The Relationship Between Pain and Interoception: A Systematic Review and Meta-Analysis

Area of Science:

• Neuroscience
• Psychology
• Pain Research

Background:

• Interoception, the sensing of internal bodily states, is crucial for homeostasis.
• Dysfunctional interoception is hypothesized to play a role in the development of chronic pain.
• Limited research has explored interoceptive abilities specifically within various pain conditions.

Purpose of the Study:

• To systematically review and meta-analyze existing literature on interoceptive alterations in individuals experiencing pain.
• To assess interoceptive accuracy, sensibility, and awareness in pain populations compared to pain-free controls.
• To identify gaps in research concerning interoception in acute and recurrent pain states.

Main Methods:

• Systematic literature search across 4 electronic databases (inception to February 2023).
• Inclusion of 28 studies for meta-analysis of interoceptive accuracy, sensibility, and awareness.
• Assessment of risk of bias and certainty of evidence for all included analyses.

Main Results:

• Meta-analyses revealed significantly reduced interoceptive accuracy and increased interoceptive sensibility in individuals with chronic pain.
• Subgroup analyses showed interoceptive sensibility varied based on measurement tools, with higher attention to bodily sensations but lower emotional reactivity reported.
• No significant differences in interoceptive awareness were found between chronic pain patients and healthy controls.

Conclusions:

• Individuals with chronic pain exhibit diminished accuracy in sensing internal bodily signals, contrasting with their self-reported heightened interoceptive awareness.
• Current evidence for acute and recurrent pain is scarce, necessitating further investigation into these domains.
• The certainty of evidence across analyses was very low, warranting cautious interpretation of findings.