Figure 2 - available via license: Creative Commons Attribution 4.0 International
Content may be subject to copyright.
Crosstalk between adipose tissue, skin, and visceral nociceptors. There is a multitude of diffusible factors secreted by adipose tissue that interact with nociceptors, triggering pain. (1) Adipose tissue is made up of an accumulation of adipocytes, macrophages, lymphocytes, neutrophils, T-cells, natural killer cells, and fibroblasts, as well as an extensive network of blood vessels. (2) Adipocytes secrete adipokines, such as adiponectin, which can reach the skin through the bloodstream. Under an inflammatory condition of the skin, the cutaneous macrophages secrete cytokines, which excite and sensitize the cutaneous nociceptors, triggering pain. Adiponectin acts on these macrophages, inhibiting the release of pain-inducing cytokines. Therefore, this adipokine has analgesic effects. (3) Fibroblasts from adipose tissue accumulated in body tissues and organs secrete growth factors that interact with G protein-coupled receptors on the membrane of nociceptors. Some of these growth factors activate intracellular cascades (e.g., ERK) that allow peripheral sensitization through ion channel phosphorylation (e.g., Nav1.8), thus favoring cation fluxes that trigger depolarization of nociceptors and pain. Other growth factors modulate ion channel opening (e.g., ASIC) and cation entry and depolarization of the nociceptor. Together, growth factors secreted by fibroblasts in adipose tissue cause hyperexcitability of nociceptors and pain. On the other hand, the endothelial cells of the blood vessels that supply adipose tissue secrete oxygen free radicals (ROS) that diffuse to the nociceptors, modulating various intracellular signaling pathways, which cause ion channel phosphorylation, peripheral sensitization and hyperarousal of nociceptors. (4) Inflammation of body tissues, such as the skin, triggers the nociceptors themselves to release adrenomedullin (ADM) or macrophages to release angiotensin-II (Ang-II), two adipokines also secreted by adipose tissue. Both diffusible factors act on receptors in the membrane of cutaneous (or visceral) nociceptors, modulating the opening of ion channels, cation fluxes, and depolarization, causing pain. (5) The macrophages (and other immune cells) of the adipose tissue accumulated in the organs of obese subjects, secrete various cytokines, which by diffusing can interact with specific receptors present in the membrane of visceral nociceptors. The interaction of cytokines is carried out on receptors coupled to G proteins. Some of these interactions (e.g., TNF-alpha) modulate the opening/closing of ion channels, causing variations in the influx of calcium ions. These ions favor the fusion of vesicles loaded with peptides (e.g., pep-tide related to the calcitonin gene or CGRP, adrenomedullin or ADM) present at the terminals of nociceptors. Thus, adipose tissue cytokines cause the release of CGRP and ADM by visceral nociceptors, peptides that interact with their respective receptors (R) that end up regulating the opening of ion channels that favor the entry of sodium ions and depolarization of the nociceptor. At other times, cytokines released by adipose tissue regulate various intracellular cascades (e.g., cAMP/PKA-PKC, ERK, p38-MAPK, IP3/DAG) responsible for the phosphorylation of ion channels and other metabotropic receptors on the nociceptor membrane, triggering peripheral sensitization and hyperexcitability of the nociceptive afferent nerve fiber. In summary, in obese subjects, there is a powerful crosstalk between the accumulated adipose tissue in the body organs and the nociceptive afferent nerve fibers present in these organs, so that the diffusible factors secreted by the adipose tissue cause sensitization and hyperexcitability of the nociceptor, triggering pain. For details, see the main text. Source for figure illustrations: https://scidraw.io/ (accessed on 8 September 2021).
Source publication
A sedentary lifestyle is associated with overweight/obesity, which involves excessive fat body accumulation, triggering structural and functional changes in tissues, organs, and body systems. Research shows that this fat accumulation is responsible for several comorbidities, including cardiovascular, gastrointestinal, and metabolic dysfunctions, as...
