MJL, Tripp DA, Rodgers WM, Stanish W. Catastrophizing and pain perception in sport participants. Journal of Applied Sport Psychology. 2000;12(2):151-167.
24. Pettersen SD, Aslaksen PM, Pettersen SA. Pain Processing in Elite and High-Level Athletes Compared to Non-athletes. Front Psychol. 2020;11:9.
25. Scott V, Gijsbers K. Pain perception in competitive swimmers. Br Med J (Clin Res Ed). 1981;283(6284):91-93.
26. Thornton C, Sheffield D, Baird A. longitudinal exploration of pain tolerance and participation in contact sports. Scand J Pain. 2017;16:36-44.
27. Manning EL, Fillingim RB. The influence of athletic status and gender on experimental pain responses. The Journal of Pain. 2002;3(6):421-428.
28. Geva N, Defrin R. Enhanced pain modulation among triathletes: a possible explanation for their exceptional capabilities. Pain. 2013;154(11):2317-2323.
29. Flood A, Waddington G, Cathcart S. Examining the relationship between endogenous pain modulation capacity and endurance exercise performance. Res Sports Med. 2017;25(3):300-312.
30. Assa T, Geva N, Zarkh Y, Defrin R. The type of sport matters: Pain perception of endurance athletes versus strength athletes. Eur J Pain. 2019;23(4):686-696.
31. Tesarz J, Gerhardt A, Schommer K, Treede RD, Eich W. Alterations in endogenous pain modulation in endurance athletes: an experimental study using quantitative sensory testing and the cold-pressor task. Pain. 2013;154(7):1022-1029.
32. Peterson JA, Schubert DJ, Campbell J, Bemben MG, Black CD. Endogenous Pain Inhibitory Function: Endurance-Trained Athletes vs Active Controls. Pain Medicine. 2019;20(9):1822-1830.
33. Deroche T, Woodman T, Stephan Y, Brewer B, Scanff C. Athletes' inclination to play through pain: A coping perspective. Anxiety, stress, and coping. 2011;24:579-587.
34. Sullivan MJL, Bishop SR, Pivik J. The Pain Catastrophizing Scale: Development and validation. Psychological Assessment. 1995;7(4):524-532.
35. Sullivan MJL, Thorn B, Haythornthwaite JA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17(1):52-64.
36. Quartana PJ, Campbell CM, Edwards RR. Pain catastrophizing: a critical review. Expert Rev Neurother. 2009;9(5):745-758.
37. Weissman-Fogel I, Sprecher E, Pud D. Effects of catastrophizing on pain perception and pain modulation. Exp Brain Res. 2008;186(1):79-85.
38. Keefe FJ, Rumble ME, Scipio CD, Giordano LA, Perri LM. Psychological aspects of persistent pain: current state of the science. J Pain. 2004;5(4):195-211.
39. Ellis A. Reason and emotion in psychotherapy. Oxford, England: Lyle Stuart; 1962.
40. Beck AT. Cognitive therapy of depression. Guilford press; 1979.
41. Chaves JF, Brown JM. Spontaneous cognitive strategies for the control of clinical pain and stress. J Behav Med. 1987;10(3):263-276.
42. Rosenstiel AK, Keefe FJ. The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain. 1983;17(1):33-44.
43. Mannes Zachary LZ, Mannes ZL, Ferguson EG, Ennis N. Negative Health Consequences of Pain Catastrophizing Among Retired National Football League Athletes. Health Psychology. 2020;39(5):452-462.
44. Tripp DA, Stanish W, Ebel-Lam A, Brewer BW, Birchard J. Fear of reinjury, negative affect, and catastrophizing predicting return to sport in recreational athletes with anterior cruciate ligament injuries at 1 year postsurgery. Sport, Exercise, and Performance Psychology. 2011;1(S):38-48.
45. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S240-252.
46. Kregel J, van Wilgen CP, Zwerver J. Pain assessment in patellar tendinopathy using pain pressure threshold algometry: an observational study. Pain Med. 2013;14(11):1769-1775.
