Coldpain

Coldpain, sometimes written as cold pain, is a term used in medical literature and lay discussions to describe pain elicited by cold exposure or pain that worsens with cold. It is not a formal diagnostic category but a descriptive concept applicable to several clinical and experimental contexts dealing with thermal nociception.

Physiologically, cold pain involves activation of peripheral thermoreceptors, notably TRPM8, which detects non-noxious cool temperatures, and TRPA1, which can respond to noxious cold. These receptors excite small-diameter nociceptive fibers, A-delta and C fibers, transmitting signals to the spinal cord and brain where pain is perceived. Central sensitization can amplify cold-related pain in chronic pain states.

Clinically, cold pain can be observed in cold-induced hyperalgesia, cryoneuropathy, and certain neuropathic conditions where cold triggers or intensifies pain. It is also a feature of cold urticaria and some cases of complex regional pain syndrome, where patients report heightened sensitivity to cold. Diagnostic assessment may utilize quantitative sensory testing and the cold pressor test, which measures pain threshold and tolerance to a controlled cold stimulus.

Management focuses on reducing exposure to cold and addressing the underlying condition. Strategies include protective clothing and environmental controls, along with standard pain management approaches such as nonsteroidal anti-inflammatory drugs for inflammatory pain, and neuropathic pain agents (e.g., gabapentinoids or certain antidepressants) when cold pain is part of a neuropathic syndrome. Avoiding cryotherapy or extreme temperature fluctuations is advised in susceptible individuals.