Multisite chronic pain and incident multiple sclerosis: A prospective cohort study

作者：Fatemeh Vazirian, Jing Tian, Jane Alty, Dawn Aitken, Flavia Cicuttini, Graeme Jones, Feng Pan · 发表于：Brain Behavior and Immunity · 年份：2026 · DOI：10.1016/j.bbi.2026.106550 · 被引用次数：1 · 研究领域：Multiple Sclerosis Research Studies、Musculoskeletal pain and rehabilitation、Pain Management and Treatment

BACKGROUND: Chronic musculoskeletal pain is common in multiple sclerosis (MS) and pain-inflammation pathways may contribute to neurodegeneration; however, whether chronic pain is associated with later MS remains unclear. This study examined associations between chronic pain and incident MS, and whether inflammation mediates this relationship. METHODS: Data from 356,010 UK Biobank participants free of MS at baseline were analysed. Chronic pain (≥3 months) in the hip, neck/shoulder, back, knee, or all over the body was documented. Participants were grouped as having no chronic pain, one or two pain sites, three or four sites, and pain all over the body. Incident MS was determined and Cox regression estimated associations between chronic pain and incident MS. Mediation analysis assessed the contribution of systemic inflammation. RESULTS: Over a median 13-year follow-up, 1,007 participants developed MS. In multivariable analyses, chronic pain was associated with a 26% increased risk of MS compared with those without chronic pain (HR 1.26; 95% CI, 1.10-1.43). A dose-response relationship was observed, with risk increasing by number of pain sites (HR 1.44; 95% CI, 1.32-1.57), and pain all over the body conferred a nearly 4.9-fold higher risk. Partial mediation by inflammation was observed (INFLA-score 1.23%, C-reactive protein 1.77%, white blood cells -0.48%). CONCLUSION: Chronic musculoskeletal pain was associated with later MS, particularly when involving multiple sites. The asso...