Do Multiple Body Modifications Alter Pain Threshold?

In recent years, epidemiological data has shown an increasing number of young people who deliberately self-injure. There have also been parallel increases in the number of people with tattoos and those who voluntarily undergo painful procedures associated with piercing, scarification, and tattooing. People with self-injury behaviors often say that they do not feel the pain. However, there is no information regarding pain perception in those that visit tattoo parlors and piercing studios compared to those who don’t. The aim of this study was to compare nociceptive sensitivity in four groups of subjects (n=105, mean age 26 years, 48 women and 57 men) with different motivations to experience pain (i.e., with and without multiple body modifications) in two different situations; (1) in controlled, emotionally neutral conditions, and (2) at a "Hell Party" (HP), an event organized by a piercing and tattoo parlor, with a main event featuring a public demonstration of painful techniques (burn scars, hanging on hooks, etc.). Pain thresholds of the fingers of the hand were measured using a thermal stimulator and mechanical algometer. In HP participants, information about alcohol intake, self-harming behavior, and psychiatric history were used in the analysis as intervening variables. Individuals with body modifications as well as without body modifications had higher thermal pain thresholds at Hell Party, compared to thresholds measured at control neutral conditions. No such differences were found relative to mechanical pain thresholds. Increased pain threshold in all HP participants, irrespectively of body modification, cannot be simply explained by a decrease in the sensory component of pain; instead, we found that the environment significantly influenced the cognitive and affective component of pain.

The subjective sensation induced by various thermal pulse stimulation in healthy volunteers

AimsNovel quantitative thermal stimulator devices (QTSDs) have been developed to deliver thermal pulse stimulation with regulated constant temperatures (0–45°C) with a Peltier element probe (16 cm2). The aim of this study was to investigate subjective sensation induced by the interaction between simultaneously applied painful cold and heat stimuli in various sites.MethodsTwenty healthy subjects (12 men and 8 women, age range: 25–45 years) participated. The intensity of cold pain (CP) and heat pain (HP) stimuli were assessed by visual analogue scale (VAS) and adjusted to elicit approximately 70/100 mm. Alternately pulse stimulations (pulse duration of 40 s; 0.025 Hz) which consisted of CP, HP, or neutral temperature (32°C) were applied. Four conditions were tested and subjective sensations were assessed: (1) one QTSD was applied to non-dominant forearm and cold-heat pulse stimulation was applied.Two QTSDs were applied to (2) non-dominant ipsilateral forearm with 5 cm apart, (3) non-dominant and contralateral forearms, (4) non-dominant forearm and ipsilateral thigh, respectively. In conditions of (2)–(4), CP-neutral pulse stimulation (C-Neutral) and neutral-HP pulse stimulation (Neutral-H) were applied simultaneously with opposite phase, respectively.ResultsCP and HP were 3.9±1.0°C (mean±SD) and 43.6±0.9°C (mean±SD), respectively. The VAS values for CP and HP were 73.4±2.0 mm (mean±SD) and 76.4 ±4.8 mm (mean±SD), respectively. Some subjects could not discriminate cold or heat sensation and some felt cold as heat (paradoxical sensation). The number of subjects with such paradoxical sensation in (1), (2), (3), (4) were 9 (45%), 2 (10%), 0 (0%) and 3 (15%), respectively.ConclusionsIn healthy volunteers, simultaneous alternately cold-heat pulse stimulation on one site triggered paradoxical thermal sensation, which to a much less degree is triggered when C-Neutral and Neutral-H were applied to different dermatomes. This suggests that the mechanism is primarily triggered peripherally.

Offset analgesia evoked by non-contact thermal stimulator

ObjectiveThe objective of this study was to test if offset analgesia could be evoked using a noncontact thermal stimulator. Offset analgesia [J. Neurophysiol. 87:2205–2208, 2002] is defined as an unproportionally large decrease in pain intensity following a slight decrease in stimulation intensity. The importance of differences in thermal properties between human hairy and glabrous skin was investigated.MethodsA 20W diode laser (970 nm) was used for the thermal stimulation. A fast (50 images/s) infrared camera measured the skin temperature and a temperature controlled feedback control loop adjusted the laser power. 8 subjects participated in this study. Stimulations were applied on the dorsum side and in the palm of the hand. Subjects were instructed to continuously rate the pain intensity. First the subject was stimulated using both a rising 35–45 °C staircase and a decreasing 45–35 °C staircase in both skin types; each staircase step was 1 °C and lasted for 15 s. Offset analgesia was tested by stimulating the hairy skin on the dorsum of the hand using two sequential temperature plateaus (48–48 °C, 48–49 °C, 49–48 °C and 49–49 °C). Each plateau was held for 5 s.ResultsFor the staircase stimulations identical surface temperatures were perceived significantly higher in glabrous than in hairy skin (p < 0.001). The offset analgesia test showed that a decrease in temperature from 49 to 48 °C evoked a drop in the pain rating which was significantly lower than observed during a 48–48 °C stimulation (p < 0.001) indicating offset analgesia.ConclusionA non-contact thermal stimulator is able to evoke offset analgesia. Furthermore, it was noted that a high penetration laser causes higher pain ratings in glabrous skin than in hairy skin—a relationship which is opposite to low penetration lasers (CO2 laser) and contact heat stimulation.

