Sex differences in pain sensitivity in the Dutch population: Insights from a Web-Based Multidimensional Randomized Controlled Trial (Preprint)

Abstract

Sex is an important factor in the development and treatment in chronic pain, but to what extend is still unclear. Other demographic factors might influence pain sensitivity differently in men and women , as well as non-pharmacological interventions.

In this study we aimed to investigate the influence of sex and other demographic, lifestyle, behavioral, clinical and environmental factors on pain sensitivity in the Dutch population. Different audiovisual stimuli were used to investigate how this would impact pain sensitivity, and what influence sex and these other variables have on the effect of this simple intervention.

We performed a study consisting of two parts: a cross sectional research, to investigate pain sensitivity (PS) differences between men and women and the influence of demographic variables, in the Dutch population and an internet intervention study to determine whether an audiovisual intervention could skew pain sensitivity.

All respondents filled in the Pain Sensitivity Questionnaire (PSQ) after an online demographic questionnaire and randomization into four groups. A cross sectional analysis was performed in the control group (n= 1746 respondents). Three groups saw a short film: one with scenes of nature (n=2650), one with laughing people (n=2735) and one with physically painful events (n=2708). The PSQ score was stated as a mean per question, on a numeric rating scale from 0-10. The cross sectional study revealed no significant differences between men and women, but showed a male to female difference in our population on the pain sensitivity questionnaire when specific background factors were present. Adding specific audiovisual stimuli has a positive impact on pain sensitivity in respondents who have chronic pain, with a higher effect in female respondents.

Scientists performing pain research need to account for factors which can influence the outcome of their study, and be aware that these factors can be sex dependent and should be analyzed accordingly. Even relatively small interventions, like watching a film, can impact pain sensitivity, especially in respondents with current chronic pain. This effect can vary as well, when different background factors present. This warrants further explorations of the possibilities simple interventions bring for patients in the clinic and personalized medicine.

Landelijk trial register; Trial 29537 Https://onderzoekmetmensen.nl/nl/trial/29537