The Effect of Observing High or Low Pain on the Development of Central Sensitization

It is unknown whether watching other people in high pain increases mechanical hypersensitivity induced by pain. We applied high-frequency electrical stimulation (HFS) on the skin of healthy volunteers to induce pinprick mechanical hypersensitivity. Before HFS participants were randomly allocated to 2 groups: in the low pain group, which was the control condition, they watched a model expressing and reporting lower pain scores, in the high pain group the model expressed and reported higher scores. The 2 videos were selected on the basis of a pilot/observational study that had been conducted before. We tested the differences in perceived intensity of the HFS procedure, in the development of hypersensitivity and the role of fear and empathy. The high pain group reported on average higher pain ratings during HFS. The perceived intensity of hypersensitivity, but not the unpleasantness or the length of the area was higher in the high pain group. Our results suggest that watching a person expressing more pain during HFS increases one's own pain ratings during HFS and may weakly facilitate the development of secondary mechanical hypersensitivity, although this latter result needs replication. PERSPECTIVE: Observing a person in high pain can influence the perceived pain intensity of a procedure leading to secondary mechanical hypersensitivity, and has a weak effect on hypersensitivity itself. The role of fear remains to be elucidated.