Alpha-amylase likewise was not found to mediate the effect of stress on pain (UC = -0.01, P = .195), after adjusting for sleep quality, physical activity, medications, and time of day.

According to Dr Harris, more research is needed to elucidate the neurobiological link between stress and pain — perhaps using serial magnetic resonance imaging (MRI) as a more direct approach to evaluate how the brain changes as symptoms vary.


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Focus on Stress Management

According to Dr Mewes, the findings underscore the importance of stress management interventions for clinicians treating patients with fibromyalgia.

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“Knowing what kind of stressors operate as pain-exacerbating factors in these patients would enable clinicians to specifically target dealing with these stressors. According to recent studies, this would imply focusing on the initiation and maintenance of positive social relationships to increase perceived social support,” Dr Mewes said.

“It is of great importance to further explore the symptom-exacerbating effects of stress on a biological and psychological level, and to learn more about how persons with fibromyalgia can effectively cope with their stressors,” Dr Mewes concluded.