["The Journal of Physiology, EarlyView. ", "\nAbstract figure legend Patients with fibromyalgia and no‐pain controls completed questionnaire ratings of chronic pain, childhood trauma, anxiety and depression. During the first session a conditioned pain modulation task was administered, with heat pain applied via thermode and cold pain via cold water‐bath. At a later session participants completed several touch‐pain modulation tasks, with touch stimuli applied to the left arm and heat pain applied to either the arm (within‐segment) or leg (between‐segments). The touch stimuli included slow brushing at the C‐tactile optimal velocity of 3 cm/s, deep oscillating pressure with a compression sleeve and roboticized tapping. Brushing and pressure were intended as pleasant affective stimuli. There were no significant differences between fibromyalgia and controls on the touch‐pain modulation tasks. Brushing significantly reduced heat pain ratings on the leg (between‐segments). Depression was associated with reduced modulation of pain by brushing, whereas trauma history was associated with greater modulation of pain. \n\n\n\n\n\n\n\n\n\nAbstract\nChronic pain is highly prevalent, and non‐pharmacological tools are a crucial part of a multimodal approach to reducing burden of pain. Among these touch‐based interventions such as massage have long been popular, yet their underlying pain‐relieving mechanisms are poorly understood. Touch‐based therapies often involve gentle stroking associated with the C‐tactile afferent pathway and deep pressure. Although chronic pain patients often find touch less pleasant than individuals without pain, the effects of chronic pain on touch‐pain modulation have not been directly studied. In the current study we systematically investigated two affective forms of touch – gentle brushing and deep pressure (compression) – on heat pain perception, testing their effects both within‐segment and between‐segment to explore their neural mechanism. We compared touch–pain modulation effects in pain‐free controls and patients with fibromyalgia (FM), a condition characterized by sensory hypersensitivity and affective alterations, hypothesizing that touch‐pain modulation would be reduced in FM. We further examined the role of trauma and depression, which are highly prevalent in FM. Significant touch‐pain modulation occurred only for between‐segment brushing. No significant differences in touch‐pain modulation were observed between FM patients and controls. Notably, trauma history and depression emerged as the strongest predictors of touch‐pain modulation. These findings suggest that touch‐pain modulation involves supraspinal mechanisms that are preserved in FM and are strongly shaped by trauma history and psychological factors. Our results provide novel insight into biopsychosocial determinants of touch‐related pain relief and its relevance to FM.\n\n\n\n\n\n\n\n\n\nKey points\n\nTouch‐based interventions such as massage are common non‐pharmacological approaches for chronic pain, but their mechanisms are poorly understood.\nChronic pain patients often exhibit reduced touch pleasantness and endogenous pain modulation, but effects of chronic pain on touch‐pain modulation have not been directly studied.\nWe tested the effects of gentle brushing and deep pressure (compression) on heat pain perception, testing both within‐segment (same dermatome) and between‐segment (between dermatome) conditions in no‐pain controls and patients with fibromyalgia (FM).\nBrushing significantly reduced heat pain in the between‐segment condition and did not differ by pain status; trauma history and depression emerged as the strongest predictors of touch‐pain modulation.\nThese findings suggest that touch‐pain modulation involves supraspinal mechanisms that are preserved in FM and strongly shaped by trauma history and psychological factors.\n\n\n"]