Conditioned pain modulation is affected by occlusion cuff conditioning stimulus intensity, but not duration

Thumbnail Image
File version
Accepted Manuscript (AM)
Smith, A
Pedler, A
Griffith University Author(s)
Primary Supervisor
Other Supervisors
File type(s)

Background: Various conditioned pain modulation (CPM) methodologies have been used to investigate diffuse noxious inhibitory control pain mechanisms in healthy and clinical populations. Occlusion cuff parameters have been poorly studied. We aimed to investigate whether occlusion cuff intensity and/or duration influenced CPM magnitudes. We also investigated the role of physical activity levels on CPM magnitude.

Methods: Two studies were performed to investigate the role of intensity and duration of occlusion cuff conditioning stimulus on test stimulus (tibialis anterior pressure pain thresholds). In Study 1, conditioning stimulus intensity of 2/10 or 5/10 (duration <20 s) was evaluated using a paired‐samples t‐test. In Study 2, duration of 2/10 conditioning stimulus was 3 min. One‐way repeated‐measures ANOVA was used to investigate the effect of time (0, 1, 2 and 3 min) on CPM magnitude.

Results: In Study 1, 27 healthy volunteers (mean ± SD: 24.9 years (±4.5); eight female) demonstrated that an occlusion cuff applied to the upper arm eliciting 5/10 local pain resulted in a significant (mean ± SD: 17% ± 46%) increase in CPM magnitude, when compared to 2/10 intensity (−3% ± 38%, p = 0.026), whereas in Study 2, 25 healthy volunteers (22.5 years (±2.7); 13 female) demonstrated that 3 min of 2/10 CS intensity did not result in a significant change in CPM (p = 0.21). There was no significant relationship between physical activity levels and CPM in either study (p > 0.22).

Conclusions: This study demonstrated that an occlusion cuff of 5/10 conditioning stimulus intensity, when compared to 2/10, significantly increased CPM magnitude. Maintaining 2/10 conditioning stimulus for 3 min did not increase CPM magnitude.

Significance: Dysfunctional conditioned pain modulation (CPM) has been associated with poor health outcomes. Various factors can influence CPM outcomes. The role of occlusion cuff conditioning stimulus intensity and duration has not been previously investigated. Intensity (5/10), but not duration of lower intensity (2/10) conditioning stimulus, affects CPM magnitude.

Journal Title
European Journal of Pain
Conference Title
Book Title
Thesis Type
Degree Program
Publisher link
Patent number
Grant identifier(s)
Rights Statement
© 2018 European Pain Federation - EFIC. This is the peer reviewed version of the following article: Conditioned pain modulation is affected by occlusion cuff conditioning stimulus intensity, but not duration, European Journal of Pain, Volume 22(1) Pages 94-102, 2018, which has been published in final form at DOI 10.1002/ejp.1093. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (
Rights Statement
Item Access Status
Access the data
Related item(s)
Clinical sciences
Clinical sciences not elsewhere classified
Pharmacology and pharmaceutical sciences
Persistent link to this record