Traumatic Life Experience and Pain Sensitization: Meta-analysis of Laboratory Findings

Namrata Nanavaty, Christopher G. Thompson, Mary W. Meagher, Carly McCord, Vani A. Mathur

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations

Abstract

Objectives: Psychological trauma often co-occurs with pain. This relationship has been explored using laboratory pain measures; however, findings have been mixed. Previous studies have limited operationalization of trauma (eg, posttraumatic stress disorder) or pain (eg, pain thresholds), which may contribute to conflicting results. Further, prior reviews likely underrepresent trauma experiences among people who are not receiving clinical care, limiting generalizability. Materials and Methods: We systematically reviewed the existing literature on the relationship between psychological trauma (eg, car accidents, sexual assault, childhood abuse, neglect) and laboratory pain (ie, quantitative sensory testing measures of pain threshold, intensity, summation, modulation), using inclusive criteria. The direction of the relationship between psychological trauma and pain sensitivity was evaluated, and moderation by purported pain mechanism (ie, pain detection, suprathreshold pain, central sensitization, inhibition) was explored. Results: Analyses were conducted using 48 studies that provided 147 effect sizes. A multivariate random-effects model with robust variance estimation resulted in a small but statistically significant overall effect size of g=0.24 (P=0.0002), reflecting a positive association between psychological trauma and enhanced laboratory pain sensitivity. Upon examination of mechanistic moderators, this relationship appears driven by effects on pain detection (g=0.28, P=0.002) and central sensitization (g=0.22, P=0.04). While effect sizes were similar across all moderators, effects on suprathreshold pain and inhibition were not statistically significant. Discussion: Findings demonstrate an overall pattern of trauma-related pain enhancement and point to central sensitization as a key underlying mechanism.

Original languageEnglish (US)
Pages (from-to)15-28
Number of pages14
JournalClinical Journal of Pain
Volume39
Issue number1
DOIs
StatePublished - Jan 14 2023

Keywords

  • adversity
  • PTSD
  • QST
  • temporal summation
  • trauma

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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