Can Quantitative Sensory Testing Move Us Closer to Mechanism-based Pain Management?

Overview

Journal Pain Med

Specialties Critical Care
Neurology
Psychiatry

Date 2013 Sep 10

PMID 24010588

Citations 114

Authors

Yenisel Cruz-Almeida

Roger B Fillingim

Affiliations

Soon will be listed here.

Abstract

Objective: This review summarizes the scientific literature relating to the use of quantitative sensory testing (QST) for mechanism-based pain management.

Design: A literature search was undertaken using PubMed and search terms including quantitative sensory testing, pain, chronic pain, response to treatment, outcome measure.

Settings And Patients: Studies including QST in healthy individuals and those with painful disorders were reviewed.

Measures: Publications reported on QST methodological issues including associations among measures and reliability. We also included publications on the use of QST measures in case-control studies, their associations with biopsychosocial mechanisms, QST measures predicting clinical pain, as well as predicting and reflecting treatment responses.

Results: Although evidence suggests that QST may be useful in a mechanism-based classification of pain, there are gaps in our current understanding that need to be addressed including making QST more applicable in clinical settings. There is a need for developing shorter QST protocols that are clinically predictive of various pain subtypes and treatment responses without requiring expensive equipment. Future studies are needed, examining the clinical predictive value of QST including sensitivity and specificity for pain classification or outcome prediction. These findings could enable third-party payers' reimbursement, which would facilitate clinical implementation of QST.

Conclusions: With some developments, QST could become a cost-effective and clinically useful component of pain assessment and diagnosis, which can further our progress toward the goal of mechanism-based personalized pain management.

Citing Articles

Understanding Cognition, Oxytocin, and Pain in Elders (UCOPE): protocol for a double-blinded cross-over trial in chronic knee osteoarthritis pain.

Cruz-Almeida Y, Montesino-Goicolea S, Valdes-Hernandez P, Huo Z, Staud R, Ebner N Trials. 2025; 26(1):44.

PMID: 39920837 PMC: 11806790. DOI: 10.1186/s13063-024-08715-4.

Gender differences in clinical presentations and sensory profiles in patients with fibromyalgia: implications of peripheral and central mechanisms.

Liu M, Harris S, Andreou A, Bo X, Al-Kaisy A Pain Rep. 2025; 10(1):e1229.

PMID: 39816906 PMC: 11732657. DOI: 10.1097/PR9.0000000000001229.

Pain sensitization and pain-related psychological factors in patients with temporomandibular disorders: an observational cross-sectional study.

Menendez-Torre A, Martin-Pintado-Zugasti A, Paris-Alemany A, Bocos-Corredor E, Molina-Alvarez M, Arribas-Romano A Clin Oral Investig. 2024; 28(11):594.

PMID: 39400763 DOI: 10.1007/s00784-024-05954-2.

The Link between Endogenous Pain Modulation Changes and Clinical Improvement in Fibromyalgia Syndrome: A Meta-Regression Analysis.

Pacheco-Barrios K, Filardi R, Gonzalez-Gonzalez L, Park N, Petrus F, Navarro-Flores A Biomedicines. 2024; 12(9).

PMID: 39335610 PMC: 11428716. DOI: 10.3390/biomedicines12092097.

Clinical and biobehavioral phenotypic assessments and data harmonization for the RE-JOIN research consortium: Recommendations for common data element selection.

Cruz-Almeida Y, Mehta B, Haelterman N, Johnson A, Heiting C, Ernberg M Neurobiol Pain. 2024; 16:100163.

PMID: 39281853 PMC: 11399706. DOI: 10.1016/j.ynpai.2024.100163.

References

Cruz-Almeida Y, Riley 3rd J, Fillingim R . Experimental pain phenotype profiles in a racially and ethnically diverse sample of healthy adults. Pain Med. 2013; 14(11):1708-18. PMC: 3983947. DOI: 10.1111/pme.12203. View

Dirks J, Petersen K, Dahl J . The heat/capsaicin sensitization model: a methodologic study. J Pain. 2003; 4(3):122-8. DOI: 10.1054/jpai.2003.10. View

Tampin B, Slater H, Hall T, Lee G, Briffa N . Quantitative sensory testing somatosensory profiles in patients with cervical radiculopathy are distinct from those in patients with nonspecific neck-arm pain. Pain. 2012; 153(12):2403-2414. DOI: 10.1016/j.pain.2012.08.007. View

Granot M, Sprecher E, Yarnitsky D . Psychophysics of phasic and tonic heat pain stimuli by quantitative sensory testing in healthy subjects. Eur J Pain. 2003; 7(2):139-43. DOI: 10.1016/S1090-3801(02)00087-3. View

