Abstract
Musculoskeletal pain affects approximately 20% of the population worldwide and represents one of the leading causes of global disability. As yet, precise mechanisms underlying the development of musculoskeletal pain and transition to chronicity remain unclear, though individual factors such as sleep quality, physical activity, affective state, pain catastrophizing and psychophysical pain sensitivity have all been suggested to be involved. This study aimed to investigate whether factors at baseline could predict musculoskeletal pain intensity to an experimental delayed onset of muscle soreness (DOMS) pain model. Demographics, physical activity, pain catastrophizing, affective state, sleep quality, isometric force production, temporal summation of pain, and psychophysical pain sensitivity using handheld and cuff algometry were assessed at baseline (Day-0) and two days after (Day-2) in 28 healthy participants. DOMS was induced on Day-0 by completing eccentric calf raises on the non-dominant leg to fatigue. On Day-2, participants rated pain on muscle contraction (visual analogue scale, VAS, 0-10cm) and function (Likert scale, 0–6). DOMS resulted in non-dominant calf pain at Day-2 (3.0±2.3cm), with significantly reduced isometric force production (P<0.043) and handheld pressure pain thresholds (P<0.010) at Day-2 compared to Day-0. Linear regression models using backward selection predicted from 39.3% (P<0.003) of VAS to 57.7% (P<0.001) of Likert score variation in DOMS pain intensity and consistently included cuff pressure pain tolerance threshold (P<0.01), temporal summation of pain (P<0.04), and age (P<0.02) as independent predictive factors. The findings indicate that age, psychological and central pain mechanistic factors are consistently associated with pain following acute muscle injury.
Highlights
Musculoskeletal pain is estimated to affect approximately 20% of individuals globally [1]
Higher self-reported leisure time physical activity has proven to be predictive of less pain and disability in people with chronic low back pain [15], and is associated with improved central pain processing, such as increased conditioned pain modulation (CPM) and reduced temporal summation of pain (TSP) [16]
Positive affective state has previously been observed to be associated with decreased pain severity in people with chronic pain [17], while studies have suggested that higher pain catastrophizing is associated with reduced CPM, indicating a less efficient pain inhibitory system [18], and higher levels of clinical pain after e.g., surgery [19] and general practitioner treatment [20]
Summary
Musculoskeletal pain is estimated to affect approximately 20% of individuals globally [1]. Demographic factors, such as age and sex [2,3,4,5,6,7,8,9], together with other individual lifestyle and psychosocial factors, and alterations in pain processing mechanisms may contribute to the risk of chronic pain development. Positive affective state has previously been observed to be associated with decreased pain severity in people with chronic pain [17], while studies have suggested that higher pain catastrophizing is associated with reduced CPM, indicating a less efficient pain inhibitory system [18], and higher levels of clinical pain after e.g., surgery [19] and general practitioner treatment [20]
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