Context in source publication
Context 1
... this section, evidence has been presented that neuropathic and nociplastic pain are symptoms and signs associated with obese subjects, and that adipose tissue, skin, heart, pancreas, liver, and other body organs of different mammalian species, including humans, present nociceptors and, therefore, can be excited and/or sensitized by the chemical substances released by the adipose tissue that is deposited on them in obese subjects. A schematic illustration of such processes involving adipose tissue chemical substance release and nociceptor activation is shown in Figure 2. (2) Adipocytes secrete adipokines, such as adiponectin, which can reach the skin through the bloodstream. ...
Citations
... Older post-TKA patients are often less active and show more SB due to comorbidities in the form of metabolic disorders (e.g., obesity or diabetes mellitus), cardiovascular disorders (e.g., hypertension or atherosclerosis), or nutritional deficiencies. Prolonged sedentary behaviour can lead to fat accumulation and muscle atrophy, thus increasing the risk of cardiovascular, gastrointestinal, and metabolic dysfunction diseases 36,37 . Therefore, it is necessary to reduce the comorbidity index and SB in elderly TKA patients. ...
To understand the status of sedentary behaviour in elderly patients after total knee arthroplasty and analyse its influencing factors so as to provide a reference for developing targeted interventions. Conveniently selected elderly patients undergoing total knee arthroplasty (> 6 months) in a tertiary hospital in Jiangsu Province were investigated using a general information questionnaire, the Charlson Comorbidity Index, patients’ self-reported sedentary behaviour information, the WOMAC Score, The Groningen Orthopaedic Social Support Scale, and Lee’s Fatigue. The median daily sedentary time was 5.5 h (4.5 h, 6.625 h) in 166 elderly patients after total knee arthroplasty, of whom 82 (49.40%) showed sedentary behaviour (≥ 6 h per day). Logistic regression analysis showed that being retired/unemployed (OR = 8.550, 95% CI 1.732–42.207, P = 0.0084), having a CCI score ≥ 3 (OR = 9.018, 95% CI 1.288–63.119, P < 0.0001), having high WOMAC scores (OR = 1.783, 95% CI 1.419–2.238, P < 0.0001), having a high social support score (OR = 1.155, 95% CI 1.031–1.294, P = 0.0130), and having a fatigue score ≥ 5 (OR = 4.848, 95% CI 1.084–21.682, P = 0.0389) made patients more likely to be sedentary. The sedentary time of elderly patients after total knee arthroplasty is long, and sedentary behaviour is common among them. Healthcare professionals should develop targeted sedentary behaviour interventions based on the influencing factors of sedentary behaviour in order to reduce the occurrence of sedentary behaviour in elderly patients after total knee arthroplasty.
... Somatic pain arises in the skin, muscles, joints, bones, or connective tissues. In contrast, visceral pain originates from smooth muscle spasms, tension in abdominal organs, insufficient blood flow, and inflammation-related diseases [1]. ...
Analgesics are medications that alleviate pain without impairing consciousness, with certain plants, such as basil (Ocimum x africanum L.), showing potential as natural pain relievers. This research investigated the analgesic effects of ethanol and ethyl acetate extracts from basil leaves on acetic acid-induced pain in rats. The study utilized percolation extraction methods with 96% ethanol and ethyl acetate solvents. Twenty-eight male white rats were divided into seven groups: one normal control group without treatment or induction, one negative control group receiving 0.5% CMC-Na, two groups treated with ethanol extracts of basil leaves at doses of 400 mg/kg BW and 800 mg/kg BW, two groups treated with ethyl acetate extracts at the same doses, and one positive control group administered 50 mg/kg BW diclofenac sodium. Thirty minutes post-treatment, 1% acetic acid was injected intraperitoneally, and writhing responses were observed over 60 minutes. The data on percentage protection from writhing were analyzed using One-way ANOVA followed by the LSD test. The findings revealed that both the ethanol and ethyl acetate extracts at an 800 mg/kg BW dosage closely matched the analgesic effectiveness of the diclofenac sodium group.
... Technological devices in the home easily provide entertainment options that replace previously outdoor activities involving physical activity. Together with sedentary lifestyles and unhealthy foods, they contribute to weight gain and obesity [28,29], triggering detrimental health problems in the general population [22,26,27,[30][31][32]. ...
