Stress and Alterations in the Pain Matrix: A Biopsychosocial Perspective on Back Pain and Its Prevention and Treatment

The genesis of chronic pain is explained by a biopsychosocial model. It hypothesizes an interdependency between environmental and genetic factors provoking aberrant long-term changes in biological and psychological regulatory systems. Physiological effects of psychological and physical stressors may...

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Bibliographic Details
Published in:International journal of environmental research and public health 2018-04, Vol.15 (4), p.785
Main Authors: Wippert, Pia-Maria, Wiebking, Christine
Format: Article
Language:English
Subjects:
Back pain
Back Pain - drug therapy
Back Pain - prevention & control
Back Pain - psychology
Biological effects
Brain research
Brain stem
Chiropractic medicine
Chronic Pain - drug therapy
Chronic Pain - prevention & control
Chronic Pain - psychology
Environmental changes
Exercise
Genetic factors
Humans
Medical imaging
Neurobiology
NMR
Norepinephrine
Nuclear magnetic resonance
Pain
Pain perception
Patients
Physical fitness
Physiological effects
Prevention
Psychological stress
Signal processing
Stress, Physiological
Stress, Psychological
Studies
Systematic review
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Summary:The genesis of chronic pain is explained by a biopsychosocial model. It hypothesizes an interdependency between environmental and genetic factors provoking aberrant long-term changes in biological and psychological regulatory systems. Physiological effects of psychological and physical stressors may play a crucial role in these maladaptive processes. Specifically, long-term demands on the stress response system may moderate central pain processing and influence descending serotonergic and noradrenergic signals from the brainstem, regulating nociceptive processing at the spinal level. However, the underlying mechanisms of this pathophysiological interplay still remain unclear. This paper aims to shed light on possible pathways between physical (exercise) and psychological stress and the potential neurobiological consequences in the genesis and treatment of chronic pain, highlighting evolving concepts and promising research directions in the treatment of chronic pain. Two treatment forms (exercise and mindfulness-based stress reduction as exemplary therapies), their interaction, and the dose-response will be discussed in more detail, which might pave the way to a better understanding of alterations in the pain matrix and help to develop future prevention and therapeutic concepts.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph15040785