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Cited by 114Fibromyalgia and Chronic Fatigue Syndrome ResearchStress Responses and CortisolPsychosomatic Disorders and Their Treatments

The DOI matches its Crossref record; 63 of the 65 references it cites were found in a registry or an index.

Stress exacerbates pain in the everyday lives of women with fibromyalgia syndrome—The role of cortisol and alpha-amylase

Fischer, Susanne, Doerr, Johanna M., Strahler, Jana, Mewes, Ricarda, Thieme, Kati, Nater, Urs M.·2016·Psychoneuroendocrinology
DOI 10.1016/j.psyneuen.2015.09.018
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Abstract

Objective Although fibromyalgia syndrome (FMS) is a chronic condition, its cardinal symptom pain is known to fluctuate over the day. Stress has often been claimed to exacerbate pain; however, there is barely any evidence on whether or not this is true on a day-to-day basis (and, alternatively, on whether pain leads to increased stress levels). Using an ecologically valid measurement design, we tested whether and how stress and pain are intertwined in participants with FMS. We additionally examined the role of the two major stress-responsive systems, the hypothalamic-pituitary-adrenal axis and the autonomic nervous system, as potential mediators of this relationship. Methods An ambulatory assessment study was conducted over the course of 14 days. On each day, 32 females with FMS provided six diary entries on momentary stress and pain levels. Saliva samples were collected at the same time points to determine cortisol and alpha-amylase as indicators of stress-responsive systems. Results Higher stress at a given measurement time point was associated with higher reported pain levels at the subsequent time point (UC=1.47, p<0.001), but not vice versa (UC<0.01, p=0.179). The stress-pain relationship was neither mediated by momentary cortisol nor by alpha-amylase; however, momentary cortisol was independently associated with momentary pain (UC=0.27, p=0.009). Conclusion Stress seems to be a powerful exacerbating factor for pain as experienced by patients with FMS in their everyday lives. Cortisol may be involved in the diurnal fluctuation of pain levels in patients with FMS. Future studies should identify relevant daily stressors in persons with FMS and scrutinize the mechanisms underlying the cortisol-pain relationship.

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  1. Hauser, 2010, [Validation of the German version of the regional pain scale for the diagnosis of fibromyalgia syndrome], Schmerz, 24, 226

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Metadata

Authors
Fischer, S., Doerr, J. M., Strahler, J., Mewes, R., Thieme, K., & Nater, U. M.
Affiliations
Philipps University of Marburg (DE)
Corresponding author
Nater, Urs M.
ORCID
Venue
Psychoneuroendocrinology
Publisher
Elsevier BV
Published
2016-01
Volume
63
Pages
68-77
ISSN
0306-4530 (ISSN-L)
DOI
10.1016/j.psyneuen.2015.09.018
OpenAlex
W1844096966
Cited by
114
References
65
Citations by year
2026: 4 · 2025: 10 · 2024: 14 · 2023: 11 · 2022: 10 · 2021: 15 · 2020: 13 · 2019: 10 · 2018: 9 · 2017: 10 · 2016: 8
FWCI
7.34
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Psychoneuroendocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
University of Marburg
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
fibromyalgia, stress, pain, cortisol, alpha-amylase, hypothalamic-pituitary-adrenal axis, autonomic nervous system, women, ambulatory assessment
MeSH terms
Adult, Autonomic Nervous System, Female, Fibromyalgia, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Middle Aged, Pain, Pituitary-Adrenal System, Saliva, Stress, Psychological, Disease Progression, Salivary alpha-Amylases

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