Biological stress systems, adverse life events and the onset of chronic multisite musculoskeletal pain

a 6-year cohort study

Ellen Generaal, Nicole Vogelzangs, Gary J Macfarlane, Rinie Geenen, Johannes H Smit, Eco J C N de Geus, Brenda W J H Penninx, Joost Dekker

Research output: Contribution to journalArticle

24 Citations (Scopus)
7 Downloads (Pure)

Abstract

OBJECTIVES: Dysregulated biological stress systems and adverse life events, independently and in interaction, have been hypothesised to initiate chronic pain. We examine whether (1) function of biological stress systems, (2) adverse life events, and (3) their combination predict the onset of chronic multisite musculoskeletal pain.

METHODS: Subjects (n=2039) of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were identified using the Chronic Pain Grade Questionnaire and followed up for the onset of chronic multisite musculoskeletal pain over 6 years. Baseline assessment of biological stress systems comprised function of the hypothalamic-pituitary-adrenal axis (1-h cortisol awakening response, evening levels, postdexamethasone levels), the immune system (basal and lipopolysaccharide-stimulated inflammation) and the autonomic nervous system (heart rate, pre-ejection period, SD of the normal-to-normal interval, respiratory sinus arrhythmia). The number of recent adverse life events was assessed at baseline using the List of Threatening Events Questionnaire.

RESULTS: Hypothalamic-pituitary-adrenal axis, immune system and autonomic nervous system functioning was not associated with onset of chronic multisite musculoskeletal pain, either by itself or in interaction with adverse life events. Adverse life events did predict onset of chronic multisite musculoskeletal pain (HR per event=1.14, 95% CI 1.04 to 1.24, p=0.005).

CONCLUSIONS: This longitudinal study could not confirm that dysregulated biological stress systems increase the risk of developing chronic multisite musculoskeletal pain. Adverse life events were a risk factor for the onset of chronic multisite musculoskeletal pain, suggesting that psychosocial factors play a role in triggering the development of this condition.

Original languageEnglish
Pages (from-to)847-854
Number of pages8
JournalAnnals of the Rheumatic Diseases
Volume75
Issue number5
Early online date22 Apr 2015
DOIs
Publication statusPublished - May 2016

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Musculoskeletal Pain
Physiological Stress
Cohort Studies
Immune system
Neurology
Autonomic Nervous System
Chronic Pain
Immune System
Lipopolysaccharides
Hydrocortisone
Netherlands
Longitudinal Studies
Anxiety
Heart Rate
Depression
Psychology
Inflammation

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Biological stress systems, adverse life events and the onset of chronic multisite musculoskeletal pain : a 6-year cohort study. / Generaal, Ellen; Vogelzangs, Nicole; Macfarlane, Gary J; Geenen, Rinie; Smit, Johannes H; de Geus, Eco J C N; Penninx, Brenda W J H; Dekker, Joost.

In: Annals of the Rheumatic Diseases, Vol. 75, No. 5, 05.2016, p. 847-854.

Research output: Contribution to journalArticle

Generaal, Ellen ; Vogelzangs, Nicole ; Macfarlane, Gary J ; Geenen, Rinie ; Smit, Johannes H ; de Geus, Eco J C N ; Penninx, Brenda W J H ; Dekker, Joost. / Biological stress systems, adverse life events and the onset of chronic multisite musculoskeletal pain : a 6-year cohort study. In: Annals of the Rheumatic Diseases. 2016 ; Vol. 75, No. 5. pp. 847-854.
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title = "Biological stress systems, adverse life events and the onset of chronic multisite musculoskeletal pain: a 6-year cohort study",
abstract = "OBJECTIVES: Dysregulated biological stress systems and adverse life events, independently and in interaction, have been hypothesised to initiate chronic pain. We examine whether (1) function of biological stress systems, (2) adverse life events, and (3) their combination predict the onset of chronic multisite musculoskeletal pain.METHODS: Subjects (n=2039) of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were identified using the Chronic Pain Grade Questionnaire and followed up for the onset of chronic multisite musculoskeletal pain over 6 years. Baseline assessment of biological stress systems comprised function of the hypothalamic-pituitary-adrenal axis (1-h cortisol awakening response, evening levels, postdexamethasone levels), the immune system (basal and lipopolysaccharide-stimulated inflammation) and the autonomic nervous system (heart rate, pre-ejection period, SD of the normal-to-normal interval, respiratory sinus arrhythmia). The number of recent adverse life events was assessed at baseline using the List of Threatening Events Questionnaire.RESULTS: Hypothalamic-pituitary-adrenal axis, immune system and autonomic nervous system functioning was not associated with onset of chronic multisite musculoskeletal pain, either by itself or in interaction with adverse life events. Adverse life events did predict onset of chronic multisite musculoskeletal pain (HR per event=1.14, 95{\%} CI 1.04 to 1.24, p=0.005).CONCLUSIONS: This longitudinal study could not confirm that dysregulated biological stress systems increase the risk of developing chronic multisite musculoskeletal pain. Adverse life events were a risk factor for the onset of chronic multisite musculoskeletal pain, suggesting that psychosocial factors play a role in triggering the development of this condition.",
author = "Ellen Generaal and Nicole Vogelzangs and Macfarlane, {Gary J} and Rinie Geenen and Smit, {Johannes H} and {de Geus}, {Eco J C N} and Penninx, {Brenda W J H} and Joost Dekker",
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T1 - Biological stress systems, adverse life events and the onset of chronic multisite musculoskeletal pain

