Are Conditioned Pain Modulation and Pain Sensitivity Risk Factors for the Development of Functional Somatic Disorder? 2026 Gormsen et al

[Andy]

Full title: Are Conditioned Pain Modulation and Pain Sensitivity Risk Factors for the Development of Functional Somatic Disorder? A Longitudinal Population-Based Study

ABSTRACT​

Background​

Disrupted pain regulation has been suggested as an important component of functional somatic disorder (FSD), but evidence from large population-based studies remains limited. This study examined whether altered pain regulation, defined as lower pressure pain threshold (PPT) and reduced conditioned pain modulation (CPM), constitutes a risk factor for developing FSD over a 5-year period in a large population-based cohort.

Methods​

PPT was recorded at baseline. During cold pressor stimulation of the hand, PPT was reassessed and the difference from baseline defined the CPM effect. Participants were randomly selected from the adult Danish population (n = 2198) of whom 1269 (57.7%) participated in the 5-year follow-up. Incident FSD cases were identified using validated self-reported symptom questionnaires. Associations between pain measures and incident FSD were examined using logistic regression analyses.

Results​

Overall, no significant associations were observed between baseline PPT (OR = 0.92, 95% CI: 0.83–1.01) or CPM (OR = 0.96, 95% CI: 0.90–1.03) and the development of FSD during the 5-year follow-up period. Similarly, changes in PPT from baseline to follow-up were not associated with incident FSD (OR = 0.91, 95% CI: 0.83–1.00).

Conclusions​

The findings do not support that altered pain regulation is a risk factor for the development of FSD in the general population. However, uncertainty persists due to possible outcome misclassification, a response rate of 57.7%, low event numbers and measurement limitations.

Significance Statement​

This large population-based longitudinal study challenges prevailing assumptions by showing that experimentally assessed pain sensitivity and conditioned pain modulation do not predict the development of functional somatic disorder (FSD). Contrary to findings from clinical samples, altered pain regulation was not a significant risk factor over 5 years. These findings question the causal role of central pain mechanisms in FSD onset and call for more research to clarify the underlying mechanisms of FSD.

Open access

 

[Sean]

These findings question the causal role of central pain mechanisms in FSD onset and call for more research to clarify the underlying mechanisms of FSD.

They also call into question the whole concept of FSD.

 

[Utsikt]

So pain measurements are not correlated with FSD long term, and stress measurements are not associated with chronic fatigue long term. (Link)

There’s really not much left of the functional disorders then.

 

[rvallee]

This large population-based longitudinal study challenges prevailing assumptions

Those assumptions are the model. Of course other assumptions will simply take their place, but it won't actually challenge the model because it's just a set of beliefs and assumptions with no attempt at coherence or validity.

They basically hand-wave it away by "nuh-uh"-ing their own results, because evidence, results and outcomes are entirely irrelevant in this ideology:

Nonetheless, they do not preclude the possibility that disturbances in central processing, not limited to pain systems, may contribute to the diverse symptom manifestations observed in FSD

The same assumption, framed, uh, the exact same way, just pointing at another invisible turtle down.

 

[rvallee]

So pain measurements are not correlated with FSD long term, and stress measurements are not associated with chronic fatigue long term. (Link)

There’s really not much left of the functional disorders then.

Oh there is a belief, a belief in the delusion that such a thing exists and must explain every single thing they don't understand yet. This belief has destroyed and immiserated millions of lives, but because of assumptions, that's a good thing.

 

[rvallee]

Even with their very generous interpretation, this is vastly lower than lots of assertive speculation about this evil mind-magic:

For example, in the fully adjusted Model 3, comparing participants with a 50-point higher baseline CPM Absolute, the odds of having developed FSD at follow-up was 0.97

Which is even more odd because this whole concept is an umbrella model for all the various chronic illnesses that medicine can't explain, all of which add up to much more than 1%. Turns out that doing statistical analyses on made-up numbers yields a lot of asses.