ArticlePain2019
The impact of anxiety on chronic musculoskeletal pain and the role of astrocyte activation.
Article in Pain, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- The efficacy of systemic glucocorticosteroids for pain in rheumatoid arthritis: a systematic literature review and meta-analysis.Rheumatology (Oxford, England) · 2021Pooled it
- Pilot Study of Cannabidiol for Treatment of Aromatase Inhibitor-Associated Musculoskeletal Symptoms in Breast Cancer.Cancer medicine · 2025Trial
- Sinomenine Liposomes Alleviate Neuropathic Pain in a Spared Nerve Injury Model by Regulating Astrocyte Reactivity Associated with Inhibition of the JAK2/STAT3 Pathway.Neurochemical research · 2026Article
- Preexisting Depression or Anxiety is Associated with Increased Wound Complications Following Breast Reduction Surgery: A Real-World Cohort Study.Aesthetic plastic surgery · 2026Article
- Key determinants for successful lifestyle change to address chronic musculoskeletal pain: The patient's perspective.PM & R : the journal of injury, function, and rehabilitation · 2026Article
- Supervised machine learning model to predict total knee replacement in a large osteoartrhitis real-world evidence dataset using retrospectively 20-year insurance data from Israel.BMC medical informatics and decision making · 2026Article
- Plasma fatty acids reflect pain, disability, and psychological well-being in knee osteoarthritis in a longitudinal study with joint replacement surgery.Scientific reports · 2026Article
- Electroacupuncture Ameliorates Hyperalgesia and Anxiety-Like Behaviors in Chemotherapy-Induced Peripheral Neuropathy Mice Through Inhibition of Astrocyte-Mediated Neuronal Activation in the Anterior Cingulate Cortex.Journal of pain research · 2026Article
- The pathophysiologic mechanisms of spinal manipulative therapy in the management of chronic musculoskeletal pain.The Journal of the Canadian Chiropractic Association · 2025Article
- Voluntary running improves synaptic degeneration of the anterior cingulate cortex in knee osteoarthritis.Molecular brain · 2025Article
- Core program elements for equitable, effective participation in a lifestyle medicine program for chronic musculoskeletal pain.PM & R : the journal of injury, function, and rehabilitation · 2025Article
- Quantitative sensory testing for pain: What exactly are we measuring?Current opinion in psychology · 2025Review
- Prevalence of Knee Pain and Its Relation to Depression, Anxiety, and Health-Related Quality of Life Among Maintenance Hemodialysis Patients.Journal of clinical medicine · 2025Article
- Is It Time to Revisit the Role of Interleukin-1 Inhibitors in Osteoarthritis?Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Review
- Article
- Astrocyte Activation in the ACC Contributes to Comorbid Anxiety in Chronic Inflammatory Pain and Involves in The Excitation-Inhibition Imbalance.Molecular neurobiology · 2024Article
- What Predicts a Longer Period of Pain in Patients Referred to an Interdisciplinary Center for Pain Care?International journal of environmental research and public health · 2024Article
- Mindfulness in Facilitating Pelvic Floor Botulinum Toxin Injection in Women with Chronic Pelvic Pain.Toxins · 2024Article
- Sustained morphine exposure alters spinal NMDA receptor and astrocyte expression and exacerbates chronic pain behavior in female rats.Pain reports · 2024Article
- Pain-phenotyping in osteoarthritis: Current concepts, evidence, and considerations towards a comprehensive framework for assessment and treatment.Osteoarthritis and cartilage open · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Anxiety and depression are associated with increased pain responses in chronic pain states. The extent to which anxiety drives chronic pain, or vice versa, remains an important question that has implications for analgesic treatment strategies. Here, the effect of existing anxiety on future osteoarthritis (OA) pain was investigated, and potential mechanisms were studied in an animal model. Pressure pain detection thresholds, anxiety, and depression were assessed in people with (n = 130) or without (n = 100) painful knee OA. Separately, knee pain and anxiety scores were also measured twice over 12 months in 4730 individuals recruited from the general population. A preclinical investigation of a model of OA pain in normo-anxiety Sprague-Dawley (SD) and high-anxiety Wistar Kyoto (WKY) rats assessed underlying neurobiological mechanisms. Higher anxiety, independently from depression, was associated with significantly lower pressure pain detection thresholds at sites local to (P < 0.01) and distant from (P < 0.05) the painful knee in patients with OA. Separately, high anxiety scores predicted increased risk of knee pain onset in 3274 originally pain-free people over the 1-year period (odds ratio = 1.71; 95% confidence interval = 1.25-2.34, P < 0.00083). Similarly, WKY rats developed significantly lower ipsilateral and contralateral hind paw withdrawal thresholds in the monosodium iodoacetate model of OA pain, compared with SD rats (P = 0.0005). Linear regressions revealed that baseline anxiety-like behaviour was predictive of lowered paw withdrawal thresholds in WKY rats, mirroring the human data. This augmented pain phenotype was significantly associated with increased glial fibrillary acidic protein immunofluorescence in pain-associated brain regions, identifying supraspinal astrocyte activation as a significant mechanism underlying anxiety-augmented pain behaviour.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.