lare. Rating on a visual analogue scale ranging from 0 to 100 mm. The 4 Secondary Hyperalgesia by Repetitive Heat Pain 41.061.5 cm2; ANOVA: p,,0.001) and of secondary hyperalgesia, which 20685848 were characterized by their remarkable small inter-individual variation of magnitude. The area of secondary hyperalgesia was significantly larger than the flare area. The flare disappeared within one day and subjects reported no persistent effects beyond that day, such as erythema. Higher degrees of tissue damage were never observed throughout the experiment. Modulation of qualitative pain characteristics Analysis of pain characteristics as assessed by the HSAL list of pain descriptors yielded a substantial overall increase very similar to the increase of VAS pain ratings. Hierarchical analysis of subscales revealed that the increase in the affective 
pain component was more pronounced than that in the sensory pain component although the difference did not reach statistical significance. This also applied to both affective pain components, namely pain-related suffering and pain-related anxiety as well. Notably, the most purely defined sensory subscale only exhibited a nonsignificant trend. All changes were already fully present at the fifth block of heat stimuli. An overview of mean values at the first, fifth and tenth block is given in Quantitative sensory testing in the zones of primary and secondary hyperalgesia Time course of primary and secondary hyperalgesia The time course of hyperalgesia parameters exhibited a maximal expression at one hour after repetitive heat pain stimulation. The maximal spread of secondary hyperalgesia at that time point was 51.0 6 3.7 mm from the thermode center, which matched exactly the mean area in the group of 18 different subjects. Notably, significant spread of hyperalgesia beyond the thermode area was met at any time after RHP, and significant reduction of the secondary hyperalgesia area was only met at 8 h after RHP. Likewise, hyperalgesia to pinprick stimulation in the primary and secondary areas peaked at one hour after RHP with a.5fold and.3fold pain increase compared to the contralateral mirror image control side. Thereafter, hyperalgesia in both hyperalgesia areas slowly declined in parallel. However, significant hyperalgesia was present at any time point for primary hyperalgesia, and secondary hyperalgesia as well. Thus, hyperalgesia lasted for more than 24 h after RHP. Notably, the magnitude of pinprick hyperalgesia in the primary and secondary areas was strongly correlated up to 8 h after RHP suggesting that they share a similar mechanism. Modulation of heat pain and heat-induced flare and secondary hyperalgesia by NSAID Ratings of repetitive heat pain in the subgroup of subjects of the acetaminophen trial were Gynostemma Extract cost representative of the full cohort. They increased significantly both with and without application of acetaminophen over time from the first to the tenth block. Mean pain ratings to the repetitive noxious thermal stimuli decreased slightly at any time of the 16476508 conditioning heat pain protocol, and pain reduction varied from 626% for the ten blocks. However, in none of the blocks nor in overall pain after application of acetaminophen did the pain reduction reach statistical significance. Likewise, the intra-session development of heat hyperalgesia as calculated from the increase in heat pain ratings from the first to the tenth block of heat stimuli remained unaltered. Moreover, there was no indication for
