Sexual Development, Pain History and Pain Sensitivity Assessed in Adolescents from the General Population

Reshaping chronic pain trajectories requires the early identification of individuals with higher background susceptibility. To address that, we quantified experimental pressure pain responses at 13 years of age in approximately 2000 adolescents from a Portuguese population-based birth cohort (Generation XXI), who already had an extensive longitudinal evaluation of reported pain history. By using computerized cuff pressure algometry, we were able to characterize a population range of experimental pain responses at a key stage for the development of chronic pain phenotypes, and to explore different influences, from physical development to psychosocial influences. When we examined pressure pain sensitivity according to sex at birth and pubertal development stage, pain detection and tolerance thresholds were similar between early pubertal boys and girls. However, both thresholds increased with pubertal development among boys, whereas they remained fairly constant among girls, suggesting Tanner stages 3-4 as key periods for the widening of sex differences in sensory dimensions of pressure pain. Our preliminary findings also suggest that pressure pain thresholds provide complementary information to reported pain, past or concurrent. Taking a life course approach to assessing pain sensitivity will allow us to build a more complete picture of the roots of adverse pain trajectories.