Vascular participation in deep cold pain.

As the magnitude of cold pain probably depends on blood flow and thus on internal limb temperature, the activated nociceptors should be close to or within the walls of veins. This hypothesis was tested by injecting small quantities (20 ml) of cold saline into an empty vein of the hand in 16 subjects. Saline temperatures below 26 degrees C elicited pure cold sensations whereas temperatures below 20 degrees C evoked both cold and pain sensations. Pain was mainly described as deep and it tended to radiate along the veins. With saline of 5 degrees C the pain tolerance level of several subjects was reached. Pain always appeared after cold and it disappeared before or together with cold. The results can be explained on the basis of two types of vascular receptors: a sensitive specific cold receptor and a nociceptor with a threshold around 20 degrees C.