Risk Factors for Pain and Chronic Pain Syndromes
By Kamau Kokayi, MD
Principal risk factors for developing low back pain include aging, weight gain, sedentary lifestyle, poor posture, suboptimal nutrition, and poor sleeping position. Most people experience low back pain at some point in their lives. A combination of regular physical exercise, healthy diet, and nutritional supplementation that favors connective tissue health is recommended to decrease the risk of developing low back pain.
Occupational risk factors from repetitive motion injuries can affect both genders equally, and rely on the type of repetitive motion involved. Carpal tunnel syndrome is a common complaint from workers performing repetitive and intensive hand and wrist movements in their jobs. Keyboarding, use of hand tools, and close repetitive work contribute to the inflammation affecting the carpal tunnel, the guiding nerve sheath through which the median nerve of the hand extends.
Thoracic outlet syndrome (TOS) is a group of disorders that affect women more frequently than men, with onset of symptoms usually beginning between the ages of 20 and 50. TOS can be caused by congenital, occupational, traumatic or other means of compression of the brachial plexus, the subclavian artery or vein, or by nonspecific causes that might include infection or disease.
Young women have an increased risk for sports-related knee injuries, as compared to their male peers, believed to be a result of anatomical, hormonal, and biomechanical factors. Increased body mass and changes in the center of mass as young women mature, as well as hormonal influence on neuromuscular control have been studied. Muscle, tendon, and ligament strength vary, as do muscle relaxation rates, during the menstrual cycle. Fatigue can be a factor in the loss of control in the biomechanics of knee flexing and hip rotation, inducing injuries to the knee.
Literature evaluating the tendency for patellofemoral pain (PFP) syndrome, a sometimes chronic pain syndrome involving the knee, to become a persistent problem likewise cites age, gender, body mass index, and foot posture as likely risk factors determining PFP pain outcomes.
Risk factors for fibromyalgia include physical and emotional workplace or domestic stressors, and a history of depression. Other pathophysiological risk factors include disturbances to pain processing in the central nervous system (central sensitization), hyporeactivity of the hypothalamic-pituitary-adrenal axis, growth hormone system disturbances, disturbed cytokine (chemical signaling) profiles with elevated pro-inflammatory and low anti-inflammatory features, as well as variations in dopamine and serotonin system output.
Myofascial pain syndrome (MPS) is associated with the same risk factors as other pain syndromes: muscle injury, repetitive strain injury (although not so much from strenuous daily work), inactivity, age, gender, and levels of stress and anxiety.
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Risk Factors for Pain and Chronic Pain Syndromes—Citations and Further Reading
Date of Publication: 09/05/2005
Article Last Updated: 11/17/2011