Biopsychosocial inﬂuence on exercise-induced injury: genetic and psychological combinations are predictive of shoulder pain phenotypes
Chronic pain is influenced by biological, psychological, social, and cultural factors. The current study investigated potential roles for combinations of genetic and psychological factors in the development and/or maintenance of chronic musculoskeletal pain. An exercise-induced shoulder injury model was used, and a priori selected geneticn (i.e. COMT) and psychological (anxiety, depressive symptoms, pain catastrophizing, fear of pain, and kinesiophobia) factors were included as predictors.
A total of 190 patients were recruited for the study. The DNA from 190 subjects was collected via buccal swabs, and the concentric–eccentric isokinetic exercise-induced pain protocol was completed on their dominant shoulder. Subjects returned to the lab postinjury at 24-hour intervals for the next 4 days for collection of data related to their shoulder pain, including pain intensity and upper extremity disability.
Results showed strong statistical evidence for interactions between the COMT diplotype and 1) pain catastrophizing for 5-day average upper extremity disability and 2) depressive symptoms for pain duration. These findings confirm the importance of the combined predictive ability of COMT with psychological distress and reveal other novel combinations of genetic and psychological factors that may merit additional investigation in other pain cohorts. > From: George et al., J Pain 15 (2014) 68-80. All rights reserved to the American Pain Society.
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