Primed for Pain
Research type
Research Study
Full title
Hyperalgesic Priming in Chronic Widespread Pain: Role of the Stress Axes
IRAS ID
349989
Contact name
Andrew Marshall
Contact email
Sponsor organisation
University of Liverpool
Duration of Study in the UK
7 years, 9 months, 31 days
Research summary
Chronic pain, a major health problem causing suffering to a third of UK adults, costs the UK economy £10 billion annually. Why individuals develop chronic pain is unclear. Injury or illness precede some chronic pain conditions, but others arise without actual tissue damage. These pain conditions, specifically the most prevalent, fibromyalgia, are the primary focus of this research.
Fibromyalgia disproportionately affects females and has an increased prevalence in lower socioeconomic groups. Stress and early life adversity, prevalent among lower socioeconomic groups, are major risk factors for developing chronic pain but how these predispose remains unclear. Research in animals indicates that previous stressful experiences leave pain sensing nerves in a state of increased sensitivity called ‘priming’. Priming causes no pain until a further trigger, which normally might not activate the pain nerves, sparks prolonged and amplified pain signalling. Whether stress results in ‘priming’ in humans is unknown. However, common characteristics of fibromyalgia: peaks and troughs of pain triggered by stress; and initial onset of chronic pain following a traumatic event, are consistent with priming.
Using microneurography - a tool that directly measures the function of pain nerves - as well as behavioural and biochemical assessment, this study will determine whether the pain nerves in people with, or at risk of developing, fibromyalgia are primed. It will also identify whether key stress hormones and inflammatory factors impacting on nerves contribute to priming.
This work will lead to a deeper understanding of the mechanisms of why people living with stress and deprivation are vulnerable to developing chronic pain. Understanding how stress contributes to the development of chronic pain will help identify at-risk individuals and guide development of novel treatment targets and early preventative interventions. Furthermore, it has the potential to inform policy addressing socioeconomic risk factors and inequality to enable earlier intervention in high-risk groups.REC name
North West - Greater Manchester Central Research Ethics Committee
REC reference
26/NW/0106
Date of REC Opinion
13 May 2026
REC opinion
Further Information Favourable Opinion