Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Comparison of the cortisol awakening response inwomen with shoulder and neck pain and women with fibromyalgia
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Norwegian University of Science and Technology, Human Movement Science Programme.
Norwegian University of Science and Technology, Department of Industrial Economics and Technology.
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Department of Psychology.
2012 (English)In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 37, no 2, 299-306 p.Article in journal (Refereed) Published
Abstract [en]

Shoulder and neck pain (SNP) and fibromyalgia syndrome (FMS), two musculoskeletal conditions of unknown pathogenesis, share some common features in terms of altered neuroendocrine responses, pain and stress perception. However, the pain distribution in SNP is localized,whereas in FMS is more widespread. Because regional musculoskeletal pain may represent an intermediate stage along a continuum towards widespread musculoskeletal pain we compared the cortisol awakening response (CAR) in women with SNP with the CAR in FMS patients and healthy controls (HC) in a controlled hospital—hotel setting. The aim of the study was to investigate whether SNP is related to a deviant regulation of the hypothalamic—pituitary—adrenal (HPA) axis. Eighteen women with SNP, 29 female FMS patients, and 27 female HC participated in the study. Cortisol samples were collected upon awakening, 30 and 60 min later. Questionnaires measuring pain levels, sleeping problems, perceived stress, and psychological characteristics were administered to the participants. Compared with HC, women with SNP had a tendency towards higher cortisol levels, whereas FMS had lower cortisol levels. Adjustment for potential confounders did not influence the results. Women with SNP and FMS patients reported more health complaints, pain, and perceived stress than the HC, but women with SNP were less affected than the FMS patients. Women with SNP showed a tendency towards an elevated HPA axis activity compared with HC. The current findings may indicate that the hypercortisolism in regional musculoskeletal pain represent an intermediate stage towards the development of a hypocortisolism in widespread musculoskeletal pain.

Place, publisher, year, edition, pages
Elsevier, 2012. Vol. 37, no 2, 299-306 p.
Keyword [en]
salivary cortisol, hypothalamic—pituitary—adrenal axis, regional musculoskeletal pain, widespread musculoskeletal pain, stress, fibromyalgia syndrome, cortisol awakening response
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-65009DOI: 10.1016/j.psyneuen.2011.06.014ISI: 000299979800014OAI: oai:DiVA.org:su-65009DiVA: diva2:460491
Funder
Swedish Research CouncilFAS, Swedish Council for Working Life and Social Research
Note
This research was supported by grants to Professor Ulf Lundberg from the Swedish Research Council and the Swedish Council for Working Life and Social Research. This study was also supported by the Centre for Musculoskeletal Research at the University of Gävle. Thanks to Associate Professor Petra Lindfors for her comments on the preliminary manuscript, Professor Magne Rø, MD, and Dr Tonje Okkenhaug Johansen, MD, for performing the clinical examinations on the participants, Mrs Ann-Christine Sjöbeck for performing the cortisol assays, and to Mr Håvard Wuttudal Lorås for assisting during data collection.Available from: 2011-11-30 Created: 2011-11-30 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Psychobiological responses in women with regional or widespread musculoskeletal pain conditions
Open this publication in new window or tab >>Psychobiological responses in women with regional or widespread musculoskeletal pain conditions
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Musculoskeletal disorders (MSDs) are very common. Regional chronic shoulder and neck pain (SNP) and widespread chronic pain due to fibromyalgia syndrome (FMS) are examples of MSDs characterized by altered physiology of the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis. The aims of this thesis are to compare the cortisol awakening response (CAR) in SNP women, FMS patients and healthy controls, and to compare salivary cortisol levels, urinary catecholamine levels (adrenaline, noradrenaline, and dopamine), and cardiovascular responses in FMS patients and healthy controls. Self-ratings of sleep, anxiety, perceived stress, and pain were also investigated. In Study I, CAR tended to be higher in SNP women than in healthy controls, whereas it was significantly higher than in FMS patients. Moreover, CAR was significantly lower in FMS patients than in healthy controls. Study II showed that cortisol levels were lower in FMS patients than in healthy controls during the rest of the day as well. In Study III, adrenaline and dopamine (but not noradrenaline) levels were significantly lower in FMS patients than in healthy controls. Resting heart rate was significantly higher in FMS patients than in healthy controls, but no differences emerged during stress provocation or unconstrained daily activities. Finally, SNP women and FMS patients reported more pain and health complaints than did healthy controls, but SNP women were less affected. Potential confounders (e.g., age, obesity, physical exercise) had no effects on the findings. Taken together, the findings show altered ANS and HPA axis regulation in FMS patients. Specifically, the hyperactive HPA axis found in SNP women (i.e., higher cortisol levels) might constitute a preliminary stage of a hypoactive HPA axis in FMS patients (i.e., lower cortisol levels). In view of this, an altered regulation of the HPA axis in the progression from regional to widespread MSDs may follow a temporal development.

Place, publisher, year, edition, pages
Stockholm: Department of Psychology, Stockholm University, 2012. 96 p.
Keyword
fibromyalgia, shoulder and neck pain, salivary cortisol, urinary catecholamines, cardiovascular responses
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-65011 (URN)978-91-7447-420-6 (ISBN)
Public defence
2012-02-10, David Magnussonsalen (U31), Frescati Hagväg 8, Stockholm, 10:00 (English)
Opponent
Supervisors
Note
At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 1: Epub ahead of print. Paper 2: Epub ahead of print.Available from: 2012-01-19 Created: 2011-11-30 Last updated: 2011-12-21Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Riva, RobertoLundberg, Ulf
By organisation
Department of PsychologyCentre for Health Equity Studies (CHESS)
In the same journal
Psychoneuroendocrinology
Psychology

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 127 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf