Highlights
- •We conducted a systematic review of perceived stress and life stressors in chronic pain.
- •There is low-quality evidence in arthritis and chronic spinal pain.
- •There is high heterogeneity between stress measures.
- •Developing a core set of stress measures may be useful to guide future studies.
Abstract
The etiologic role of work-related psychological stress in the development of musculoskeletal
pain disorders (MDs) has been systematically investigated. Less clear, however, is
the role of perceived stress and life stressors. This review aimed to assess the evidence
for an etiologic role of perceived stress and life stressors in the development of
chronic MDs. Database searches were conducted to identify prospective longitudinal
studies that assessed perceived stress and life stressors in individuals without,
or in the first 6 weeks of, musculoskeletal pain. The primary outcome was the development
of a chronic MD. Methodologic quality was investigated using an adapted version of
the Quality Assessment Tool for Observational Cohort studies and Cross-Sectional studies,
and the strength of evidence using the Grading of Recommendations Assessment, Development
and Evaluation approach. Seven studies were included representing data from 6 independent
cohorts. There was some evidence to support the etiologic role of perceived stress
and life stressors in the development of arthritis (low quality) and chronic spinal
pain (low quality). The limited number of studies, the poor quality of the evidence,
and the heterogeneity of stress measures used across studies suggest that further
high quality prospective studies are required to clarify the role of perceived stress
and life stressors in the development of chronic MDs.
PROSPERO: CRD42017059949
Perspective
This review summarizes and critically appraises the evidence for the etiologic role
of perceived stress and life stressors in the development of chronic MDs. The limited
number of studies, the low quality of the evidence, and the heterogeneity across studies
suggest that further research is needed on perceived stress and life stressors in
MDs.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of PainAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Risk factors for onset of chronic oro-facial pain–results of the North Cheshire oro-facial pain prospective population study.Pain. 2010; 149: 354-359
- Development of temporomandibular disorder symptoms: A 3‐year cohort study of university students.Oral Rehabil. 2011; 38: 395-403
- Depression: The predisposing influence of stress.Behav Brain Sci. 1982; 5: 89-99
- Grading quality of evidence and strength of recommendations.BMJ. 2004; 328 (1490-1490)
- A note on the magnitude of hazard ratios.Cancer. 2016; 122: 1298-1299
- Association of depression and anxiety alone and in combination with chronic musculoskeletal pain in primary care patients.Psychosom Med. 2008; 70: 890-897
- The association between psychological factors and the development of complex regional pain syndrome type 1 (CRPS1)-a prospective multicenter study.Eur J Pain. 2011; 15: 971-975
- Chronic pain, chronic stress and depression: Coincidence or consequence?.J Neuroendocrinol. 2001; 13: 1009-1023
- Psychological processes underlying the development of a chronic pain problem: A prospective study of the relationship between profiles of psychological variables in the fear-avoidance model and disability.Clin J Pain. 2006; 22: 160-166
- The burden of musculoskeletal disease–a global perspective.Clin Rheumatol. 2006; 25: 778-781
- The role of psychosocial work factors in the development of musculoskeletal disorders in workers.Med Pr. 2011; 62: 653-658
- The role of psychosocial stress in the development of chronic musculoskeletal pain disorders: Protocol for a systematic review and meta-analysis.Syst Rev. 2017; 6: 224
- Epidemiology of chronic musculoskeletal pain.Best Pract Res Clin Rheumatol. 2011; 25: 173-183
- A power primer.Psychol Bull. 1992; 112: 155-159
- Strategies for measuring stress in studies of psychiatric and physical disorders.in: Cohen S. Kessler R.C. Underwood L.G. Measuring Stress: A Guide for Health and Social Scientists. Oxford University Press, New York, NY1995,: pp 3-28
- Chronic musculoskeletal pain.BMJ. 2012; 346
- More than a feeling: A unified view of stress measurement for population science.Front Neuroendocrinol. 2018; 49: 146-169
- Psychosocial work stress, leisure time physical exercise and the risk of chronic pain in the neck/shoulders: Longitudinal data from the Norwegian HUNT Study.Int J Occup Med Environ Health. 2016; 29: 585-595
- Biological stress systems, adverse life events and the onset of chronic multisite musculoskeletal pain: A 6-year cohort study.Ann Rheum Dis. 2016; 75: 847-854
- Psychometric properties of the life events checklist.Assessment. 2004; 11: 330-341
- Causal diagrams for epidemiologic research.Epidemiology. 1999; 10: 37-48
- Bias and causal associations in observational research.Lancet. 2002; 359: 248-252
- Prognostic factors in first‐time care seekers due to acute low back pain.Eur J Pain. 2007; 11: 290-298
- A cross-national study of the course of persistent pain in primary care.Pain. 2001; 92: 195-200
- Rating quality of evidence and strength of recommendations: GRADE: An emerging consensus on rating quality of evidence and strength of recommendations.BMJ. 2008; 336: 924-926
- Chronic and acute stress and the prediction of major depression in women.Depress Anxiety. 2009; 26: 718-723
