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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

CiteScore 2017: 0.84

SCImago Journal Rank (SJR) 2017: 0.401
Source Normalized Impact per Paper (SNIP) 2017: 0.452

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Volume 13, Issue 1


Pressure and cold pain threshold reference values in a large, young adult, pain-free population

Robert Waller
  • Corresponding author
  • School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia 6845, Australia
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Anne Julia Smith
  • School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia 6845, Australia
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  • De Gruyter OnlineGoogle Scholar
/ Peter Bruce O’Sullivan
  • School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia 6845, Australia
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  • De Gruyter OnlineGoogle Scholar
/ Helen Slater
  • School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia 6845, Australia
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  • De Gruyter OnlineGoogle Scholar
/ Michele Sterling
  • RECOVER Injury Research Centre, NHMRC Centre of Research Excellence in Road Traffic Injury, Menzies Health Institute, Griffith University, QLD, 4222, Australia
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  • De Gruyter OnlineGoogle Scholar
/ Joanne Alexandra McVeigh
  • School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia 6845, Australia
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/ Leon Melville Straker
  • School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia 6845, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2016-10-01 | DOI: https://doi.org/10.1016/j.sjpain.2016.08.003


Background and aims

Currently there is a lack of large population studies that have investigated pain sensitivity distributions in healthy pain free people. The aims of this study were: (1) to provide sex-specific reference values of pressure and cold pain thresholds in young pain-free adults; (2) to examine the association of potential correlates of pain sensitivity with pain threshold values.


This study investigated sex specific pressure and cold pain threshold estimates for young pain free adults aged 21–24 years. A cross-sectional design was utilised using participants (n =617) from the Western Australian Pregnancy Cohort (Raine) Study at the 22-year follow-up. The association of site, sex, height, weight, smoking, health related quality oflife, psychological measures and activity with pain threshold values was examined. Pressure pain threshold (lumbar spine, tibialis anterior, neck and dorsal wrist) and cold pain threshold (dorsal wrist) were assessed using standardised quantitative sensory testing protocols.


Reference values for pressure pain threshold (four body sites) stratified by sex and site, and cold pain threshold (dorsal wrist) stratified by sex are provided. Statistically significant, independent correlates of increased pressure pain sensitivity measures were site (neck, dorsal wrist), sex (female), higher waist-hip ratio and poorer mental health. Statistically significant, independent correlates of increased cold pain sensitivity measures were, sex (female), poorer mental health and smoking.


These data provide the most comprehensive and robust sex specific reference values for pressure pain threshold specific to four body sites and cold pain threshold at the dorsal wrist for young adults aged 21–24 years. Establishing normative values in this young age group is important given that the transition from adolescence to adulthood is a critical temporal period during which trajectories for persistent pain can be established.


These data will provide an important research resource to enable more accurate profiling and interpretation of pain sensitivity in clinical pain disorders in young adults. The robust and comprehensive data can assist interpretation of future clinical pain studies and provide further insight into the complex associations of pain sensitivity that can be used in future research.

Keywords: Reference values; Pain thresholds; Pain sensitivity; Quantitative sensory testing; Raine study


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About the article

School of Physiotherapy and Exercise Science, Building 408, Level 3, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia. Fax: +161 9266 3699.

Received: 2016-06-06

Revised: 2016-07-27

Accepted: 2016-08-03

Published Online: 2016-10-01

Published in Print: 2016-10-01

Ethical issues: Ethics approval for the Raine Study Cohort 22 year follow up was obtained from the University of Western Australia (UWA) (RA/4/1/5202).

Author contributions: Significant contributions to this work were made by all authors listed: conception and design (RW, AS, POS, MS, LS), literature review (RW, AS, POS, HS, JMcV, LS), data collection (RW, AS, LS), statistical analysis (RW, AS, HS, LS), writing design (RW, AS, POS, HS, JMcV, LS).

Funding: The 22 year Raine Study follow-up was funded by NHMRC project grants 1027449, 1044840 and 1021855.

Conflict of interest: All authors declare no conflicts of interest (RW, AS, POS, HS, MS, JM, LS).

Citation Information: Scandinavian Journal of Pain, Volume 13, Issue 1, Pages 114–122, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2016.08.003.

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