Agostinho C, Scherens A, Richter H, Schaub C, Rolke R, Treede R . Habituation and short-term repeatability of thermal testing in healthy human subjects and patients with chronic non-neuropathic pain. Eur J Pain. 2008; 13(8):779-85. DOI: 10.1016/j.ejpain.2008.10.002. View

Kosek E, Ordeberg G . Lack of pressure pain modulation by heterotopic noxious conditioning stimulation in patients with painful osteoarthritis before, but not following, surgical pain relief. Pain. 2000; 88(1):69-78. DOI: 10.1016/S0304-3959(00)00310-9. View

Arendt-Nielsen L, Yarnitsky D . Experimental and clinical applications of quantitative sensory testing applied to skin, muscles and viscera. J Pain. 2009; 10(6):556-72. DOI: 10.1016/j.jpain.2009.02.002. View

Franz M, Spohn D, Ritter A, Rolke R, Miltner W, Weiss T . Laser heat stimulation of tiny skin areas adds valuable information to quantitative sensory testing in postherpetic neuralgia. Pain. 2012; 153(8):1687-1694. DOI: 10.1016/j.pain.2012.04.029. View

Rhudy J, DelVentura J, Terry E, Bartley E, Olech E, Palit S . Emotional modulation of pain and spinal nociception in fibromyalgia. Pain. 2013; 154(7):1045-56. PMC: 3679206. DOI: 10.1016/j.pain.2013.03.025. View

10.

Staud R, Robinson M, Price D . Temporal summation of second pain and its maintenance are useful for characterizing widespread central sensitization of fibromyalgia patients. J Pain. 2007; 8(11):893-901. PMC: 2174917. DOI: 10.1016/j.jpain.2007.06.006. View

11.

Claus D, Hilz M, Neundorfer B . Thermal discrimination thresholds: a comparison of different methods. Acta Neurol Scand. 1990; 81(6):533-40. DOI: 10.1111/j.1600-0404.1990.tb01015.x. View

12.

Hassett A, Simonelli L, Radvanski D, Buyske S, Savage S, Sigal L . The relationship between affect balance style and clinical outcomes in fibromyalgia. Arthritis Rheum. 2008; 59(6):833-40. DOI: 10.1002/art.23708. View

13.

Edwards R, Sarlani E, Wesselmann U, Fillingim R . Quantitative assessment of experimental pain perception: multiple domains of clinical relevance. Pain. 2005; 114(3):315-319. DOI: 10.1016/j.pain.2005.01.007. View

14.

Price D, Hu J, Dubner R, Gracely R . Peripheral suppression of first pain and central summation of second pain evoked by noxious heat pulses. Pain. 1977; 3(1):57-68. DOI: 10.1016/0304-3959(77)90035-5. View

15.

Finan P, Buenaver L, Bounds S, Hussain S, Park R, Haque U . Discordance between pain and radiographic severity in knee osteoarthritis: findings from quantitative sensory testing of central sensitization. Arthritis Rheum. 2012; 65(2):363-72. PMC: 3863776. DOI: 10.1002/art.34646. View

16.

King C, Wong F, Currie T, Mauderli A, Fillingim R, Riley 3rd J . Deficiency in endogenous modulation of prolonged heat pain in patients with Irritable Bowel Syndrome and Temporomandibular Disorder. Pain. 2009; 143(3):172-178. PMC: 3629692. DOI: 10.1016/j.pain.2008.12.027. View

17.

Riley 3rd J, King C, Wong F, Fillingim R, Mauderli A . Lack of endogenous modulation and reduced decay of prolonged heat pain in older adults. Pain. 2010; 150(1):153-160. PMC: 3631013. DOI: 10.1016/j.pain.2010.04.020. View

18.

Quevedo A, Coghill R . Filling-in, spatial summation, and radiation of pain: evidence for a neural population code in the nociceptive system. J Neurophysiol. 2009; 102(6):3544-53. PMC: 2804406. DOI: 10.1152/jn.91350.2008. View

19.

Neddermeyer T, Fluhr K, Lotsch J . Principle components analysis of pain thresholds to thermal, electrical, and mechanical stimuli suggests a predominant common source of variance. Pain. 2008; 138(2):286-291. DOI: 10.1016/j.pain.2007.12.015. View

20.

Harrison G, Young A, McMahon S . Ultraviolet radiation-induced inflammation as a model for cutaneous hyperalgesia. J Invest Dermatol. 2004; 122(1):183-9. DOI: 10.1046/j.0022-202X.2003.22119.x. View