- The influence of perceived stress on the onset of arthritis in women: Findings from the Australian Longitudinal Study on Women's Health.Ann Behav Med. 2013; 46: 9-18
- The impact of work-related psychosocial stressors on the onset of musculoskeletal disorders in specific body regions: A review and meta-analysis of 54 longitudinal studies.Work Stress. 2011; 25: 243-256
- Recovery-stress patterns and low back pain: Differences in pain intensity and disability.Musculoskeletal Care. 2017; 16: 18-25
- Cohort studies of aetiology and prognosis: They're different.J Physiother. 2014; 60: 241-244
- Cochrane Handbook for Systematic Reviews of Interventions.The Cochrane Library, Wiley and Sons, Chichester, UK2005
- Psychosocial work aspects, stress and musculoskeletal pain among musicians. A systematic review in search of correlates and predictors of playing-related pain.Work. 2016; 54: 657-668
- Association between stress and temporomandibular disorder.Nihon Hotetsu Shika Gakkai Zasshi. 2008; 52: 375-380
- Job demands, job decision latitude, and mental strain: Implications for job redesign.Adm Sci Q. 1979; : 285-308
- Traumatic experiences in childhood and the risk of arthritis: A prospective cohort study.Can J Public Health. 2004; 95: 361-365
- Work-related psychosocial factors and chronic pain: A prospective cohort study in Canadian workers.J Occup Environ Med. 2004; 46: 1263-1271
- Stressful experiences in childhood and chronic back pain in the general population.Clin J Pain. 2005; 21: 478-483
- The incremental effect of psychosocial workplace factors on the development of neck and shoulder disorders: A systematic review of longitudinal studies.Int Arch Occup Environ Health. 2013; 86: 375-395
- Low back pain (non-specific).Best Pract Res Clin Rheumatol. 2007; 21: 77-91
- Psychosocial work stressors as antecedents of musculoskeletal problems: A systematic review and meta-analysis of stability-adjusted longitudinal studies.Soc Sci Med. 2012; 75: 1163-1174
- A systematic review of risk factors associated with transitioning from regional musculoskeletal pain to chronic widespread pain.Eur J Pain. 2012; 16: 1084-1093
- Theory-based stress measurement.Psychol Inq. 1990; 1: 3-13
- Review of the psychometric evidence of the perceived stress scale.Asian Nurs Res (Korean Soc Nurs Sci). 2012; 6: 121-127
- Occupational psychological factors increase the risk for back pain: A systematic review.J Occup Rehabil. 2001; 11: 53-66
- Prognostic factors for musculoskeletal pain in primary care: A systematic review.Br J Gen Pract. 2007; 57: 655-661
- Observational research methods. Research design II: Cohort, cross sectional, and case-control studies.Emerg Med J. 2003; 20: 54-60
- Burden of disability due to musculoskeletal (MSK) disorders.Best Pract Res Clin Rheumatol. 2014; 28: 353-366
- Epidemiology of chronic musculoskeletal pain.Best Pract Res Clin Rheumatol. 2007; 21: 403-425
- Predicting the transition from acute to persistent low back pain.Occup Med. 2011; 61: 127-131
National Heart, Lung, and Blood Institute. Quality assessment tool for observational cohort and cross-sectional studies. Available at: https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools. Accessed August 30, 2017
- Does income matter for troublesome neck pain? A population-based study on risk and prognosis.J Epidemiol Community Health. 2012; 66: 1063-1070
- A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain.Spine. 2002; 27: E109-E120
- Campbell Methods Policy Note on Converting Between Effect Sizes.The Campbell Collaboration, Oslo, Norway,2016
- Impact of psychological stress on irritable bowel syndrome.World J Gastroenterol. 2014; 20: 14126-14131
- Psychosocial risk factors for chronic low back pain in primary care–a systematic review.Fam Pract. 2011; 28: 12-21
- The prevalence and burden of arthritis.Rheumatology. 2002; 41: 3-6
- Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy.Circulation. 1999; 99: 2192-2217
- Cochrane Consumers and Communication Review Group: Data synthesis and analysis.Cochrane Consumers an Communication Review Group,. 2013; (Available at:)http://cccrg.cochrane.orgDate accessed: January 10, 2018
- Psychosocial, physical, and neurophysiological risk factors for chronic neck pain: A prospective inception cohort study.J Pain. 2015; 16: 1288-1299
S Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA: Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ 4:1-9, 2015
- Reducing bias through directed acyclic graphs.BMC. 2008; 8: 70
- Adverse health effects of high-effort/low-reward conditions.J Occup Health Psychol. 1996; 1: 27-41
- Spinal pain and co-occurrence with stress and general well-being among young adolescents: A study within the Danish National Birth Cohort.Eur J Pediatr. 2017; 176: 807-814
- Musculoskeletal disorders and the Global Burden of Disease study.Ann Rheumatic Dis. 2014; 73: 949-950
- Sample design of the national population health survey.Health Rep. 1995; 7 (29-38): 31-42
- Stress, inflammation and pain: A potential role for monocytes in fibromyalgia-related symptom severity.Stress Health. 2016; 32: 503-513
- Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010.Lancet. 2012; 380: 2163-2196
Article info
Publication history
Published online: February 21, 2019
Footnotes
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. VB is a recipient of a Western Sydney University Postgraduate Research Award Scholarship. WJC (#1094434), MBL and SMS (#1105040) received salary support from The National Health and Medical Research Council of Australia. The authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2019 by the American Pain Society