Childhood is a crucial stage of human development in which the lifestyles children adopt can have a significant impact on their well-being throughout their lives. The aim of this study was to analyze and compare the healthy habits and Body Mass Index (BMI) of students from a primary school that participated in a program to promote physical activity and healthy eating one year earlier with other students from two schools that had not participated in this type of program. We analyzed a sample of 287 Spanish students, aged between 8 and 12 years. A survey of healthy habits was completed, and anthropometric data were taken to determine their Body Mass Index (BMI). The questionnaire data indicated that there are some significant differences (p = ≤ 0.05) in the consumption of some unhealthy foods between the evaluated groups. An amount of 11% of the sample was considered obese and 26% were overweight; no significant differences were found between the groups. This study suggests that the healthy habits strategy implemented by a school improves pupils’ habits, especially in reducing the consumption of unhealthy foods. Despite the positive effects, the data indicate that these programs fall short of government recommendations, particularly in areas such as physical activity and certain dietary choices.
... Several studies indicate that obesity has an inflammatory component and is associated with chronic low-grade inflammation in, for example, adipose tissue, skeletal muscle, liver, pancreas, intestine and brain (45). In obese subjects, visceral and abdominal fat tissues secrete, for example, cytokines, chemokines (e.g., TNF-α, IL-6, IL-18, MCP-1/CCL2, CCL19, HGF, CSF-1, and VEGF-A), osteopontin, interferon-gamma, adipokines and micro-RNAs that can exert functional and pathophysiological alterations in various tissues (46)(47)(48)(49). However, the knowledge concerning such secretions in chronic widespread pain including FM is lacking and the number of cytokines and chemokines per study is generally limited. ...
... One possibility is that the significance of the BC variables just reflects that patients with FM have more adipose tissue and less fat free muscle volume, without any causal explanation. However, the literature as well as our regression of FIC-index (Table 4 and Supplementary Table 8) show that adipose tissues are indeed active tissues secreting proteins actively involved in immunological and inflammatory processes (46)(47)(48). Moreover, most of the identified compounds that correlated with FIC-index have previously been reported as important variables for discriminating FM with obesity from non-obese FM patients (see Supplementary Table 8) (44). ...
... A mix of increased plasma proteins-i.e., the five most significant were M-CSF/CSF-1, MDC/CCL22, IL-1RA, MIP-1α/CCL3, and IL-2RA-were associated with FIC-index (Table 4 and Supplementary Table 8, right part). These positive associations are consistent with obesity studies reporting activated peripheral immune and inflammation processes (45,46,146). For example, VAT and SAT secrete cytokines and chemokines as well as several compounds also found here (Supplementary Table 8): MIP-1α/CCL3, MCP1/CCl2, I-309/CCL1, and IL-18 (46). ...
Objectives
This explorative study analyses interrelationships between peripheral compounds in saliva, plasma, and muscles together with body composition variables in healthy subjects and in fibromyalgia patients (FM). There is a need to better understand the extent cytokines and chemokines are associated with body composition and which cytokines and chemokines differentiate FM from healthy controls.
Methods
Here, 32 female FM patients and 30 age-matched female healthy controls underwent a clinical examination that included blood sample, saliva samples, and pain threshold tests. In addition, the subjects completed a health questionnaire. From these blood and saliva samples, a panel of 68 mainly cytokines and chemokines were determined. Microdialysis of trapezius and erector spinae muscles, phosphorus-31 magnetic resonance spectroscopy of erector spinae muscle, and whole-body magnetic resonance imaging for determination of body composition (BC)—i.e., muscle volume, fat content and infiltration—were also performed.
