Pain catastrophizing has been associated with higher pain intensity, increased risk of developing chronic pain and poorer outcomes after pain treatments. Despite this, the mechanisms by which pain catastrophizing influences pain remain poorly understood. It has been hypothesised that pain catastrophizing may impair descending inhibition of spinal level nociception. The aims of this study were to compare spinal nociceptive processing in people with chronic widespread pain and pain free controls and examine potential relationships between measures of pain catastrophizing and spinal nociception.
26 patients with chronic widespread pain and 22 healthy pain-free individuals participated in this study. Spinal nociception was measured using the nociceptive flexion reflex (NFR) threshold and NFR inhibition, measured as the change in NFR area during exposure to a second, painful conditioning stimulus (cold water immersion). Pain catastrophizing was assessed using the pain catastrophizing scale and a situational pain catastrophizing scale.
Compared to pain free controls, patients with chronic widespread pain had higher pain catastrophizing scores and lower NFR thresholds. While NFR area was reduced by a painful conditioning stimulus in healthy controls, this was not apparent in individuals with chronic widespread pain. No significant correlations were observed between measures of pain catastrophizing and spinal nociception.
Despite increased excitability and decreased inhibition of spinal nociception in patients with chronic widespread pain, we could find no evidence of a significant relationship between pain catastrophizing and measures of spinal nociceptive processing.