Relative differences of brain, sensory, psychological, motor, and tissue domains across musculoskeletal pain conditions: Systematic review and multivariate meta-analyses.
Rebekka Döding, Lars Donath, Katja Ehrenbrusthoff et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and multivariate meta-analysis compared adults with fibromyalgia, knee osteoarthritis, low back pain, or neck pain with pain-free controls across brain, sensory, psychological, motor, and tissue domains. It included observational studies and baseline data from randomised trials. Across 118 studies (N = 11,822), the largest pooled case-control differences were in psychological measures (g = 1.08, 95% CI 0.94-1.22) and sensory measures (g = 0.85, 95% CI 0.61-1.08); tissue measures showed the smallest difference (g = 0.30, 95% CI 0.05-0.55). Fibromyalgia showed larger differences across domains than the other conditions.
Key findings
- Psychological measures had the largest pooled difference from pain-free controls (g = 1.08, 95% CI 0.94-1.22; moderate-certainty evidence).
- Sensory measures showed a pooled difference of g = 0.85 (95% CI 0.61-1.08; moderate-certainty evidence).
- Differences were smaller for motor (g = 0.66), brain (g = 0.59), and tissue measures (g = 0.30); certainty ranged from very low to low.
- Multidomain effect patterns varied by diagnosis, with fibromyalgia showing larger differences across domains than the other conditions.
Why it matters
The findings show that musculoskeletal pain conditions are associated with differences across several assessment domains, but the magnitude is not uniform. Psychological and sensory measures showed larger case-control differences than brain, motor, or tissue measures. This integrated comparison may help frame multidomain assessment and research without implying that any single domain explains pain or that observed differences establish causation.
What to keep in mind
The evidence combined observational studies and baseline data from randomised trials, so the case-control differences do not establish causation. Certainty was low or very low for brain, motor, and tissue findings.