ArticleThe Journal of physiology2026
Modulation of pain by affective touch: effects of childhood trauma, depression, chronic pain, and spinal segment.
Article in The Journal of physiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Chronic pain is highly prevalent, and non-pharmacological tools are a crucial part of a multimodal approach to reducing burden of pain. Among these touch-based interventions such as massage have long been popular, yet their underlying pain-relieving mechanisms are poorly understood. Touch-based therapies often involve gentle stroking associated with the C-tactile afferent pathway and deep pressure. Although chronic pain patients often find touch less pleasant than individuals without pain, the effects of chronic pain on touch-pain modulation have not been directly studied. In the current study we systematically investigated two affective forms of touch - gentle brushing and deep pressure (compression) - on heat pain perception, testing their effects both within-segment and between-segment to explore their neural mechanism. We compared touch-pain modulation effects in pain-free controls and patients with fibromyalgia (FM), a condition characterized by sensory hypersensitivity and affective alterations, hypothesizing that touch-pain modulation would be reduced in FM. We further examined the role of trauma and depression, which are highly prevalent in FM. Significant touch-pain modulation occurred only for between-segment brushing. No significant differences in touch-pain modulation were observed between FM patients and controls. Notably, trauma history and depression emerged as the strongest predictors of touch-pain modulation. These findings suggest that touch-pain modulation involves supraspinal mechanisms that are preserved in FM and are strongly shaped by trauma history and psychological factors. Our results provide novel insight into biopsychosocial determinants of touch-related pain relief and its relevance to FM. KEY POINTS: Touch-based interventions such as massage are common non-pharmacological approaches for chronic pain, but their mechanisms are poorly understood. Chronic pain patients often exhibit reduced touch pleasantness and endogenous pain modulation, but effects of chronic pain on touch-pain modulation have not been directly studied. We tested the effects of gentle brushing and deep pressure (compression) on heat pain perception, testing both within-segment (same dermatome) and between-segment (between dermatome) conditions in no-pain controls and patients with fibromyalgia (FM). Brushing significantly reduced heat pain in the between-segment condition and did not differ by pain status; trauma history and depression emerged as the strongest predictors of touch-pain modulation. These findings suggest that touch-pain modulation involves supraspinal mechanisms that are preserved in FM and strongly shaped by trauma history and psychological factors.
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