Temperature and the cold pressor test

J Pain. 2004 May;5(4):233-7. doi: 10.1016/j.jpain.2004.03.004.


As a method of experimental pain induction, the cold pressor test is thought to mimic the effects of chronic conditions effectively. A survey of previous studies using the cold pressor, however, revealed a lack of standardization and control of water temperature, questioning comparability and reliability. This study reports the influence of temperature on pain tolerance and intensity by using a commercially available circulating water bath. Twenty-six participants (12 men, 14 women) underwent 4 cold pressor trials with temperature order counterbalanced across 1 degrees C, 3 degrees C, 5 degrees C, and 7 degrees C, temperatures representative of the range used in previous literature. After each cold immersion participants rated pain intensity on a visual analogue scale and the McGill Pain Questionnaire. Tolerance times were recorded for each trial. Significant main effects of temperature were found for tolerance time, with higher temperatures resulting in longer times, and pain intensity, with lower temperatures resulting in higher intensities. Gender differences were found, with men tolerating the stimulus for significantly longer than women. It was concluded that small differences in water temperature have a significant effect on pain intensity and tolerance time. The use of cold pressor equipment that ensures a precise constant temperature of circulating water is necessary to ensure comparable and reliable results.

Perspective: The cold pressor method of experimental pain induction has been widely used in the evaluation of psychological and physiological pain treatments. This article highlights the need for clear methodologic guidelines for the technique and demonstrates that very minor changes in experimental protocol can produce significant differences.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analysis of Variance
  • Cold Temperature / adverse effects*
  • Female
  • Humans
  • Male
  • Pain Measurement / methods*
  • Pressure
  • Sex Characteristics
  • Surveys and Questionnaires
  • Temperature*