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Understanding pain of stress etiology, comprising changes in muscle excitability, hormones and the nervous system.
Clintec, Karolinska Institutet.
Swedish School of Sport and Health Sciences, GIH, Department of Physical Activity and Health.ORCID iD: 0000-0001-9040-2158
2020 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

G. Alfvén1, E. Andersson2, 3

1. Clintec, Karolinska Institute, Stockholm, Sweden. 2. The Department of Neuroscience, Karolinska institute, Stockholm, Sweden. 3. The Swedish School of Sport and Health Sciences, Stockholm, Sweden.

Corresponding author:  G Alfvén (gosta.alfven@slmk.org) Karolinska Institute, Sweden

ABSTRACT 

Background: Recurrent pain of stress etiology is a common, worldwide problem with impaired quality of life and decreased school attendance. Research show that pain of stress etiology, often called psychosomatic pain, often is a complex of multiple pains, other symptoms and augmented widespread muscular tension with a specific pattern of tender points (1). 

Objective and Method: We will in a clinical context present electromyography (EMG) data, showing a novel and a missing link, regarding central and peripheral neurophysiological changes of significant importance for better understanding recurrent multiple pain. 

Results: During high acoustic signals, the startle reaction was shown, via EMG, to be potentiated, more easily and more often elicited in several muscles related to the pain, in 19 children with recurrent stress related pain in the head, neck and abdomen, diagnosed according to strict defined criteria (2), and compared to 23 matched controls. Also, higher resting muscle activity was shown. We will also present data showing increased cortisol and decreased oxytocin and increased risk for developing fibromyalgia in children with psychosomatic pain. 

Conclusion. Stressors potentiated the startle reaction with increased muscle activity in rest and increased excitability. These reactions and increased cortisol and decreased oxytocin in those children are in accordance with findings of the right dominance of stress in the bi-cameral brain (3). These neurophysiological facts can be of importance for the understanding of clinical manifestation of recurrent pain and must be heeded in the treatment of patients with pain related to stress.  

1. Alfven G, Grillner S, Andersson E. Review of childhood pain highlights the role of negative stress. Acta Paediatr.2019; Jun4.doi:10.1111/apa.14884.

2. Alfvén G, Grillner S, Andersson E. Children with chronic stress-induced recurrent muscle pain have enhanced startle reaction. Eur J Pain.2017;21:1561-1570.

3. Strigo IA, Craig AD. Interoception, homeostatic emotions and sympathovagal balance. 

Philos Trans R Soc Lond B Biol Sci.2016;Nov19;371(1708).

Place, publisher, year, edition, pages
2020.
National Category
Clinical Medicine
Research subject
Medicine/Technology
Identifiers
URN: urn:nbn:se:gih:diva-6495OAI: oai:DiVA.org:gih-6495DiVA, id: diva2:1518108
Conference
World Child Health Congress, November 9-10, 2020 (Webinar)
Available from: 2021-01-15 Created: 2021-01-15 Last updated: 2021-01-15Bibliographically approved

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