ReviewNeuroscience and biobehavioral reviews2019
The interaction between stress and chronic pain through the lens of threat learning.
Review in Neuroscience and biobehavioral reviews, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 96 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
96 citing papers in PubMed, 1 synthesis or guideline pooled it, 157 citations in OpenAlex.
- The stress-fascia-pain axis in myofascial pain syndrome: a mechanistic integrative review and conceptual synthesis.Frontiers in pain research (Lausanne, Switzerland) · 2026Pooled it
- Trial
- Reconsolidation Blockade with Propranolol as a Novel Treatment for Chronic Low-Back Pain: A Double-Blind Randomized Placebo-Controlled Feasibility Study.Journal of pain research · 2026Trial
- Pain Reduction and Posture Alignment Improvement in Older Adults with Chronic Low Back Pain: A Novel Approach Using Spinal Thermal Massage Bed and Calf Pneumatic Cell Compression.Medical science monitor : international medical journal of experimental and clinical research · 2023Trial
- Mechanisms Underlying Pain Avoidance in Complex Regional Pain Syndrome.European journal of pain (London, England) · 2026Observational
- Review
- Not All Microbiomes Reflect Chronic Pain: Evidence from the Urinary Tract in a Case-Control Study.Journal of clinical medicine · 2026Article
- When Pain Shapes Dental Anxiety: A Cross-Sectional Mediation Study in Patients Requiring Endodontic Treatment.Journal of clinical medicine · 2026Article
- Central sensitization, work-related stress, and musculoskeletal pain symptoms in desk-based workers with and without migraine: a cross-sectional study.The journal of headache and pain · 2026Observational
- Pain, Sleep Latency, and Mental and Physical Health in Individuals with Self-Reported Hypermobile Ehlers-Danlos Syndrome.Healthcare (Basel, Switzerland) · 2026Article
- A Multi-Institutional and Nationwide Analysis of the Social Determinants of Persistent Pain After Surgery.Anesthesia and analgesia · 2026Observational
- The greater the pleiotropic effects, the greater the benefits - cannabis as a "biopsychosocial" drug: a mixed-methods study on chronic non-cancer pain.Journal of cannabis research · 2026Article
- Factors Associated with Pain, Disability, and Quality of Life in Adults Aged 18-65 with Nonspecific Chronic Neck Pain: A Single-Center Observational Study.Healthcare (Basel, Switzerland) · 2026Article
- Psychoneuroendocrine Associations with Momentary Pelvic Pain in Endometriosis.International journal of behavioral medicine · 2026Article
- Review
- Acute and chronic stress differentially regulate pain via distinct ensembles in the paraventricular nucleus of hypothalamus.Molecular psychiatry · 2026Article
- Peripheral Nerve-Cancer Interactions in the Tumor Microenvironment: A Three-Dimensional Framework Integrating Mechanisms, Modulators, and Therapeutic Strategies.Research (Washington, D.C.) · 2026Review
- Pressure point: blood flow restriction exercise and the pain paradox in musculoskeletal injury and persistent pain populations-a narrative review.Frontiers in pain research (Lausanne, Switzerland) · 2026Review
- Association of the 24-hour movement behaviours composition with workers' chronic musculoskeletal pain.PloS one · 2026Article
- The involvement of attentional biases in endogenous pain inhibition and autonomic reactivity.PloS one · 2026Article
36 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
Stress and pain are interleaved at multiple levels - interacting and influencing each other. Both are modulated by psychosocial factors including fears, beliefs, and goals, and are served by overlapping neural substrates. One major contributing factor in the development and maintenance of chronic pain is threat learning, with pain as an emotionally-salient threat - or stressor. Here, we argue that threat learning is a central mechanism and contributor, mediating the relationship between stress and chronic pain. We review the state of the art on (mal)adaptive learning in chronic pain, and on effects of stress and particularly cortisol on learning. We then provide a theoretical integration of how stress may affect chronic pain through its effect on threat learning. Prolonged stress, as may be experienced by patients with chronic pain, and its resulting changes in key brain networks modulating stress responses and threat learning, may further exacerbate these impairing effects on threat learning. We provide testable hypotheses and suggestions for how this integration may guide future research and clinical approaches in chronic pain.
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What OpenQuestion holds
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.