Reduction of Postburn Hyperalgesia after Local Injection of Ketorolac in Healthy Volunteers

Background Nonsteroidal antiinflammatory drugs may be particularly effective against prostaglandin-mediated, post-injury hyperalgesia and related inflammatory pain. However, their usefulness may be limited by their systemic side effects. The current study determined if local effectiveness can be achieved by low-dose intradermal nonsteroidal antiinflamatory drug administration. Methods Ten healthy volunteers were asked to make magnitude estimations of the pain induced by a contact thermal stimulator at 1 degree C increments between 43 and 51 degrees C at three 1 x 1 cm study sites on each forearm during three study phases:(1) baseline; (2) after pretreatment with 10 microl 0.9% saline (n=1 site on each forearm), 0.3 mg ketorolac (n=1 on each forearm), or nothing (n=1 on each forearm); and (3) after "injury" by a mild burn at the ketorolac- and saline-treated sites on one arm or by injection of 10 nmol bradykinin at all three sites on the other arm. The effects of pretreatment on the pain induced by thermal testing were assessed using repeated-measures analysis of variance. Results Pretreatment with ketorolac had a selective effect on the postburn injury hyperalgesia, reducing the increase in pain intensity (P&lt;0.05) but not the decline in pain threshold. It had no effect on the responses to thermal stimuli before injury or on the pain of burning, which were similar at ketorolac- and saline-treated sites. The effect of pretreatment with ketorolac on bradykinin-induced hyperalgesia was not achieved after bradykinin injection at sites pretreated with saline as well as ketorolac.

Comparison of heat and mechanical receptive fields of cutaneous C-fiber nociceptors in monkey

1. Receptive-field properties were investigated in cutaneous C-fiber nociceptive afferents (CMH) responsive to mechanical and heat stimuli. Teased-fiber techniques were used to record from 28 CMHs that innervated the hairy skin of upper or lower limb in anesthetized monkeys. 2. The response to mechanical stimuli was studied with the use of calibrated von Frey probes. The response to heat stimuli was studied with the use of a laser thermal stimulator that provided stepped increases in skin temperature with rise times to the desired temperature near 100 ms. The size of the receptive field (RF) for mechanical stimuli was determined by use of a suprathreshold stimulus that consisted of a 0.5-mm-diam probe that exerted a 200-mN force (10 bar). The size of the heat RF was determined by use of a 49 degrees C stimulus applied to a 7.5-mm-diam area for 1 s. 3. Heat thresholds were determined with an ascending series of stimulus intensities and were found to be stable over many hours: they ranged from 37 to 46 degrees C (mean, 41.1 degrees C). Mechanical thresholds ranged from 1.3 to 7.3 bar (mean, 3.3 bar). There was no correlation between mechanical and heat thresholds. Both thresholds extended well below the corresponding psychophysical pain thresholds in the literature. This suggests that spatial and/or temporal summation of C-fiber input are important for pain induced by either stimulus modality. 4. Mechanical RF diameters ranged from 3.3 to 9.6 mm (mean, 4.7 mm); heat RF diameters ranged from punctate (less than 1 mm) to 9.5 mm (mean, 4.3 mm). There was a significant linear correlation between mechanical and heat RF sizes with a slope of one. The distance between the center of the mechanical RF and the center of the heat RF along one axis ranged from 0 to 1.1 mm (mean, 0.4 mm). These data indicate that the heat RFs coincided with the mechanical RFs. 5. Within the mechanical RF determined with the suprathreshold stimuli, all CMHs had one or more punctate areas of maximal mechanical sensitivity where mechanical threshold was lowest. Heat excitability extended greater than 2 mm beyond these mechanically sensitive spots. Because lateral transmission of the heat stimulus is small, this indicates that heat transduction occurs outside the regions of maximal mechanical sensitivity. 6. Both the threshold to heat and the response magnitude at suprathreshold intensities depended on the percentage of the RF area overlapped by the heat stimulus. This indicates that multiple transducer sites probably contribute to the total evoked response.(ABSTRACT TRUNCATED AT 400 WORDS)

Halothane sensitizes cutaneous nociceptors in monkeys

The effects of halothane on the responses of C-fiber (CMHs) and A-fiber (AMHs) nociceptive afferents sensitive to mechanical and heat stimuli were studied in monkeys. The response to heat stimuli was studied with use of a laser thermal stimulator that provided stepped increases in skin temperature over a 7.5-mm-diameter area with rise times to the desired temperature near 100 ms. Recordings were obtained from single fibers that innervated the glabrous skin of the hand using a teased-fiber dissection technique. In initial studies the response of 32 CMHs and 45 AMHs in monkeys anesthetized with pentobarbital sodium (3-6 mg X kg-1 X h-1) was compared with the response of 12 CMHs and 23 AMHs in monkeys anesthetized with a combination of halothane (0.8%) and N2O (67%). A standardized set of 10 3-s heat stimuli ranging from 41 to 49 degrees C delivered every 30 s were applied to the receptive field. Both AMHs and CMHs had a lower threshold and greater response to suprathreshold heat stimuli under conditions of halothane-N2O anesthesia. The threshold to mechanical stimuli, as tested by von Frey hairs, was not significantly different. Five CMHs and 5 AMHs were studied in a crossover study in which responses to the 41-49 degrees C stimuli were obtained first under halothane-N2O (0.8%-67%) anesthesia, then under an ultrashort acting barbiturate, methohexital (2-9 mg/kg over 15 min), and finally once again under halothane-N2O anesthesia. For the five CMHs, the mean cumulative response was 1.8 times greater, whereas for the five AMHs the response was 4.7 times greater under halothane as opposed to barbiturate anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)