The impact of anxiety on chronic musculoskeletal pain and the role of astrocyte activation

Burston, James J.; Valdes, Ana; Woodhams, Stephen G; Mapp, P.I.; Stocks, Joanne; Watson, David J.; Gowler, Peter R W; Xu, Luting; Sagar, Devi Rani; Fernandes, Gwen; Frowd, Nadia; Marshall, Laura; Zhang, Weiya; Doherty, Michael; Walsh, David A.; Chapman, Victoria

doi:10.1097/j.pain.0000000000001445

Cited by 47 publications

(41 citation statements)

References 64 publications

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“…Young Fisher rats exhibit primary mechanical hyperalgesia at the inflamed knee joint only during the early phase (7 days) of the MIA‐induced OA model, whereas old Fischer rats show profound primary mechanical hyperalgesia that persists during the late OA phase (Ro et al, 2020). Pain‐related responses in preclinical OA models may depend on rat strains, the dose of the chemicals used to induce OA, types of behavioral assays, and the site of stimulation (Burston et al, 2019; Fecho et al, 2005; Malfait et al, 2013; Yoon et al, 1999). For example, YM Sprague Dawley rats display secondary hyperalgesia at a cutaneous site remote from the inflamed knee joint that persists during the late phase (Burston et al, 2019), but it is not known how age or sex impacts primary hyperalgesia or any OA‐related pain responses in Sprague Dawley rats.…”

Section: Discussionmentioning

confidence: 99%

“…Pain‐related responses in preclinical OA models may depend on rat strains, the dose of the chemicals used to induce OA, types of behavioral assays, and the site of stimulation (Burston et al, 2019; Fecho et al, 2005; Malfait et al, 2013; Yoon et al, 1999). For example, YM Sprague Dawley rats display secondary hyperalgesia at a cutaneous site remote from the inflamed knee joint that persists during the late phase (Burston et al, 2019), but it is not known how age or sex impacts primary hyperalgesia or any OA‐related pain responses in Sprague Dawley rats. Unfortunately, there is no study that directly compared MIA‐induced joint pathology or pain‐related responses between Fischer and Sprague Dawley rats.…”

Section: Discussionmentioning

confidence: 99%

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Pain modulatory network is influenced by sex and age in a healthy state and during osteoarthritis progression in rats

et al. 2021

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Old age and female sex are risk factors for the development of osteoarthritis (OA) and chronic pain. We investigated the effects of sex and age on pain modulatory networks in a healthy state and during OA progression. We used functional MRI to determine the effects of sex and age on periaqueductal gray functional connectivity (PAG FC) in a healthy state (pre‐OA) and during the early and late phases of monosodium iodoacetate‐induced OA in rats. We then examined how sex and age affect longitudinal changes in PAG FC in OA. In a healthy state, females exhibited more widespread PAG FC than males, and this effect was exaggerated with aging. Young males had moderate PAG FC changes during the early phase but recruited additional brain regions, including the rostral anterior cingulate cortex (ACC), during the late phase. Young females exhibited widespread PAG FC in the early phase, which includes connections to insula, caudal ACC, and nucleus accumbens (NAc). Older groups had strong PAG FC with fewer regions in the early phase, but they recruited additional brain regions, including NAc, in the late phase. Overall, our findings show that PAG FC is modulated by sex and age in a healthy state. A widespread PAG network in the early phase of OA pain may contribute to the transition from acute to chronic OA pain and the increased risk of developing chronic pain for females. Enhanced PAG FC with the reward system may represent a potential mechanism underlying chronic OA pain in elderly patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pain modulatory network is influenced by sex and age in a healthy state and during osteoarthritis progression in rats

et al. 2021

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“…OA pain and depressive symptoms interact in a recursive cycle, with each contributing to increased fatigue and disability, which may lead to pain worsening over time [20]. Furthermore, in a large sample of pain-free adults, high anxiety was found to predict new onset joint pain over a 12-month follow up period [115] and it was associated with increased pain sensitivity in people with established knee OA [115]. Similarly, people with OA who had the highest levels of psychological distress and pain vigilance showed a generalized increase in pain sensitivity [116], while higher levels of pain catastrophizing have been associated with a long-term worsening of OA pain [117].…”

