The Predictive Value of Mechanistic Pain Profiling, and How this Can Enrich Clinical Pain Research

Patients with long-standing and severe chronic pain demonstrated lowered pain thresholds, facilitated temporal summation of pain, and impaired conditioned pain modulation when compared with pain-free subjects, and these assessments form the basis for a mechanistic pain profile. Recent evidence suggests that some patients are more pain sensitive than others and that pre-treatment pain sensitive pain mechanistic profiles are associated with poor pain-relieving response to standard pain treatment (e.g., surgery, NSAID treatment, and exercise therapy). Anti-depressants (such as serotonin-noradrenaline re-uptake inhibitors) might interact with the pain profiles, but the evidence is mixed. Emerging evidence suggests that mechanistic pain profiles can be modulated by cognitive factors, and that these are related to e.g., sleep deprivation.

This talk will provide an overview of mechanistic pain profiling of patients with chronic pain with a focus on osteoarthritis, and how these profiles are linked to treatment outcomes. This talk will discuss factors associated with the modulation of mechanistic pain profiles with focus on duloxetine and sleep deprivation, and how mechanistic pain profiles might enrich clinical trials in future.