Conditioned pain modulation and psychological factors in young adults with recurrent or chronic neck pain

Alberto Arribas-Romano, Josué Fernández-Carnero, Yeray González-Zamorano, Leonardo Rodríguez-Lagos, Francisco Gurdiel-Álvarez, Miguel Molina-Álvarez, David Morales Tejera, Francisco Mercado-Romero

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Controversy exists with the presence of alterations in descending pain inhibition mechanisms in patients with non-specific neck pain (NSNP). The aim of the present study was to evaluate the status of conditioned pain modulation CPM, remote pressure pain thresholds (PPT), and psychological factors in a specific subgroup of patients with NSNP such as young adult students. In addition, possible associations between CPM, psychological factors, and pain characteristics were analyzed.

METHODS: Thirty students with recurrent or chronic NSNP and 30 pain-free students were included in this cross-sectional study. The following measures were assessed: CPM, remote PPT, psychological factors (depression, anxiety, pain catastrophizing, and kinesiophobia), pain characteristics (duration, intensity, severity of chronic pain, interference with daily life), and central sensitization inventory (CSI).

RESULTS: No significant differences were found in the efficacy of CPM between students with chronic or recurrent NSNP and pain-free students (β coefficient = -0.67; 95% CI = -1.54, 0.20). However, students with pain showed a significantly higher remote PPT (mean difference = -1.94; 95% CI = -2.71, -1.18). and a greater presence of anxious (mean difference = 6; 95% CI = 2, 9) and depressive symptoms (mean difference = 8.57; 95% CI = 3.97, 13.16). In addition, significant moderate or strong correlations were found between CPM and pain intensity (partial r = 0.41), pain catastrophizing and mean pain intensity (r = 0.37), grade (r = 0.50), and interference of pain (r = 0.57), kinesiophobia and disability (r = 0.38), and depression and CSI (r = 0.39).

CONCLUSIONS: Young adult students with chronic or recurrent NSNP present remote hyperalgesia and symptoms of depression and anxiety but not dysfunctional CPM.

Original languageEnglish
Article number13313
Pages (from-to)419-430
Number of pages12
JournalPain Practice
Issue number3
Early online date2023
Publication statusPublished - Mar 2024

Bibliographical note

Publisher Copyright:
© 2023 World Institute of Pain.


  • neck pain
  • psychological factors
  • central pain mechanism
  • central sensitization
  • conditioned pain modulation


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