Distinct effects of fibromyalgia pain, depression and anxiety on perception of affective touch and pain

J Physiol. 2026 Apr 4. doi: 10.1113/JP290243. Online ahead of print.

ABSTRACT

Gentle stroking that activates C-tactile afferents is typically pleasant, calming and pain relieving. Deep pressure touch frequently elicits similar affective responses. However touch is often less pleasant for individuals with chronic pain. It is important to understand the reasons for this clinical difference because of the close relationship of pain with reduced social connection, and the widespread use of touch-based therapies for pain relief. It is not known whether differences in touch perception in chronic pain relate to pain-specific processes or to comorbid affective symptoms. The current study compared affective touch perception in adults with the chronic pain condition fibromyalgia (FM) and no-pain (NP) controls, and the contributions of pain, depression, anxiety and trauma history to differences in touch perception. We hypothesized that deep pressure - like gentle stroking - would be less pleasant in FM and that these differences would be associated with depression and trauma history. Touch was rated as significantly less pleasant and more intense in FM. Chronic pain intensity best predicted reductions in touch pleasantness, whereas preferences for brushing versus tapping (affective touch preference) were positively predicted by depression and anxiety scores. In contrast heat pain unpleasantness was significantly predicted only by depression and anxiety. These results suggest that blunted touch pleasantness in FM is best explained by pain-specific processes, whereas pain unpleasantness is more closely associated with affective processes. KEY POINTS: Pleasant touch perception is often reduced in chronic pain, but the reasons for this are not clear. Patients with fibromyalgia (FM) and no-pain controls rated their perception of gentle stroking, deep pressure and heat pain. All touch types were less pleasant and more intense in FM participants. Chronic pain intensity predicted reductions in touch pleasantness, whereas affective symptoms predicted affective touch preference and heat pain unpleasantness. Findings suggest that blunted touch pleasantness in FM is more related to pain processes than to comorbid affective symptoms.

PMID:41935022 | DOI:10.1113/JP290243