The Biology of Stress Intolerance in Patients with Chronic Pain-State of the Art and Future Directions

• Stress has been consistently linked to negative impacts on physical and mental health. More specifically, patients with chronic pain experience stress intolerance, which is an exacerbation or occurrence of symptoms in response to any type of stress. The pathophysiological mechanisms underlying this phenomenon remain unsolved. In this state-of-the-art paper, we summarised the role of the autonomic nervous system (ANS) and hypothalamus-pituitary-adrenal (HPA) axis, the two major stress response systems in stress intolerance. We provided insights into such mechanisms based on evidence from clinical studies in both patients with chronic pain, showing dysregulated stress systems, and healthy controls supported by preclinical studies, highlighting the link between these systems and symptoms of stress intolerance. Furthermore, we explored the possible regulating role for (epi)genetic mechanisms influencing the ANS and HPA axis. The link between stress and chronic pain has become an important area of research as it has the potential to inform the development of interventions to improve the quality of life for individuals living with chronic pain. As stress has become a prevalent concern in modern society, understanding the connection between stress, HPA axis, ANS, and chronic health conditions such as chronic pain is crucial to improve public health and well-being.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Nyckelord

chronic pain

stress intolerance

autonomic nervous system

hypothalamus-pituitary-adrenal axis

genetics

epigenetics

catechol-o-methyltransferase

autonomic nervous-system

heart-rate-variability

low-back-pain

corticotropin-releasing factor

glucocorticoid-receptor gene

chronic-fatigue-syndrome

blood

mononuclear-cells

hypothalamic-pituitary

sympathoadrenal responses

General & Internal Medicine

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)