Chronic pain, perceived stress, and cellular aging: an exploratory study

The relationship between chronic pain, stress, and TL was analyzed in 36 ethnically diverse, older adults, half of whom reported no chronic pain and the other half had chronic knee osteoarthritis (OA) pain. Subjects completed a physical exam, radiographs, health history, and psychosocial questionnaires. Blood samples were collected and TL was measured by quantitative polymerase chain reaction (qPCR). Four groups were identified characterized by pain status and the Perceived Stress Scale scores: 1) no pain/low stress, 2) no pain/high stress, chronic pain/low stress, and 4) chronic pain/high stress. TL differed between the pain/stress groups (p = 0.01), controlling for relevant covariates. Specifically, the chronic pain/high stress group had significantly shorter TL compared to the no pain/low stress group. Age was negatively correlated with TL, particularly in the chronic pain/high stress group (p = 0.03).Although preliminary in nature and based on a modest sample size, these findings indicate that cellular aging may be more pronounced in older adults experiencing high levels of perceived stress and chronic pain.A recent Institute of Medicine report documents the public health consequences of chronic pain in America with estimates of 116 million adults affected and costs of $635 billion annually [1]. One of the challenges illuminated in the report is the difficulty in identifying specific pathophysiological targets due to significant variability in the experience of chronic pain. Consequently, biological markers reflecting the physiological burden of chronic pain on an individual system would offer significant clinical and scientific utility.Leukocyte telomere length (TL) is a measure of cellular aging and is associated with age-related disease onset, chronic health conditions, psychosocial stress, and mortality [2-5]. Importantly, recent findings indicate a direct relationship between telomeres and mitochondria, connecting for the first time two major theories of ag