Chronic pain research has been limited by a lack of theoretical models providing a frame of reference for investigations. Allostatic load is an evidence-based theory explaining the complex contributions of individual and socioenvironmental factors on an individual’s health status. The body is designed to adapt and strengthen in response to stress. Stress is a stimulatory challenge that invokes physiological and neurobiological strengthening, growth, and change. Allostasis is the body’s ability to maintain stability in response to life experiences. It is only when stress is persistent, prolonged, and/or of significant intensity without adequate recovery that adaptive physiological and neurobiological systems start to show signs of dysregulation, allostatic load, and eventual allostatic overload. High allostatic load indicates lower health reserve which can contribute to slower treatment response and increased morbidity and mortality risk. Allostatic load can be measured in several ways including brain structure and function, structural brain age, a clinical stress composite, and telomere length. Applying the concept of allostatic load to chronic pain, early and intermittent experiences of chronic pain would serve as a stimulus, promoting physiological and neurobiological adaptive responses, e.g., increases in biological measures. Persisting and intense experiences of pain for long durations without adequate recovery would facilitate physiological and neurobiological dysregulation and possible “blunting” in biological measures. Evidence across disciples would suggest that the variability observed in health outcomes between individuals with chronic pain is due to the limitations of a linear approach in investigations. A review of our publications below show highly consistent findings that align with the allostatic load model and the hormesis inverted U response and demonstrate the utility of individual health measures in understanding the biological burden of chronic pain and associations with health outcomes.
Associated Publications:
Disentangling factors contributing to individual differences and health disparities in chronic pain and whole person health with measures of allostatic load. Full Article.
Elucidating individual differences in chronic pain and whole person health with allostatic load biomarkers. PMID: 37701788
Accelerated Aging in Adults with Knee Osteoarthritis Pain: Consideration for Frequency, Intensity, Time, and Total Pain Sites. PMID: 29392207
Allostatic Load and Pain Severity in Older Adults: Results from the English Longitudinal Study of Ageing. PMID: 27988258
Elucidating individual differences in chronic pain and whole person health with allostatic load biomarkers. PMID: 37701788
Investigating the Burden of Chronic Pain: Inflammatory and Metabolic Composite. PMID: 27445627
Chronic Pain, Perceived Stress, and Cellular Aging: an Exploratory Study. PMID: 22325162
Telomeres and Epigenetics: Potential Relevance to Chronic Pain. PMID: 22770844