Citation Caes L & Roche M (2020) Adverse early life experiences are associated with changes in pressure and cold pain sensitivity in young adults. Commentary on: Waller R, Smith AJ, OʼSullivan PB, et al. The association of early life stressors with pain sensitivity and pain experience at 22 years. Pain 2020;161:220-9.. Annals of Palliative Medicine. https://doi.org/10.21037/apm-20-914
Abstract First paragraph: Over the past two decades, understanding on the importance and impact of early life events on health and well-being in later life has expanded considerably. Accordingly, childhood stress and trauma during this critical period has been demonstrated to elicit profound changes physiological functioning, which in turn is associated with an increased risk of developing conditions such as chronic pain. Preclinical and animal studies have provided evidence for changes in several neurobiological substrates including the stress hypothalamic-pituitary-adrenal axis, immune system and epigenetic mechanisms, in the association between early life stress and altered pain processing in later life (1,2). However, clinical data is limited and often conflicted on whether childhood stress and trauma results in increased (3,4) or decreased (4-6) pain sensitivity or experience. The Western Australian pregnancy cohort (Raine) Study commenced in 1989 and has provided longitudinal physiological, psychological and socioeconomic data on a large cohort of parents and offspring over the past 30 years. A recent study by Waller and colleagues published in Pain, utilized data from the Raine study to assess the association between a wide range of early life stressors, pressure and cold sensitivity and pain experience in young adults (7). The authors are to be commended for their rigorous analyses of this large cohort data resulting in robust data which demonstrates that adverse early life experiences are associated with changes in pressure and cold pain sensitivity at 22 years. These data provide further support that early life experiences are associated with altered long-term nociceptive processing. Given the lack of longitudinal studies in this area and the social and economic burden of treating acute and chronic pain, this study provides robust evidence on early life stress as a risk factor for altered pain processing thus providing valuable insight into possible biomarkers and novel treatment strategies for such conditions.