Abstract
Chronic musculoskeletal pain (MSP) is common following traumatic or stressful life events and is more common in women than men. However, female specific predictors and mediators of chronic posttraumatic MSP are poorly understood. In the current study we examined the relationship between circulating 17β-estradiol (E2) levels, RNA transcripts that E2 might influence, and chronic MSP development in women following traumatic motor vehicle collision (MVC) without fractures/tissue injury. Blood plasma and RNA was collected from individuals enrolled in the emergency department (ED) following MVC trauma and MSP severity (0-10NRS) was assessed 6 weeks 6 months and 1 year following MVC. E2 levels were measured via ELISA and RNA expression via RNA seq. The association between E2 levels and post-MVC chronic MSP development (n=95) and the association between E2, RNA expression, and post-MVC chronic MSP (n=41) was assessed using repeated measures mixed models adjusted for age and ED study site. Women with higher circulating levels of E2 at the time of trauma exposure reported less severe pain following MVC compared to women with lower circulating levels of E2 (0-10NRS at 1 year: 3.24 vs 5.05, p=0.008). RNA transcripts (p
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