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Racial and ethnic differences in experimental pain sensitivity: systematic review and meta-analysis

Kim, Hee Jun; Yang, Gee Su; Greenspan, Joel D.; Downton, Katherine D.; Griffith, Kathleen A.; Renn, Cynthia L.; Johantgen, Meg; Dorsey, Susan G.


In the above article, which published in the February 2017 issue of PAIN, the authors have identified the following errors, which they wish to correct:

The authors wish to express their appreciation to Dr. J. Rhudy for bringing these errors to their attention.

PAIN. 158(10):2055, October 2017.

doi: 10.1097/j.pain.0000000000000731
Comprehensive Review

Our objective was to describe the racial and ethnic differences in experimental pain sensitivity. Four databases (PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, and PsycINFO) were searched for studies examining racial/ethnic differences in experimental pain sensitivity. Thermal–heat, cold–pressor, pressure, ischemic, mechanical cutaneous, electrical, and chemical experimental pain modalities were assessed. Risk of bias was assessed using the Agency for Healthcare Research and Quality guideline. Meta-analysis was used to calculate standardized mean differences (SMDs) by pain sensitivity measures. Studies comparing African Americans (AAs) and non-Hispanic whites (NHWs) were included for meta-analyses because of high heterogeneity in other racial/ethnic group comparisons. Statistical heterogeneity was assessed by subgroup analyses by sex, sample size, sample characteristics, and pain modalities. A total of 41 studies met the review criteria. Overall, AAs, Asians, and Hispanics had higher pain sensitivity compared with NHWs, particularly lower pain tolerance, higher pain ratings, and greater temporal summation of pain. Meta-analyses revealed that AAs had lower pain tolerance (SMD: −0.90, 95% confidence intervals [CIs]: −1.10 to −0.70) and higher pain ratings (SMD: 0.50, 95% CI: 0.30–0.69) but no significant differences in pain threshold (SMD: −0.06, 95% CI: −0.23 to 0.10) compared with NHWs. Estimates did not vary by pain modalities, nor by other demographic factors; however, SMDs were significantly different based on the sample size. Racial/ethnic differences in experimental pain sensitivity were more pronounced with suprathreshold than with threshold stimuli, which is important in clinical pain treatment. Additional studies examining mechanisms to explain such differences in pain tolerance and pain ratings are needed.

Supplemental Digital Content is Available in the Text.

aDepartment of Pain and Translational Symptom Science, University of Maryland, Baltimore, MD,

bDepartment of Neural and Pain Sciences, University of Maryland, Baltimore, MD,

cHealth Sciences and Human Services Library, University of Maryland, Baltimore, MD,

dDepartment of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD,

eDepartment of Organizational Systems and Adult Health, School of Nursing, University of Maryland, Baltimore, MD.

Corresponding author. Address: University of Maryland School of Nursing, Baltimore, MD 21201, USA. Tel.: 1-410-706-7250; fax: 1-410-706-0344. E-mail address: (S.G. Dorsey).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received May 06, 2016

Received in revised form August 23, 2016

Accepted September 08, 2016

© 2017 International Association for the Study of Pain
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