Results
After standardizing BC measurements to remove the confounding effect of Body Mass Index, fat infiltration and content are generally increased, and fat-free muscle volume is decreased in FM. Mainly saliva proteins differentiated FM from controls. When including all investigated compounds and BC variables, fat infiltration and content variables were most important, followed by muscle compounds and cytokines and chemokines from saliva and plasma. Various plasma proteins correlated positively with pain intensity in FM and negatively with pain thresholds in all subjects taken together. A mix of increased plasma cytokines and chemokines correlated with an index covering fat infiltration and content in different tissues. When muscle compounds were included in the analysis, several of these were identified as the most important regressors, although many plasma and saliva proteins remained significant.
Discussion
Peripheral factors were important for group differentiation between FM and controls. In saliva (but not plasma), cytokines and chemokines were significantly associated with group membership as saliva compounds were increased in FM. The importance of peripheral factors for group differentiation increased when muscle compounds and body composition variables were also included. Plasma proteins were important for pain intensity and sensitivity. Cytokines and chemokines mainly from plasma were also significantly and positively associated with a fat infiltration and content index.
Conclusion
Our findings of associations between cytokines and chemokines and fat infiltration and content in different tissues confirm that inflammation and immune factors are secreted from adipose tissue. FM is clearly characterized by complex interactions between peripheral tissues and the peripheral and central nervous systems, including nociceptive, immune, and neuroendocrine processes.
... Although physical activity can exhibit an advantageous effect on various GI symptoms, such influence depends mainly upon the exercise mode, duration, and intensity [68]. For example, prolonged repetitive physical activity such as running can impair BGA signaling and sensitization, intestinal barrier integrity, GI motility, esophageal sphincter tone and ultimately induce GI dysfunction and severe symptoms [69,70] such as nausea, diarrhea, and GI bleeding [68]. Nevertheless, this evidence seems low-quality to make specific recommendations to use physical activity as therapy for patients with IBS as it is based on the heterogeneity of study designs, interventions, and outcome measures [56]. ...
... Generally, anaerobic strength exercise has higher adverse effects than aerobic endurance exercise [37,39]. Vigorous exercise, such as competitive running, can impair brain-gut axis signaling, trigger splanchnic ischemia and blood hypoperfusion where blood is moved forward the working muscles, exacerbating nutrient absorption, increasing intestinal permeability and motility dysfunction, and aggravating the severity of IBS GI and extra-GI symptoms [68][69][70][82][83][84][85][86]. ...
Purpose: Irritable bowel syndrome is one of the most common gastrointestinal disorders worldwide that negatively affects health and quality of life and imposes high costs. Increasing attention is being paid to non-pharmacological therapies,
like physical exercise, to manage and alleviate irritable bowel syndrome symptoms, but the underlying mechanism is unclear, and the evidence is inconclusive. This article aims to provide an overview analysis of the recent evidence that links physical exercise with irritable bowel symptoms.
Material and methods. For the last five years of research (2018-2023), we searched several international scientific databases, including Web of Science, Scopus, Science Direct, ADI, the Cochrane Central Register of Controlled Trials,
PubMed, Medline, Clinical trials.gov, Google Scholar, and the WHO database.
Results. Generally, exercise exerts variable effects on gut physiology, integrity, and health. Much research recommended adopting regular light-to-moderate aerobic exercise and relaxation anaerobic exercise to enhance the patient’s psychological well-being and alleviate global irritable bowel syndrome symptoms. These types of exercise are purported to improve bowel function, motility, tone, habits, immunity, microbial diversity, and quality of life due to a decrease in psychological stress, depression, anxiety index, irritable bowel syndrome symptom severity score, intestinal hypersensitivity, and gut permeability. In contrast, more studies reported several disruptive effects of vigorous aerobic exercise on gut integrity and physiology that can compromise irritable bowel syndrome symptoms by inducing splanchnic hypoperfusion, gastrointestinal epithelial wall damage, malabsorption, dysbiosis, and bacterial translocation, thus calling into question the positive outcomes of the exercise.
Conclusions. There is overwhelming evidence recommending regular light-to-moderate aerobic exercise and anaerobic relaxation exercises for patients with IBS. However, this evidence seems low-quality, making it challenging to confirm
the actual impacts of exercise. Ethnicity, study design, type and intensity of exercise, and methodological issues are among the reasons that are put forward to account for this low-quality evidence. Thus, well-designed plausible studies, particularly randomized controlled trials and research on individualized exercise intervention settings that consider exercise frequency, intensity, time, type, volume, and progression, are highly demanded to enable drawing specific exercise recommendations for irritable bowel syndrome patients without adverse effects.
