January 21, 2021, by mstalniceanu
How anxiety may impact our future health
Written by Emma Gow, 3rd Year Neuroscience BSc
Anxiety is a relatively common disorder that normally affects around 5% of people in the UK [1], which appears to have increased due to the introduction of a national lockdown during the current COVID-19 pandemic [2]. These circumstances present us with the challenge of ensuring that we take our mental health seriously and work towards improving our mental wellbeing, as long-term anxiety can have a great toll on our overall heath. High levels of anxiety have been found to cause acute high blood pressure [3], consequently leading to an increased risk of stroke or heart disease [4]. Along with the obvious personal risk, there are also newly discovered long-term effects of prolonged anxiety that could affect the population in the near future.
A recent study from the School of Life Sciences has uncovered that high anxiety levels can affect the way we experience chronic pain [5]. In the study they focus on osteoarthritis, a condition affecting over 9 million elderly people in the UK [6] which causes severe chronic pain of the joints and ultimately a level of disability due to this pain [5].
The study looked at the effect of anxiety in the perception of this chronic pain and whether pre-existing anxieties have any effect on the severity of osteoarthritis that develops later in life. Using a cohort of people over the age of 40 gathered from the community, they established the level of anxiety the participants were suffering from using a self-assessed questionnaire. They were then separated into groups of those suffering from osteoarthritic knee pain and those who were pain free. Selected participants from each group underwent quantitative sensory testing to establish the level of pain they were feeling at various points on their leg by measuring their pain thresholds using a mechanical stimulus.
After analysing the data, they found that the pain thresholds were lower in the osteoarthritis group compared to the pain free group, meaning that they felt pain at a lower pressure. They also found that the overall anxiety scores were higher in the osteoarthritis group compared to the pain free group. The two factors of anxiety and lowered pain threshold were significantly correlated in the osteoarthritis group but not in the pain free group, which suggests that anxiety levels do affect the level at which we feel pain, especially with chronic conditions such as osteoarthritis.
The participants also took part in a follow up study a year later to assess their level of knee pain. The results of this follow up indicated that high anxiety scores in the initial assessment led to increased levels of knee pain, and were able to predict the onset of osteoarthritis after a year. Therefore, this study suggests that persistent anxiety could lead to future health problems having a greater impact when they develop and could accelerate the onset of these chronic conditions. Despite this being novel research, it highlights some very important secondary effects of anxiety which will become more apparent with further research.
Chronic pain is a major public health problem, causing significant economic and social impacts [7]. It is estimated that chronic pain costs the UK economy up to £11 billion [8], with that mostly being due to costs of treatment and work absences. This shows that we need to put great importance on the nation’s mental health struggles at this time as ignoring the problem at hand may lead to increased complications in the years to come, and potentially worsen an already struggling economy.
References
[1] NHS, “Overview: Generalised anxiety disorder in adults,” NHS, December 2018. [Online]. Available: https://www.nhs.uk/conditions/generalised-anxiety-disorder/. [Accessed January 2021].
[2] K.-Y. Pan, A. A. Kok, M. Eikelenboom, M. Horsfall, F. Jörg and R. A. Luteijn, “The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: a longitudinal study of three Dutch case-control cohorts,” The Lancet Psychiatry, pp. 1-9, 2020.
[3] J. B. Byrd and R. D. Brook, “Anxiety in the “Age of Hypertension”,” Current Hypertension Reports , vol. 16, p. 486, 2014.
[4] NHS, “Overview: High blood pressure (hypertension),” NHS, October 2019. [Online]. Available: https://www.nhs.uk/conditions/high-blood-pressure-hypertension/. [Accessed January 2021].
[5] J. J. Burston, A. M. Valdes, S. G. Woodhams, P. I. Mapp, J. Stocks, D. J. Watson, P. R. Gowler, L. Xu, D. R. Sagar, G. Fernandes, N. Frowd, L. Marshall, W. Zhang, M. Doherty, D. A. Walsh and Ch, “The impact of anxiety on chronic musculoskeletal pain and the role of astrocyte activation,” Pain, vol. 160, no. 3, pp. 658-669, 2019.
[6] NHS, “Overview: Arthritis,” NHS, December 2018. [Online]. Available: https://www.nhs.uk/conditions/arthritis/. [Accessed January 2021].
[7] M. Dueñas, B. Ojeda, A. Salazar, J. A. Mico and I. Failde, “A review of chronic pain impact on patients, their social environment and the health care system,” Journal of Pain Research, vol. 9, pp. 457-467, 2016.
[8] C. J. Philips, “Economic burden of chronic pain,” Expert Review of Pharmacoeconomics & Outcomes Research, vol. 6, no. 5, pp. 591-601, 2006
Photo by Anna Shvets from https://www.pexels.com/
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