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The investigators have previously found moderately painful massage produces comparable changes in pain sensitivity as a conditioned pain modulation paradigm in healthy participants suggesting shared underlying mechanisms. The researchers aim to extend these findings by understanding the influence of expectation on these findings.
Massage is a muscle biased intervention individuals seek for pain alleviation; however, the mechanisms of massage are not well established. In this study, the investigators aim to determine the effect of expectations on massage related hypoalgesia. Individuals meeting eligibility criteria and agreeing to participate will attend one session that lasts approximately one hour. A myofascial trigger point (taut band of muscle tissue) will be assessed on the neck of the participant. Next, a baseline assessment of pressure pain threshold will be performed followed by random assignment to one of four study arms.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pain Inducing Massage and Positive Expectation Instructions | Experimental | A myofascial trigger point will be assessed in the trapezius muscle and massage applied to this area of the neck. Participants in this arm will receive a positive expectation instructional set followed by a moderately painful massage (pain = 50/100). Massage will be applied for one minute, four times with assessment of pressure pain threshold at the foot between each interval. |
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| Pain Inducing Massage and Negative Expectation Instructions | Active Comparator | A myofascial trigger point will be assessed in the trapezius muscle and massage applied to this area of the neck. Participants in this arm will receive a negative expectation instructional set followed by a moderately painful massage (pain = 50/100). Massage will be applied for one minute, four times with assessment of pressure pain threshold at the foot between each interval. |
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| Pain Free Massage and Positive Expectation Instructions | Active Comparator | A myofascial trigger point will be assessed in the trapezius muscle and massage applied to this area of the neck. Participants in this arm will receive a positive expectation instructional set followed by a pain free massage (pain = 0/100). Massage will be applied for one minute, four times with assessment of pressure pain threshold at the foot between each interval. |
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| Pain Free Massage and Negative Expectation Instructions |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pain Inducing Massage | Other | A pain inducing massage (pain intensity = 50/100) will be applied for 60 seconds, 4 times. |
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| Measure | Description | Time Frame |
|---|---|---|
| Pressure Pain Threshold | A computerized pressure algometer with a 1cm diameter rubber tip will be applied to the web space of the non-dominant foot. Participants are instructed to say "stop" so the stimulus can be terminated when the sensation first transitions from pressure to pain (threshold). | 1 hour |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Joel Bialosky, PT, PhD | University of Florida | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UF Health | Gainesville | Florida | 32610 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36069038 | Derived | Wilson AT, Bishop MD, Beneciuk JM, Tilley HE, Riley JL 3rd, Cruz-Almeida Y, Bialosky JE. Expectations affect pain sensitivity changes during massage. J Man Manip Ther. 2023 Apr;31(2):84-92. doi: 10.1080/10669817.2022.2118449. Epub 2022 Sep 7. |
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| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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Participants will be masked to the type of instructional set received during the intervention. However, participants will be notified of this upon completion of the study.
| Active Comparator |
A myofascial trigger point will be assessed in the trapezius muscle and massage applied to this area of the neck. Participants in this arm will receive a negative expectation instructional set followed by a pain free massage (pain = 0/100). Massage will be applied for one minute, four times with assessment of pressure pain threshold at the foot between each interval. |
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| Pain Free Massage | Other | A pain free massage (pain intensity = 0/100) will be applied for 60 seconds, 4 times. |
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| Positive Expectation Instructional Set | Other | Participants will be instructed that the massage is effective for some people with neck pain. |
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| Negative Expectation Instructional Set | Other | Participants will be instructed that the massage is ineffective for some people with neck pain. |
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