Dr. Karin Steere
PURPOSE: The aim of this review was to investigate the relationship between heart rate (HR) or blood pressure (BP) and chronic pain conditions.
BACKGROUND: Treatment of chronic pain has placed enormous economic burden on the healthcare system. Autonomic nervous system (ANS) dysregulation is correlated to chronic pain. One measure of ANS dysregulation is heart rate variability (HRV), and decreased HRV can predict adverse future prognosis in a variety of conditions. While HRV validly measures ANS dysregulation, inexpensive and quicker measurements of HR and BP have been less investigated.
METHODS: Searches in PubMed, Ovid, Google Scholar, and CINAHL were performed using combinations of the following search terms: “HR”, “BP”, “chronic pain”, “persistent pain”. Inclusion criteria was preregistered though PROSPERO.
RESULTS: Review of 47 articles found differences in HR and BP measurements between individuals with and without chronic pain conditions. These differences varied in their significance and were found in various states including at rest, during physical activity, during psychological or physical stress tests, or before and after specific interventions.
CONCLUSIONS: Differences in HR and BP exist in individuals with chronic pain conditions compared to healthy, age-matched controls, which may be indicative of ANS dysregulation. Further research is needed to determine if HR and BP are valid measures of ANS dysregulation in individuals with chronic pain. HR and BP are quicker and more cost-effective measurements compared to HRV, and if they validly measure ANS dysregulation, may provide insight into the future prognosis of individuals with chronic pain conditions.
University of Puget Sound
Steere, Dr. Karin; Steere, Jason DPT; Cottrill, Kasey; and Geiger, Zoe, "Autonomic Nervous System Changes In Individuals With Chronic Pain: A Systematic Review Of The Literature" (2019). Physical Therapy Research Symposium. 53.