T2 - a 6-year cohort study

AU - Generaal, Ellen

AU - Vogelzangs, Nicole

AU - Macfarlane, Gary J

AU - Geenen, Rinie

AU - Smit, Johannes H

AU - de Geus, Eco J C N

AU - Penninx, Brenda W J H

AU - Dekker, Joost

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2016/5

Y1 - 2016/5

N2 - OBJECTIVES: Dysregulated biological stress systems and adverse life events, independently and in interaction, have been hypothesised to initiate chronic pain. We examine whether (1) function of biological stress systems, (2) adverse life events, and (3) their combination predict the onset of chronic multisite musculoskeletal pain.METHODS: Subjects (n=2039) of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were identified using the Chronic Pain Grade Questionnaire and followed up for the onset of chronic multisite musculoskeletal pain over 6 years. Baseline assessment of biological stress systems comprised function of the hypothalamic-pituitary-adrenal axis (1-h cortisol awakening response, evening levels, postdexamethasone levels), the immune system (basal and lipopolysaccharide-stimulated inflammation) and the autonomic nervous system (heart rate, pre-ejection period, SD of the normal-to-normal interval, respiratory sinus arrhythmia). The number of recent adverse life events was assessed at baseline using the List of Threatening Events Questionnaire.RESULTS: Hypothalamic-pituitary-adrenal axis, immune system and autonomic nervous system functioning was not associated with onset of chronic multisite musculoskeletal pain, either by itself or in interaction with adverse life events. Adverse life events did predict onset of chronic multisite musculoskeletal pain (HR per event=1.14, 95% CI 1.04 to 1.24, p=0.005).CONCLUSIONS: This longitudinal study could not confirm that dysregulated biological stress systems increase the risk of developing chronic multisite musculoskeletal pain. Adverse life events were a risk factor for the onset of chronic multisite musculoskeletal pain, suggesting that psychosocial factors play a role in triggering the development of this condition.

AB - OBJECTIVES: Dysregulated biological stress systems and adverse life events, independently and in interaction, have been hypothesised to initiate chronic pain. We examine whether (1) function of biological stress systems, (2) adverse life events, and (3) their combination predict the onset of chronic multisite musculoskeletal pain.METHODS: Subjects (n=2039) of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were identified using the Chronic Pain Grade Questionnaire and followed up for the onset of chronic multisite musculoskeletal pain over 6 years. Baseline assessment of biological stress systems comprised function of the hypothalamic-pituitary-adrenal axis (1-h cortisol awakening response, evening levels, postdexamethasone levels), the immune system (basal and lipopolysaccharide-stimulated inflammation) and the autonomic nervous system (heart rate, pre-ejection period, SD of the normal-to-normal interval, respiratory sinus arrhythmia). The number of recent adverse life events was assessed at baseline using the List of Threatening Events Questionnaire.RESULTS: Hypothalamic-pituitary-adrenal axis, immune system and autonomic nervous system functioning was not associated with onset of chronic multisite musculoskeletal pain, either by itself or in interaction with adverse life events. Adverse life events did predict onset of chronic multisite musculoskeletal pain (HR per event=1.14, 95% CI 1.04 to 1.24, p=0.005).CONCLUSIONS: This longitudinal study could not confirm that dysregulated biological stress systems increase the risk of developing chronic multisite musculoskeletal pain. Adverse life events were a risk factor for the onset of chronic multisite musculoskeletal pain, suggesting that psychosocial factors play a role in triggering the development of this condition.

U2 - 10.1136/annrheumdis-2014-206741

DO - 10.1136/annrheumdis-2014-206741

M3 - Article

VL - 75

SP - 847

EP - 854

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 5

ER -