Pain Experience and Sensory Changes in Astronauts During and After Short-Lasting Commercial Spaceflight: A Proof-of-Concept Study

Andrea K Sauer,1,* Marie Vigouroux,2,3,* Patrick M Dougherty,4 Juan Pablo Cata,5,6,* Pablo M Ingelmo2,3,7,8,* 1Department of Anesthesia, University of Bonn, Bonn, Germany; 2Department of Anesthesia, McGill University, Montreal, QC, Canada; 3Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Montreal, QC, Canada; 4Department of Pain Medicine, The University of Texas – MD Anderson Cancer Center, Houston, TX, USA; 5Department of Anesthesia and Perioperative Medicine, The University of Texas – MD Anderson Cancer Center, Houston, TX, USA; 6Anesthesiology and Surgical Oncology Research Group, Houston, TX, USA; 7Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada; 8Research Institute, McGill University Health Center, Montreal, QC, Canada*These authors contributed equally to this workCorrespondence: Pablo M Ingelmo, Edwards Family Interdisciplinary Center for Complex Pain, Montreal Children’s Hospital, Room A02.3525, Glen Site, 1001 Boul, Décarie, Montreal, QC, H4A 3J1, Canada, Tel +1 514 412-4448, Fax +1 514 412-4341, Email pablo.ingelmo@mcgill.caAbstract: Space travel has been associated with musculoskeletal pain, yet little is known about the nociceptive changes and pain experience during spaceflight. This preliminary study aims to investigate the pain experience and sensory alterations in astronauts following a 17-day mission to the International Space Station (ISS) on Axiom Space’s AX-1 commercial space flight. Two participants were enrolled, and data were collected pre-flight, in-flight, post-flight, and three-month post-flight. Validated pain questionnaires assessed anxiety, catastrophizing, impact on physical and mental health, disability, and overall pain experience. Qualitative interviews were conducted post-landing and conditioned pain modulation (CPM) and quantitative sensory testing (QST) were performed. Both astronauts reported musculoskeletal pain during and after the flight, which was managed with anti-inflammatories and stretching techniques. Pain levels returned to baseline after three months. Pain questionnaires revealed heightened pain experiences in-flight and immediately post-flight, although their adequacy in assessing pain in space is uncertain. Qualitative interviews allowed astronauts to describe their pain experiences during the flight. Sensory changes included increased mechanical touch detection thresholds, temporal pain summation, heat pain thresholds, and differences in conditioned pain modulation post-flight. This preliminary study suggested that spaceflight may affect various aspects of sensory perception and regulation in astronauts, albeit in a variable manner. More data are needed to gain insight of on gain and loss of sensory functions during space missions. Further investigation into the multifactorial stressors affecting the somatosensory system during space travel could contribute to advancements in space and pain medicine.Keywords: chronic pain, quantitative sensory testing, microgravity, radiation, back pain

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