The cortisol awakening response in patients with acute and chronic low back pain. Relations with psychological risk factors of pain chronicity

• Published in: Schmerz (Berlin, Germany) Vol. 21; no. 3; pp. 202 - 211
• Main Authors: Sudhaus, S, Fricke, B, Schneider, S, Stachon, A, Klein, H, von Düring, M, Hasenbring, M
• Format: Journal Article
• Language: German
• Published: Germany 01-06-2007
• Subjects: Acute Disease; Back Pain - physiopathology; Back Pain - psychology; Chronic Disease; Cognition Disorders - etiology; Depression - etiology; Humans; Hydrocortisone - pharmacology; Psychological Tests; Wakefulness - drug effects
• ISSN: 0932-433X
• DOI: 10.1007/s00482-006-0521-4

Peculiarities of the hypothalamic-pituitary-adrenal axis activity in stress-related pain-disorders and potential relations with psychological risk factors of pain chronicity have been discussed controversially.
The cortisol awakening responses of 31 low back pain patients (14 acute, 17 chronic) and 14 healthy controls were compared. In addition the interrelations between awakening response and chronic stress as well as depressive mood and - for the first time - maladaptive painprocessing and -copingstrategies were investigated.
The groups did not differ in their cortisol awakening responses. Chronic stress, depressive mood and maladaptive cognitive painprocessing did not correlate with the awakening response. There were, however, significant interrelations between awakening responses and the behavioral paincoping-strategies.
Behavioral paincoping-strategies should be considered as a potentially important contributing psychological factor in the relation between the activity of the hypothalamic-pituitary-adrenal axis and stress-related pain disorders.