Clinical and Experimental Tools for Measuring Pain

One clinically useful collection of tools for measuring the pain experiences of patients with chronic pain conditions is referred to as quantitative sensory testing (QST). QST includes an array of non-invasive procedures that quantify human pain perception during the administration of standardized noxious stimuli with predetermined physical properties and following specific protocols. The use of QST for measuring responses to painful stimuli often includes a multimodal, multi-tissue approach whereby different stimulus modalities (thermal—hot and cold, mechanical, electrical, ischemic and chemical) are applied to different tissues (skin, muscles, and viscera). Common QST response measures include static (e.g., pain threshold, pain tolerance, and suprathreshold pain responses) as well as dynamic (e.g., conditioned pain modulation, temporal summation) aspects of pain perception. At present, QST remains primarily a research tool; however, the goal is ultimately for QST to complement and extend the bedside physical examination. There is currently evidence that QST is predictive of chronic pain development and severity over time, as well as responses to pain treatments.