Determining real change in conditioned pain modulation: a repeated measures study in healthy volunteers

Conditioned pain modulation (CPM) is a psychophysical measure thought to be the human correlate of diffuse noxious inhibitory control (DNIC)49, initially identified electrophysiologically in rats22 and suggested as early as 1937 in humans as a phenomenon where ‘pain inhibits pain’.9 It is proposed that pain at one site, the ‘conditioning stimulus’, can modulate (facilitate or inhibit) the experience of pain at a second distant site, the ‘test stimulus’34 via a spino-bulbar-spinal loop.30

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