Keywords: irritable bowel syndrome symptoms, exercise, physical activity, life quality, anxiety, depression
... Altered daily routines (sleeping, working, and leisure activities) contributed to a more sedentary lifestyle and access to unhealthy food. Existing knowledge clearly states that a sedentary lifestyle is associated with weight gain, which involves fat accumulation that leads to structural and functional changes in tissues, organs, and body systems [47]. Notwithstanding pain-related routine changes, the overall modern western lifestyle (significant sedentariness and easy access to energy condensed food) may also play a significant role. ...
Background
Despite the existing evidence regarding the interrelated relationship between pain and obesity, knowledge about patients’ perspectives of this relationship is scarce, especially from patients with chronic pain and obesity after completing Interdisciplinary Pain Rehabilitation Program (IPRP).
Aims
This qualitative study expands the understanding of patients’ perspectives on how chronic pain and obesity influence each other and how the two conditions affect the ability to make lifestyle changes.
Method
A purposive sample of patients with Body Mass Index (BMI) ≥ 30 kg/m ² and who had completed an IPRP were recruited for individual semi-structured interviews. The transcribed interviews were analysed using latent content analysis and a pattern of theme and categories was constructed based on the participants’ perspectives.
Results
Sixteen patients (aged 28–63 years, 11 female, BMI 30–43 kg/m ² ) shared their experiences of chronic pain, obesity and lifestyle changes after IPRP. The analysis revealed one overall theme ( lifestyle changes are burdensome with a body broken by both pain and obesity ) and four categories ( pain disturbing days and nights worsens weight control , pain-related stress makes lifestyle changes harder , a painful and obese body intertwined with negative emotions and the overlooked impact of obesity on chronic pain ). Most participants perceived that their pain negatively impacted their obesity, but they were uncertain whether their obesity negatively impacted their pain. Nevertheless, the participants desired and struggled to make lifestyle changes.
Conclusion
After IPRP, patients with chronic pain and obesity perceived difficulties with self-management and struggles with lifestyle changes. They experienced a combined burden of the two conditions. Their perspective on the unilateral relationship between pain and obesity differed from the existing evidence. Future tailored IPRPs should integrate nutritional interventions and address the knowledge gaps as well.
... Overweight and obesity are often multifactorial, including factors contributing to gaining and retaining excess weight. Commonly mentioned factors include social and environmental factors (such as fast food culture, sedentary work environment, etc.), and personal factors (such as diet, lack of exercise, genetics, and mental health symptoms) [7][8][9][10][11][12]. ...
Background:
Depression, anxiety, and stress symptoms have been found to be associated with overweight or obesity, but the gender differences in the associations have not been well-examined. Based on a national sample of endocrinologists in China, we examined such associations with a focus on gender differences.
Methods:
Data were collected from endocrinologists in China using an online questionnaire, which included demographic data, body weight, and height. Depression, anxiety, and stress symptoms were assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21).
Results:
In total, 679 endocrinologists (174 males and 505 females) completed the survey. One-fourth (25.6%) were classified as overweight, with a significant gender difference (48.9% in males vs. 17.6% in females, p < 0.05). Overall, 43.4% of the participants endorsed probable depressive symptoms (54.6% in males and 39.6% in females, p = 0.004), 47.6% for anxiety (51.7% in males vs. 46.1% in females, p = 0.203), and 29.6% for stress symptoms (34.5% in males vs. 27.92% in females, p = 0.102). After controlling for confounders, in the whole group, male gender (aOR = 4.07, 95% CI:2.70-6.14, p < 0.001), depression (aOR = 1.05, 95% CI:1.00-1.10, p = 0.034) and age (aOR = 1.03, 95% CI:1.00-1.05, p = 0.018) were positively associated with overweight. In males, depression (aOR = 1.14, 95% CI:1.05-1.25, p = 0.002), administration position (aOR = 4.36, 95% CI:1.69-11.24, p = 0.002), and night shifts/month (aOR = 1.26, 95% CI:1.06-1.49, p = 0.008) were positively associated with overweight, while anxiety (aOR = 0.90, 95% CI:0.82-0.98, p = 0.020) was negatively associated with overweight. In females, only age (aOR = 1.04, 95% CI:1.01-1.07, p = 0.014) was significantly associated with overweight status, while depression and anxiety were not associated with overweight. Stress symptoms were not associated with overweight in either gender.