47. Dover G, Amar V. Development and Validation of the Athlete Fear Avoidance Questionnaire. J Athl Train. 2015;50(6):634-642.
48. Spielberger C, Gorsuch R, Lushene R, Vagg PR, Jacobs G. Manual for the State-Trait Anxiety Inventory. Vol IV1983.
49. Barnes LL, Barnes LLB, Harp D, Jung WS. Reliability generalization of scores on the Spielberger state-trait anxiety inventory. Educational and Psychological Measurement. 2002;62(4):603-618.
50. Cohen J. Statistical power analysis for the behavioural sciences. 2nd Ed. ed. Hillside, NJ.: Lawrence Erlbaum Associates.; 1988.
51. Berkley KJ. Sex differences in pain. Behavioral and Brain Sciences. 1997;20(3):371-380.
52. Unruh AM. Gender variations in clinical pain experience. Pain. 1996;65(2-3):123-167.
53. Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL, 3rd. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009;10(5):447-485.
54. Bartley EJ, Fillingim RB. Sex differences in pain: a brief review of clinical and experimental findings. Br J Anaesth. 2013;111(1):52-58.
55. Fillingim R. Biopsychosocial contributions to sex differences in pain. BJOG: An International Journal of Obstetrics & Gynaecology. 2015;122(6):769-769.
56. Samulowitz A, Gremyr I, Eriksson E, Hensing G. "Brave Men" and "Emotional Women": A Theory-Guided Literature Review on Gender Bias in Health Care and Gendered Norms towards Patients with Chronic Pain. Pain Res Manag. 2018;2018:6358624.
57. Riley Iii JL, Robinson ME, Wise EA, Myers CD, Fillingim RB. Sex differences in the perception of noxious experimental stimuli: a meta-analysis. Pain. 1998;74(2):181-187.
58. Tousignant-Laflamme Y, Marchand S. Excitatory and inhibitory pain mechanisms during the menstrual cycle in healthy women. Pain. 2009;146(1-2):47-55.
59. Cimmino MA, Ferrone C, Cutolo M. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2011;25(2):173-183.
60. Sullivan MJL, Tripp DA, Santor D. Gender differences in pain and pain behavior: The role of catastrophizing. Cognitive Therapy and Research. 2000;24(1):121-134.
61. Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choinière M. A systematic literature review of 10 years of research on sex/gender and experimental pain perception - part 1: are there really differences between women and men? Pain. 2012;153(3):602-618.
62. Chesterton LS, Barlas P, Foster NE, Baxter DG, Wright CC. Gender differences in pressure pain threshold in healthy humans. Pain. 2003;101(3):259-266.
63. Popescu A, LeResche L, Truelove EL, Drangsholt MT. Gender differences in pain modulation by diffuse noxious inhibitory controls: A systematic review. Pain. 2010;150(2):309-318.
64. George SZ, Hirsh AT. Psychologic influence on experimental pain sensitivity and clinical pain intensity for patients with shoulder pain. J Pain. 2009;10(3):293-299.
65. Dixon KE, Thorn BE, Ward LC. An evaluation of sex differences in psychological and physiological responses to experimentally-induced pain: a path analytic description. Pain. 2004;112(1-2):188-196.
66. Leblanc J, Hildes JA, Heroux O. Tolerance of Gaspe fishermen to cold water. J Appl Physiol. 1960;15:1031-1034.
67. Brändström H, Wiklund U, Karlsson M, Ängquist KA, Grip H, Haney M. Autonomic nerve system responses for normal and slow rewarmers after hand cold provocation: effects of long-term cold climate training. Int Arch Occup Environ Health. 2013;86(3):357-365.
68. Kvist J, Ek A, Sporrstedt K, Good L. Fear of re-injury: a hindrance for returning to sports after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2005;13(5):393-397.
69. Loucks AB. Energy balance and body composition in sports and exercise. J Sports Sci. 2004;22(1):1-14.
70. Levine FM, Lee De Simone L. The effects of experimenter gender on pain report in male and female subjects. Pain. 1991;44(1):69-72.
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