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Expectations affect pain sensitivity changes during massage
Abigail T Wilson1,2, Mark D Bishop3,4, Jason M Beneciuk3,5
1School of Kinesiology and Physical Therapy, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA.
The Journal of Manual & Manipulative Therapy
|September 7, 2022
Summary
Positive expectations enhance pain relief during massage, while negative expectations can worsen pain perception. Understanding these psychological factors is crucial for effective pain management strategies involving manual therapy.
Area of Science:
- Neuroscience
- Psychology
- Pain Management
Background:
- Pain-inducing massage shares neurophysiological mechanisms with conditioned pain modulation, similar to cold pressor tasks.
- Both manual therapy and conditioned pain modulation are significantly influenced by participant expectations (positive or negative).
Purpose of the Study:
- To investigate the impact of positive and negative expectations on pain perception during both pain-free and pain-inducing massage.
- To explore how psychological expectations modulate neurophysiological responses to massage.
Main Methods:
- 56 healthy participants were randomized into positive or negative expectation groups.
- Participants received either pain-free or pain-inducing massage, with pressure pain threshold (PPT) measured throughout.
- A repeated measures ANCOVA analyzed interaction effects between massage type, expectation set, and PPT.
Main Results:
- A significant three-way interaction (massage x expectation x PPT) and a time x expectation interaction were found for pain-inducing massage.
- Participants with positive expectations showed significantly higher PPT at minutes 3 and 4 of pain-inducing massage compared to those with negative expectations.
Conclusions:
- Psychological expectations play a critical role in modulating pain sensitivity changes experienced during massage.
- Clinicians should consider the influence of patient expectations when administering pain-inducing massage to optimize outcomes.
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