Conclusions:
One-fourth of endocrinologists in China are overweight, with a rate in males nearly triple the one in females. Depression and anxiety are significantly associated with overweight in males but not females. This suggests possible differences in the mechanism. Our findings also highlight the need to screen depression and overweight in male physicians and the importance of developing gender-specific interventions.
... Obesity with high BMI (body mass index) is a persistent problem from many years and has led to several complications including diabetes, cardiovascular dysfunction, neurological problem and even cancer (Liu et al. 2020). Unhealthy food habit, sedentary life style, urbanization and less exercise is fueling the risk of fat accumulation (Park et al. 2020;Verdu et al. 2021). Obesity is linked with insulin resistance, altered glucose tolerance, hypertension, liver damage thereby causing a high risk of mortality (Kahn and Flier 2000;Bendor et al. 2020).Despite various applications of synthetic drug and liposuction, the epidemiological rate of obese person is always high and urge for effective and sustainable intervention for high social impact. ...
Lipase and protease inhibitors have received substantial attention in weight-loss drug market and inhibitors from natural sources have been a hotspot research in present medicinal field. Hence the focus of the present investigation was to evaluate lipase and protease inhibitory efficiency of jaggery prepared under high temperature (open-pan jaggery-OJ), low temperature (vacuum evaporated jaggery-VJ) and lyophilized sugarcane juice (SJ) which served as a control. The above samples were subjected to direct and Soxhlet extraction for phytochemicals using aqueous, methanol and ethyl acetate solvents. Lipase and protease inhibitory activity was observed in aqueous extract of OJ and to a lesser extent in VJ. With respect to methanolic extract of samples, decline in enzyme inhibitory efficiency in OJ and VJ was observed compared to SJ. Ethyl acetate extracts exhibited trace levels of inhibitory activity in OJ and VJ compared to SJ. This study provides necessary information to make jaggery as a choice for managing obesity and associated complications.
... According to our findings, metabolic diseases overlap in the MSK pain population as they appeared to form a group of their own. Obesity, hypertension, and diabetes often go hand in hand at the population levelparticularly as obesity has a strong and negative influence on these cardiometabolic risk factors [62]. In accordance with the present results, a cardiometabolic cluster with the highest prevalence of cardiovascular risk factors and outcomes was also recorded among people living with osteoarthritis [20]. ...
... In accordance with the present results, a cardiometabolic cluster with the highest prevalence of cardiovascular risk factors and outcomes was also recorded among people living with osteoarthritis [20]. It is possible that chronic inflammatory state/other pathophysiological processes [62,63], mechanical stress (e.g. higher load or skeletal muscle strength deterioration related to obesity) [64], or congruent precursors, such as sedentary/inactive lifestyle [62,65] account for the detected accumulation of metabolic diseases in our MSK pain population. A part of MSK pain reports may also be related to complications of diabetes such as angio-or neuropathy. ...
... In accordance with the present results, a cardiometabolic cluster with the highest prevalence of cardiovascular risk factors and outcomes was also recorded among people living with osteoarthritis [20]. It is possible that chronic inflammatory state/other pathophysiological processes [62,63], mechanical stress (e.g. higher load or skeletal muscle strength deterioration related to obesity) [64], or congruent precursors, such as sedentary/inactive lifestyle [62,65] account for the detected accumulation of metabolic diseases in our MSK pain population. A part of MSK pain reports may also be related to complications of diabetes such as angio-or neuropathy. ...
