Appraisals of pain from controlled stimuli: Relevance to quantitative sensory testing


Correspondence should be addressed to Erin A. Dannecker, University of Missouri-Columbia, Department of Physical Therapy, 106 Lewis Hall, Columbia, MO 65211-4250, USA (e-mail:


Objective Sensory testing has been advocated for the diagnosis, prognosis, and outcome evaluation of pain patients, but responses to controlled stimuli have not been well correlated to clinical pain. As an initial step for improving the clinical relevance of sensory testing, this investigation compared appraisals of and responses to controlled pain stimuli.

Design A prospective within subjects design was used.

Methods Heat, ischaemic, and delayed-onset muscle pain were induced in the upper extremity of 44 participants (47.7% women) during four experimental sessions.

Results The threat of heat and ischaemic pain was higher than delayed-onset muscle pain (F2, 86=5.30, p<.01, η2=.11). Threat, challenge, predictability, and controllability were related to heat pain most consistently. The affective-sensory ratios of ischaemic and delayed-onset muscle pain resembled those of clinical pain and were higher than heat pain (F2, 84=11.64, p<.01, η2=.22). Delayed-onset muscle pain meaningfully affected daily activities, which correlated to delayed-onset muscle pain ratings (rs=.60–.68, ps <.001).

Conclusions Heat stimuli may be well suited for instructional manipulations of appraisals to improve the clinical relevance of quantitative sensory testing and delayed-onset muscle pain's effects on daily activities are clinically relevant.