ABSTRACT
As documented in recent reviews, there is considerable evidence of abnormal
pain perception across a broad range of clinical conditions (1). The apparent
patterns are generally syndrome-specific, with globally enhanced sensitivity in
some conditions (e.g., fibromyalgia), locally diminished sensitivity to pain in
other conditions (e.g., diabetic neuropathy), and in some cases a variable mixture
of both [e.g., postherpetic neuralgia (PHN)]. This growing body of evidence for
alterations in pain perception in many clinical populations has stimulated a great
deal of interest in experimental pain assessment, or quantitative sensory testing
(QST), and its potential application in the clinical setting. However, it is also
important to note that individual variability in pain perception is substantial even
within nonclinical samples (2,3), and QST can be used to study these individual
differences in pain sensitivity and pain processing. This chapter provides an
overview of the methodology and clinical relevance of QST, highlighting its
applications in clinical settings. Throughout the chapter, the terms QST and
experimental pain assessment will be used interchangeably to describe a variety
of psychophysical procedures that include multiple methods for evaluating
responses to standardized noxious stimuli.
