Identifying Optimal Methods for Thermal Quantitative Sensory Testing

Objective: This study sought to investigate thermal pain sensitivity using two different numerical rating scales (NRS) and several different measures of thermal pain perception. This investigation also examined how gender and psychosocial factors such as dental anxiety and fear of pain predict thermal pain sensitivity. Methods: Participants were thirty-nine (twenty males and nineteen females) healthy individuals who completed a series of questionnaires assessing psychosocial factors. Two identical sessions of thermal testing were conducted using the pain and sensation NRS. The thermal tests measured pain threshold and tolerance, ratings of suprathreshold stimuli and temperatures that were matched to ratings of 25, 50, and 75 on the NRS. Results: Pain and sensation rating scales yielded similar pain reports, though the ratings using the pain scale tended to be slightly lower than the ratings using the sensation scale. The temperatures at which participants matched ratings of 25, 50 and 75 were significantly lower than predicted based on their actual pain ratings of stimuli at similar temperatures. For most pain measures collected, women reported greater sensitivity than men. Regarding psychological factors, higher fear of pain predicted greater sensitivity to pain in women, but not men. Surprisingly, greater dental anxiety was associated with lower pain ratings in men. Conclusion: These findings suggest that measurement of thermal pain sensitivity can be influenced by multiple factors, including the pain scales used, the nature of the testing protocols, and by individual difference factors such as gender and psychological variables. This research was supported by a UFCD Student Summer Research Fellowship, the Comprehensive Center for Pain Research, and NIH NS41670 and NS42754.