Background & Aims
One of the most challenging health conditions to address is chronic widespread pain, the mechanisms of which are not fully understood. Studying chronic pain is crucial for several reasons. Chronic pain significantly impacts the quality of life for those affected, often leading to physical and psychological distress. Understanding the underlying mechanisms helps in developing more effective treatments, providing relief to individuals suffering from prolonged pain conditions. In present study, we utilized classical conditioning procedure to investigate whether the expanded area of pain results from classical conditioning between nociceptive stimuli originating from different nociceptive foci.
Methods
Ninety-four healthy participants were randomly assigned to one of three experimental groups or a control group. In the first group participant underwent classical conditioning through pairing of visual cues with the magnitude of the painful area. They were also informed through verbal suggestion, that one of the visual cues (blue or green slide) will announce pain distributed at larger area (pain induced via 2 electrodes) and the other cue will precede pain distributed at smaller area (pain induced via 1 electrode). In the second group participants were only exposed to classical conditioning without verbal suggestion while in the third group they only received verbal suggestion. Fourth group served as a control: participants were neither exposed to classical conditioning nor verbal suggestion. Nociceptive stimuli were administered through electrodes attached to participants’ hands, activating either two electrodes for large distribution or one for small distribution.
Results
Classical conditioning with verbal suggestion was effective at inducing pain at larger area despite nociceptive stimulation targeting small area of the body (p < 0.001). Furthermore, this effect was preserved even of two methods were used separately: Either classical conditioning alone (p < 0.05) or verbal suggestion alone (p < 0.01) produced conditioned pain distribution. We did not find statistical effect in the control group (p > 0.05).
Conclusions
Pain distribution can be shaped by associative learning and verbal suggestion. Classical conditioning alone, verbal suggestion alone or combined verbal suggestion with classical conditioning can be responsible for persisted widespread pain. Further research are needed to characterize boundaries of this effect.
References
Adamczyk, W. M., Wiercioch-Kuzianik, K., Bajcar, E. A., & B?bel, P. (2019). Rewarded placebo analgesia: A new mechanism of placebo effects based on operant conditioning. European Journal of Pain, 23(5), 923–935.
Babel, P., Adamczyk, W., Swider, K., Bajcar, E. A., Kicman, P., & Lisinska, N. (2018). How Classical Conditioning Shapes Placebo Analgesia: Hidden versus Open Conditioning. Pain Medicine (Malden, Mass.), 19(6), 1156–
B?bel, P., Bajcar, E. A., Adamczyk, W., Kicman, P., Lisi?ska, N., ?wider, K., & Colloca, L. (2017). Classical conditioning without verbal suggestions elicits placebo analgesia and nocebo hyperalgesia. PloS One, 12(7).
Diego, Fornasari. (2012). Pain mechanisms in patients with chronic pain.. Clinical Drug Investigation, 32(1):45-52. doi: 10.2165/11630070-000000000-00000
Presenting Author
Daria Nowak
Poster Authors
Daria Nowak
The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
Lead Author
Natalia Kruszyna
The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
Lead Author
Jakub Nastaj
M.A.
The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
Lead Author
Jacek Skalski
M.A.
The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
Lead Author
Tibor Szikszay
University of Luebeck
Lead Author
Kerstin Luedtke
University of Luebeck
Lead Author
Wac?aw M. Adamczyk
PhD
The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
Lead Author
Topics
- Mechanisms: Psychosocial and Biopsychosocial