Related Experiment Video

Updated: Jan 21, 2026

Author Spotlight: Quantifying Pain Experience – An Illustrative Approach Using the Pain Body Diagram

Author Spotlight: Quantifying Pain Experience – An Illustrative Approach Using the Pain Body Diagram

Published on: July 7, 2023

Endogenous pain modulation in children with functional abdominal pain disorders

Roselien Pas^1,2,3, Emma Rheel^1,2, Sophie Van Oosterwijck^3,4

¹Pain in Motion International Research Group.

|July 24, 2019

Insights

Young children with functional abdominal pain disorders exhibit heightened pain sensitivity and impaired pain modulation. Their endogenous analgesic systems function less effectively, contributing to their condition.

Area of Science:

Pediatric Gastroenterology
Pain Medicine
Neuroscience

Background:

Functional abdominal pain disorders (FAPDs) are prevalent in children, yet the underlying pain mechanisms remain poorly understood.
Endogenous analgesic mechanisms, crucial for pain regulation, have not been extensively studied in pediatric FAPD populations.

Purpose of the Study:

To compare conditioned pain modulation (CPM) and pressure pain thresholds (PPTs) in children with FAPD versus healthy controls.
To investigate psychosocial factors, including pain-related fear and parental catastrophizing, in pediatric FAPD.

Main Methods:

A case-control study involving 39 children with FAPD (aged 6-12) and 36 pain-free controls.
Utilized pressure algometry for PPTs and the cold pressor task for CPM assessment.
Employed validated questionnaires for child and parent-reported outcomes.

Main Results:

Children with FAPD demonstrated significantly lower PPTs across all tested sites, indicating heightened pain sensitivity (secondary hyperalgesia).
A reduced CPM response was observed in children with FAPD, suggesting impaired endogenous pain inhibition.
Children with FAPD reported greater functional disability and pain-related fear, with higher parental pain catastrophizing.

Conclusions:

Pediatric FAPD is associated with altered pain processing, including secondary hyperalgesia and deficient endogenous analgesia.
Psychosocial factors like pain-related fear and parental catastrophizing are elevated in this population.
Findings highlight the complex interplay of biological and psychosocial factors in pediatric FAPD.

Read full analysis

Abstract:

Functional abdominal pain disorders (FAPDs) are common among young individuals. To date, relatively little is known regarding the function of the endogenous analgesic mechanisms in this vulnerable group. Therefore, this case-control study aimed to compare conditioned pain modulation (CPM), pressure algometry, and psychosocial variables in 39 young children (aged 6-12 years) with FAPD and 36 age- and sex-matched pain-free controls. Pressure algometry was used to assess pressure pain thresholds (PPTs) at both symptomatic (umbilicus) as remote (trapezius and tibia) test sites. Conditioned pain modulation was recorded as an increase in the PPT at the trapezius test site in response to experimental conditioning pain imposed by the cold pressor task (12 ± 1°C). The assessors were blinded to the diagnoses. Parent-proxy and/or self-reported questionnaires were used to assess child's pain intensity, functional disability, pain-related fear, and parental pain catastrophizing. Compared with pain-free controls, young children with FAPD showed lower PPTs at all test sites (P < 0.05), a lower CPM response (P = 0.02), more functional disability (P < 0.001), and pain-related fear (P < 0.001). Parents of children with FAPD catastrophized more about their child's pain than parents of healthy children (P < 0.001). No sex differences were found for the experimental pain measurements (P > 0.05), nor was there a significant correlation between the child- and parent-reported questionnaires and the CPM effect (P > 0.05). In summary, young children with FAPD demonstrated secondary hyperalgesia and decreased functioning of endogenous analgesia.

More Related Videos

An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP

An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP

Published on: January 27, 2010

Intracranial Pharmacotherapy and Pain Assays in Rodents

Intracranial Pharmacotherapy and Pain Assays in Rodents

Published on: April 9, 2019

Related Concept Videos

Pain

Pain

Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...

Analgesia and Pain Management

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...

Primary Motives: Sleep, Sex, and Pain Avoidance

Primary Motives: Sleep, Sex, and Pain Avoidance

Primary motives such as sleep, sex, and pain avoidance are crucial drivers of behavior in humans and animals. These motives ensure survival, reproductive success, and overall well-being by prompting actions that meet essential bodily needs.
Sleep is a fundamental physiological drive that fosters a state of restfulness crucial for several bodily functions. It facilitates body restoration, the process by which the body repairs, rejuvenates, and maintains itself during sleep, including memory...

Intrinsically Disordered Proteins

Intrinsically Disordered Proteins

Intrinsically disordered proteins are a group of proteins that do not fold into specific three-dimensional structures. Their structural flexibility allows them to complement ordered proteins to perform functions that are inaccessible to rigid structures. They are more common in eukaryotes than prokaryotes and may either be exclusively intrinsically disordered or hybrid proteins, consisting of a mix of ordered and disordered regions. The absence of a rigid structure in these proteins can be...

Abdominal Aorta

Abdominal Aorta

Once the aorta traverses the diaphragmatic plane at the aortic hiatus, it is known as the abdominal aorta. This anatomical structure is positioned leftward of the spinal column, encased within a cocoon of adipose tissue behind the peritoneal cavity. It terminates at the L4 vertebra, where it splits into the common iliac arteries. Prior to this bifurcation, the abdominal aorta gives rise to several vital branches.
The celiac trunk, a singular artery, divides into the left gastric artery, which...

Ultrasound I: Abdominal Ultrasonography

Ultrasound I: Abdominal Ultrasonography

Introduction:
Abdominal ultrasonography, commonly known as abdominal ultrasound, is a vital, non-invasive medical imaging technique widely used in healthcare.
Procedure:
This diagnostic tool allows the clinician to visually inspect internal structures within the abdomen, including vital organs such as the liver, gallbladder, pancreas, kidneys, and spleen.
The abdominal ultrasound process begins with applying a special gel to the patient's skin over the abdomen. This gel enhances the...

Articles linked to this work by shared authors, journal, and citation graph.

Adapting Tension-Type Headache to the International Association for the Study of Pain (IASP) Taxonomy: A Conceptual Proposal.

Biomedicines·2026

The role of fatigue and sleep quality in the link between pain severity, perceived injustice and pain catastrophizing in breast cancer survivors with pain: a network analysis.

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer·2026

Clinical applications of epigenetic signatures in chronic pain management and health outcome prediction.

Epigenomics·2026

Validity and reliability of remote administration of the one-leg stand, timed up and go and 30-second sit-to-stand via video call in patients with lumbar spinal stenosis awaiting decompression surgery.

BMC musculoskeletal disorders·2026

Predictive socio-cultural factors of pain intensity, disability, and quality of life in patients with nonspecific musculoskeletal pain: a prospective cohort study.

Pain·2026

Pregnant women's experiences of the digital self-care program women-in-motion to manage physical activity and pelvic girdle pain: A qualitative study.

Digital health·2026

See all related articles