Papers of the Week

The aetiological role of work-related psychological stress in the development of musculoskeletal pain disorders (MDs) has been systematically investigated. Less clear however, is the role of perceived stress and life stressors. This review aimed to assess the evidence for an aetiological role of perceived stress and life stressors in the development of chronic MDs. Database searches were conducted to identify prospective longitudinal studies that assessed perceived stress and life stressors in individuals without, or in the first 6 weeks of musculoskeletal pain. The primary outcome was the development of a chronic MD. Methodological quality was investigated using an adapted version of the Quality Assessment Tool for Observational Cohort studies and Cross-Sectional studies, and the strength of evidence using the GRADE approach. Seven studies were included representing data from six independent cohorts. There was some evidence to support the aetiological role of perceived stress and life stressors in the development of arthritis (low quality) and chronic spinal pain (low quality). The limited number of studies, the poor quality of the evidence and heterogeneity of stress measures used across studies suggest that further high quality prospective studies are required to clarify the role of perceived stress and life stressors in the development of chronic MDs. PROSPERO: CRD42017059949 Perspective: This review summarizes and critically appraises the evidence for the aetiological role of perceived stress and life stressors in the development of chronic MDs. The limited number of studies, the low quality of the evidence and heterogeneity across studies suggest that further research is needed on perceived stress and life stressors in MDs.