Relationship between stress and pain in work‐related upper extremity disorders: The hidden role of chronic multisymptom illnesses*

Abstract

A model is presented that unites seemingly disparate findings across numerous investigations and provides a framework for understanding how genetics, triggering events, stressors, and early life events can affect CNS activity. Resultant symptom expression (e.g., pain and fatigue) from central dysregulation would be expected to occur in a subset of individuals in the population, including a subset of individuals with work-related upper extremity disorders. Thus when symptoms such as pain and fatigue persist beyond a reasonable period, consideration of CMI and associated assessment and interventions focused on central mechanisms may be worthwhile.

Altered cortical excitability in subjectively electrosensitive patients: Results of a pilot study

“…In line with these findings, our results suggest that subjectively electrosensitive patients are characterized by a distinct neurophysiological pattern, which is quite different from that of subjects with anxietyrelated personality traits [21]. Additional support for this finding comes from recent studies demonstrating that diseases primarily related to CMI and probably encompassing syndromes such as subjective electrosensitivity only show a modest link to classical psychiatric disorders [11]. With regard to our study, only two subjects fulfilled the criteria of major depression or anxiety disorder, strongly suggesting that alterations in cortical excitability in subjectively electrosensitive patients do not result from the additive presence of psychiatric diseases.…”

“…Due to these findings, symptom generation in these patients may be rather based on dysfunctional attributions of somatic symptoms to electromagnetic field exposure than to the exposure itself. The symptoms of subjectively electrosensitive patients are unspecific and overlap with many other syndromes of environmental intolerance, such as multiple chemical sensitivity or sick building syndrome [9,10], suggesting that hypersensitivity to electromagnetic fields should be considered as a form of a more general diagnostic entity labeled as chronic multisymptom illnesses (CMI) [11]. Despite serious scientific problems in definition and diagnostic criteria, the social impact of these illnesses is considerable, taking into account their high prevalence [1,2,4] and typical course, often ending in disablement [12].…”

Psychosocial and physiological correlates of self-reported hearing problems in male and female musicians in symphony orchestras

“…Different medical symptoms, such as muscle pain and headache, are by and of themselves stressors apart from their own pathological manifestations. It is also expected that individuals with stress-related problems have several different somatic and psychiatric symptoms since co-morbidity is common in stress-related disorders (Aaron and Buchwald, 2003;Aaron et al, 2001;Ciccone and Natelson, 2003;Clauw and Williams, 2002;Ursin and Eriksen, 2001). This calls for a more multidimensional approach in the diagnosis and treatment of stress-related hearing problems.…”

Predictors of Incident Chronic Widespread Pain Among Veterans Following the First Gulf War

“…These stressors or triggering events may be physical (eg, injury), 15,16 immune (eg, infection), 17,18 emotional (eg, trauma, psychosocial distress), 16,[19][20][21][22][23][24] chemical, [25][26][27] or any other mechanism that disrupts the body homeostasis. [28][29][30][31] To date, the search for a biological model to explain CWP among GW veterans has been unsuccessful. 5,32,33 Given the nature of the GWI and its overlap with many other chronic unexplained illnesses such as FMS, we suggest that the biopsychosocial model may provide a better solution to this diagnostic conundrum.…”