The Role of Sleep in the Transition from Acute to Chronic Musculoskeletal Pain in Youth—A Narrative Review

Abstract

Musculoskeletal pain is common in the general pediatric population and is a challenge to youth, their parents, and society. The majority of children experiencing musculoskeletal pain will recover; however, a small subgroup of youth develops chronic pain. There is limited understanding of the factors that affect the transition from acute to chronic pain in youth. This review introduces sleep deficiency in the acute to chronic pain transition, exploring the potential mediational or mechanistic role and pathways of sleep in this process, including the interaction with sensory, psychological, and social components of pain and highlighting new avenues for treatment. Biological mechanisms include the increased production of inflammatory mediators and the effect on the hypothalamus-pituitary-adrenal (HPA) axis and on the dopaminergic signaling. Psychological and social components include the effect of sleep on the emotional-affective and behavioral components of pain, the negative impact on daily and social activities and coping strategies and on the reward system, increased pain catastrophizing, fear of pain, pain-related anxiety, hypervigilance, and social isolation. Future longitudinal studies are needed to elucidate these mechanistic pathways of the effect of sleep on the transition from acute to chronic pain, which may lead to the development of new treatment targets to prevent this transition.

Limitations in Daily Activities as the Strongest Predictor of Pharmacotherapy Usage for Pain in Indonesia

“…Pain can cause a reduction in the frequency of social activities, making it more difficult to create or maintain strong peer connections, a greater reliance on family support, and limits in conducting daily tasks and physical exercise. [7] Chronic pain that is not appropriately controlled has a multifaceted negative influence on individuals' health and activities. Patients with increasing intensity chronic pain have reported progressively severe impacts on overall health, interference with daily activities, and employment.…”

Lack of regular physical activity and adequate sleep are risk factors for musculoskeletal pain in medical college students - a cross-sectional study

“…22 Some studies suggest that sleep deprivation causes the release of in ammatory factors that affect the regulation of the hypothalamic-pituitary-adrenal axis, reducing the secretion of dopamine and thus causing musculoskeletal pain; 23 others assume that sleep deprivation causes increased sensitivity to pain sensation, decreased willingness to exercise and a range of psychological problems such as anxiety, depression and fear of pain, which are mutually reinforcing with musculoskeletal pain. 24,25 This study did not further analyze the risk factors for musculoskeletal pain in each part of the body, and expanding the sample size to study their risk factors in different parts of the body would be more effective in preventing musculoskeletal pain.…”

Predictors of persistent pain in patients with acute neck pain treated with physical therapy: A prospective study with 2 years follow up

“…An increasing body of evidence has been conducted to investigate the effect of sleep disturbances on the progression of pain from an acute to a chronic stage (Andreucci et al, 2021;Kääriä et al, 2012).…”