Pain Catastrophizing and Fear of Pain Predict the Experience of Pain in Body Parts Not Targeted by a Delayed-Onset Muscle Soreness Procedure

• We measured pain responses to a nonnoxious stimulus before and after unilateral experimental injury induction.
• Reported pain intensity increased over repeated exposure in injury-free body sites.
• The reported increase was predicted by pain catastrophizing and pain-related fear.

The present study examined whether pain catastrophizing and pain-related fear predict the experience of pain in body regions that are not targeted by an experimental muscle injury protocol. A delayed-onset muscle soreness (DOMS) protocol was used to induce pain unilaterally in the pectoralis, serratus, trapezius, latissimus dorsi, and deltoid muscles. The day after the DOMS protocol, participants were asked to rate their pain as they lifted weighted canisters with their targeted (ie, injured) arm and their nontargeted arm. The lifting task is a nonnoxious stimulus unless participants are already experiencing musculoskeletal pain. Therefore, reports of pain on the nontargeted arm were operationalized as pain in response to a nonnoxious stimulus. Eighty-two healthy university students (54 men, 28 women) completed questionnaires on pain catastrophizing and fear of pain and went through the DOMS protocol. The analyses revealed that catastrophizing and pain-related fear prospectively predicted pain experience in response to a nonnoxious stimulus. The possible mechanisms underlying this effect and clinical implications are discussed.PerspectivePain catastrophizing and fear of pain prospectively predict the pain experience in response to a nonnoxious stimulus. The pattern of findings is consistent with the predictions of current models of generalization of pain-related fear.