Background
Chronic diseases often accumulate with musculoskeletal (MSK) pain. However, less evidence is available on idiosyncratic patterns of chronic diseases and their relationships with the severity of MSK pain in general MSK pain populations.
Material and methods
Questionnaire-based data on physician-diagnosed chronic diseases, MSK pain and its dimensions (frequency, intensity, bothersomeness, and the number of pain sites), and confounders were collected from the Northern Finland Birth Cohort 1966 at the age of 46. Latent Class Analysis (LCA) was used to identify chronic disease clusters among individuals who reported any MSK pain within the previous year (n = 6105). The associations between chronic disease clusters, pain dimensions, and severe MSK pain, which was defined as prolonged (over 30 d within the preceding year), bothersome (Numerical Rating Scale >5), and multisite (two or more pain sites) pain, were analyzed using logistic regression and general linear regression models, adjusted for sex and educational level (n for the full sample = 4768).
Results
LCA resulted in three clusters: Metabolic (10.8% of the full sample), Psychiatric (2.9%), and Relatively Healthy (86.3%). Compared to the Relatively Healthy cluster, the Metabolic and Psychiatric clusters had higher odds for daily pain and higher mean pain intensity, bothersomeness, and the number of pain sites. Similarly, the odds for severe MSK pain were up to 75% (95% confidence interval: 44%–113%) and 155% (81%–259%) higher in the Metabolic and Psychiatric clusters, respectively, after adjustments for sex and educational level.
Conclusions
Distinct patterns of chronic disease accumulation can be identified in the general MSK pain population. It seems that mental and metabolic health are at interplay with severe MSK pain. These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.
Key messages
This large study on middle-aged people with musculoskeletal pain aimed to examine the idiosyncratic patterns of chronic diseases and their relationships with the severity of musculoskeletal pain. Latent class cluster analysis identified three chronic disease clusters: Psychiatric, Metabolic, and Relatively Healthy. People with accumulated mental (Psychiatric cluster) or metabolic diseases (Metabolic cluster) experienced more severe pain than people who were relatively healthy (Relatively Healthy cluster). These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.
... 40 41 Nociplastic pain mechanisms (i.e. the amplification of neural signalling within the CNS) may underlie some presentations of low back pain and OA, 42 43 and since back and knee pain are common in people with obesity, 19 nociplastic pain, by extension, may also contribute to the pain experience. 44 However, there is uncertainty as to whether or not people with obesity are more sensitive to experimentally evoked pain compared with people without obesity. 38 45 46 The extent to which the mechanisms of pain may differ between people with and without obesity remains unclear. ...
Introduction
Pain is prevalent in people living with overweight and obesity. Obesity is associated with increased self-reported pain intensity and pain-related disability, reductions in physical functioning and poorer psychological well-being. People living with obesity tend to respond less well to pain treatments or management compared with people living without obesity. Mechanisms linking obesity and pain are complex and may include contributions from and interactions between physiological, behavioural, psychological, sociocultural, biomechanical and genetic factors. Our aim is to study the multidimensional pain profiles of people living with obesity, over time, in an attempt to better understand the relationship between obesity and pain.
Methods and analysis
This longitudinal observational cohort study will recruit (n=216) people living with obesity and who are newly attending three weight management services in Ireland. Participants will complete questionnaires that assess their multidimensional biopsychosocial pain experience at baseline and at 3, 6, 12 and 18 months post-recruitment. Quantitative analyses will characterise the multidimensional pain experiences and trajectories of the cohort as a whole and in defined subgroups.
Ethics and dissemination
The study protocol has been approved by the Ethics and Medical Research Committee of St Vincent’s Healthcare Group, Dublin, Ireland (reference no: RS21-059) and the University College Dublin Human Research Ethics Committee (reference no: LS-E-22-41-Hinwood-Smart). Findings will be disseminated through peer-reviewed journals, conference presentations, public and patient advocacy groups, and social media.
Study registration
Open Science Framework Registration DOI: https://doi.org/10.17605/OSF.IO/QCWUE .
