The Clinical journal of pain
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Observational Study
A Mediational Analysis of Stress, Inflammation, Sleep, and Pain in Acute Musculoskeletal Trauma.
Differences in pain severity among acutely injured people may be related to the perceived stress of the event and pre-existing vulnerabilities. In this study, we test the hypotheses that pretrauma life stress influences posttrauma pain severity, and 2 potential mediating pathways, 1 biological (C-reactive protein, CRP) and 1 contextual (sleep quality). ⋯ Pretrauma life stress predicted pain severity, sleep interference, and plasma CRP. In mediation analysis, pretrauma stress was associated with pain severity only through its association with sleep interference, while CRP did not mediate the association. Implications of these results are discussed.