Section: Introductionmentioning

confidence: 99%

Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis

Rice

McNair

Huysmans

et al. 2019

JCM

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Osteoarthritis (OA) is a leading cause of chronic pain and disability in older adults, which most commonly affects the joints of the knee, hip, and hand. To date, there are no established disease modifying interventions that can halt or reverse OA progression. Therefore, treatment is focused on alleviating pain and maintaining or improving physical and psychological function. Rehabilitation is widely recommended as first-line treatment for OA as, in many cases, it is safer and more effective than the best-established pharmacological interventions. In this article, we describe the presentation of OA pain and give an overview of its peripheral and central mechanisms. We then provide a state-of-the-art review of rehabilitation for OA pain—including self-management programs, exercise, weight loss, cognitive behavioral therapy, adjunct therapies, and the use of aids and devices. Next, we explore several promising directions for clinical practice, including novel education strategies to target unhelpful illness and treatment beliefs, methods to enhance the efficacy of exercise interventions, and innovative, brain-directed treatments. Finally, we discuss potential future research in areas, such as treatment adherence and personalized rehabilitation for OA pain.

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“…They are typically characterized by pain and restricted mobility, reducing people’s ability to work and participate in social roles with associated impacts on mental well-being ( Sleijser-Koehorst et al, 2019 ; World Health Organization, 2019 ). In addition, psychological disorders, such as depression and anxiety can increase the incidence risk of musculoskeletal diseases ( Gaspersz et al, 2018 ; Burston et al, 2019 ). Effectiveness of acupuncture in the treatment of musculoskeletal diseases has been reviewed in detail elsewhere ( MacPherson et al, 2017 ).…”

Section: Clinical Evidence For Acupuncturementioning

confidence: 99%

Acupuncture for Psychological Disorders Caused by Chronic Pain: A Review and Future Directions

Lin

Yang

et al. 2021

Front. Neurosci.

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Accumulating evidence supports an association between chronic pain and psychological disorders, a connection that seems to be bidirectional. Treating both the pain and psychological conditions together is essential for effective treatment outcomes. Acupuncture is a somatosensory-guided mind–body therapy that can tackle the multidimensional nature of pain with fewer or no serious adverse effects. In this review, we discuss the use of acupuncture in some conditions with a high incidence of psychological disorders caused by chronic pain: headache, musculoskeletal pain, low back pain, and cancer pain, focusing on the effect and potential mechanisms of acupuncture. Overall clinical studies indicated that acupuncture might effectively contribute to management of psychological disorders caused by chronic pain. Mechanistic studies showed that acupuncture significantly alleviated such psychological disorders by regulating the activity of amygdala and insula, and regulating functional connectivity of insular and limbic regions/medial prefrontal cortex in humans and the corresponding animal models. In addition, 5-HT in the dorsal raphe nucleus, opioid receptors in the cingulate cortex, and plasma met-enkephalin are involved in acupuncture relief of pain and psychological symptoms. Substantial evidences from animal and human research support a beneficial effect of acupuncture in psychological disorders caused by chronic pain.

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The impact of anxiety on chronic musculoskeletal pain and the role of astrocyte activation

Abstract: Supplemental Digital Content is Available in the Text. Anxiety predicts onset of knee pain and drives greater osteoarthritis pain in humans. Our validated preclinical model identifies supraspinal astrocytosis as a potential mechanism.

Cited by 47 publications

References 64 publications

Pain modulatory network is influenced by sex and age in a healthy state and during osteoarthritis progression in rats

Pain modulatory network is influenced by sex and age in a healthy state and during osteoarthritis progression in rats

Best Evidence Rehabilitation for Chronic Pain Part 5: Osteoarthritis

Acupuncture for Psychological Disorders Caused by Chronic Pain: A Review and Future Directions

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