Trial reportPain2013
The importance of context: when relative relief renders pain pleasant.
Trial report in Pain, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
77 citing papers in PubMed, 3 syntheses or guidelines pooled it, 185 citations in OpenAlex.
- Are mind-body therapies effective for relieving cancer-related pain in adults? A systematic review and meta-analysis.Psycho-oncology · 2022Pooled it
- The effect of acute physical pain on subsequent negative emotional affect: A meta-analysis.Personality disorders · 2018Pooled it
- Understanding Monitoring Technologies for Adults With Pain: Systematic Literature Review.Journal of medical Internet research · 2017Pooled it
- The effect of occipital nerve field stimulation on the descending pain pathway in patients with fibromyalgia: a water PET and EEG imaging study.BMC neurology · 2018Trial
- Inverted Perceptual Judgment of Nociceptive Stimuli at Threshold Level following Inconsistent Cues.PloS one · 2015Trial
- Placebo improves pleasure and pain through opposite modulation of sensory processing.Proceedings of the National Academy of Sciences of the United States of America · 2013Trial
- The hijacked insula: A stratified model of affective touch modulation in chronic pain.Journal of neuropsychology · 2026Review
- Conditioned Pain Modulation and Pleasant Pain Relief as Complementary Processes Reflecting Individual Differences in Pain Coping: A Clustering Approach.European journal of pain (London, England) · 2026Article
- Contextual Modulation of Fronto-Central, Parietal, and Global Peak Alpha Frequency.European journal of pain (London, England) · 2026Article
- Do partner handholding effects linger? Order effects of handholding support on mechanical hypersensitivity in women.Pain reports · 2026Article
- Competing value signals impair reward-learning via dopaminergic mechanisms and increase exploration.PLoS biology · 2026Article
- Touch, temperature, and relief: a multilevel integrative model of hedonic regulation in massage and thermal therapies.Frontiers in physiology · 2026Article
- From mechanisms to meanings: toward a content-sensitive psychiatry.Frontiers in psychiatry · 2026Article
- Psychological contributors to pain before, during, and after endodontic procedures: A scoping review.British journal of pain · 2025Article
- Mendelian Randomization Analysis Reveal the Role of Circulating Inflammatory Proteins in Mediating Functional Brain Networks and Peripheral Neuropathic Pain Effects.Brain and behavior · 2025Article
- Oxytocin and opioid antagonists: A dual approach to improving social behavior.Annals of the New York Academy of Sciences · 2025Review
- A prospective study of the association between pain and catastrophizing after selective nerve root blockade.Pain practice : the official journal of World Institute of Pain · 2025Article
- Sex Differences in Pain Sensitivity in a Dutch Cohort: Cross-Sectional and Web-Based Multidimensional Study.Journal of medical Internet research · 2024Article
- The Locus Coeruleus in Chronic Pain.International journal of molecular sciences · 2024Review
- Brain representations of affective valence and intensity in sustained pleasure and pain.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
Context can influence the experience of any event. For instance, the thought that "it could be worse" can improve feelings towards a present misfortune. In this study we measured hedonic feelings, skin conductance, and brain activation patterns in 16 healthy volunteers who experienced moderate pain in two different contexts. In the "relative relief context," moderate pain represented the best outcome, since the alternative outcome was intense pain. However, in the control context, moderate pain represented the worst outcome and elicited negative hedonic feelings. The context manipulation resulted in a "hedonic flip," such that moderate pain elicited positive hedonics in the relative relief context. Somewhat surprisingly, moderate pain was even rated as pleasant in this context, despite being reported as painful in the control context. This "hedonic flip" was corroborated by physiological and functional neuroimaging data. When moderate pain was perceived as pleasant, skin conductance and activity in insula and dorsal anterior cingulate were significantly attenuated relative to the control moderate stimulus. "Pleasant pain" also increased activity in reward and valuation circuitry, including the medial orbitofrontal and ventromedial prefrontal cortices. Furthermore, the change in outcome hedonics correlated with activity in the periacqueductal grey (PAG) of the descending pain modulatory system (DPMS). The context manipulation also significantly increased functional connectivity between reward circuitry and the PAG, consistent with a functional change of the DPMS due to the altered motivational state. The findings of this study point to a role for brainstem and reward circuitry in a context-induced "hedonic flip" of pain.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.