ABSTRACT

Seasonality is evident in several aspects of human health and behavior, whereas seasonality in chronic pain is less well studied. We examined seasonal variation in pain severity and pain dissemination, as well as in pain-associated conditions, such as sleep impairment, sleep timing, mental distress, fatigue and physical activity. We also examined if any of these associated conditions moderated the seasonality in pain. This prospective study was conducted in the subarctic municipality of Tromsø, Norway (69º North), on a sample of patients with chronic musculoskeletal pain (N = 56). Data were collected with self-report questionnaires and objective actigraphy measures (7 days) twice: winter and summer. Mixed linear regression models were fitted. A modest seasonality effect was observed in pain severity (highest in summer), but not in pain dissemination. Seasonality with increased physical activity and delayed sleep timing in the summer was also present. The remaining pain-associated self-report or objective measures indicated no seasonality. The season–pain association was not significantly moderated by any of the pain-associated conditions. Previous studies on healthy individuals residing in polar areas have suggested an opposite seasonal effect with delay of the sleep–wake rhythm in winter. Our results based on a clinical sample thus represent a novel finding that needs to be examined further with regard to seasonal circadian entrainment and alignment in pain populations. These results may have clinical value for the treatment of patients with musculoskeletal pain as seasonality may require seasonal adjustments of pain treatment strategies.

摘要

在人类健康和行为的多个方面，季节性是显而易见的，而对慢性疼痛的季节性则研究较少。我们检查了疼痛严重程度和疼痛传播以及与疼痛相关的状况（例如睡眠障碍，睡眠时间，精神困扰，疲劳和体育活动）的季节性变化。我们还检查了这些相关疾病是否缓解了疼痛的季节性。这项前瞻性研究是在挪威特罗姆瑟市（北角69º）的亚北极地区，对患有慢性肌肉骨骼疼痛（N= 56）。两次使用自我报告调查表和客观书法措施（冬季和夏季）收集数据（7天）。拟合混合线性回归模型。在疼痛的严重程度（夏季最高）中观察到了适度的季节性影响，但在疼痛的传播中却没有。在夏季还出现季节性运动，运动量增加，睡眠时间延迟。其余与疼痛相关的自我报告或客观测量均未显示季节性。疼痛相关的状况均未显着缓解季节疼痛关联。先前对居住在极地地区的健康个体的研究表明，相反的季节效应会延迟冬季的睡眠觉醒节律。因此，基于临床样本的我们的结果代表了一个新发现，需要就疼痛人群中的季节性昼夜节律夹带和排列进行进一步研究。这些结果可能对肌肉骨骼疼痛患者的治疗具有临床价值，因为季节性可能需要季节性调整疼痛治疗策略。