{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:43:31Z","timestamp":1790109811687,"version":"4.0.1"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":77,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Several chronic musculoskeletal disorders are characterized by pain, fatigue, dizziness and other associated symptoms that may be related to autonomic dysfunction. The aim of this review was to estimate the prevalence of autonomic dysfunction in chronic musculoskeletal pain conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>MEDLINE and Embase were searched through 4 October 2024 for all peer-reviewed studies of dysautonomia in adult musculoskeletal conditions. Risk of bias was assessed using an adapted Newcastle\u2013Ottawa Scale. The prevalence of dysautonomia and relative risk compared with healthy controls were estimated using random effects meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 17 studies (13 fibromyalgia, 3 Ehlers\u2013Danlos syndrome, 1 rheumatoid arthritis) were identified, including 1003 participants with musculoskeletal pain and 417 healthy controls. In people with chronic musculoskeletal pain, the pooled prevalence of dysautonomia was 64% (95% CI 51, 76; I2\u2009=\u200993%), more than twice as likely as healthy controls [pooled risk ratio 2.28 (95% CI 1.51, 3.45); I2\u2009=\u200924%). Most studies objectively assessed the neurocardiovascular system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The high prevalence of dysautonomia in patients with chronic musculoskeletal painful conditions illustrates the association between dysautonomia and chronic pain, suggesting regular screening for dysautonomia is warranted for all patients with chronic musculoskeletal pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/rap\/rkag034","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T06:08:16Z","timestamp":1773900496000},"source":"Crossref","is-referenced-by-count":1,"title":["The prevalence of dysautonomia in chronic musculoskeletal pain: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9164-5730","authenticated-orcid":false,"given":"Norah A","family":"Almutairi","sequence":"first","affiliation":[{"name":"Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds , Leeds,","place":["UK"]},{"name":"Physical Therapy and Rehabilitation Department, College of Applied Medical Sciences, Majmaah University , Al Majma\u2019ah,","place":["Kingdom of Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7035-3096","authenticated-orcid":false,"given":"Darren C","family":"Greenwood","sequence":"additional","affiliation":[{"name":"Leeds Institute for Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds , Leeds,","place":["UK"]},{"name":"Leeds Institute for Data Analytics, University of Leeds , Leeds,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0334-2968","authenticated-orcid":false,"given":"Manoj","family":"Sivan","sequence":"additional","affiliation":[{"name":"Academic Department of Rehabilitation Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds , Leeds,","place":["UK"]},{"name":"National Demonstration Centre of Rehabilitation Medicine, Leeds Teaching Hospitals NHS Trust , Leeds,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"2026041221041077900_rkag034-B1","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/J.PAIN.0000000000001384","article-title":"Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the International Classification of Diseases (ICD-11)","volume":"160","author":"Treede","year":"2019","journal-title":"Pain"},{"key":"2026041221041077900_rkag034-B2","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1097\/J.PAIN.0000000000000160","article-title":"A classification of chronic pain for ICD-11","volume":"156","author":"Treede","year":"2015","journal-title":"Pain"},{"key":"2026041221041077900_rkag034-B3","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.1093\/PM\/PNY270","article-title":"Multi-site pain is associated with long-term patient-reported outcomes in older adults with persistent back pain","volume":"20","author":"Rundell","year":"2019","journal-title":"Pain Med"},{"key":"2026041221041077900_rkag034-B4","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1016\/J.MCNA.2020.05.002","article-title":"Musculoskeletal pain in older adults: a clinical review","volume":"104","author":"Welsh","year":"2020","journal-title":"Med Clin North Am"},{"key":"2026041221041077900_rkag034-B5","article-title":"Access to pain management: Declaration of Montreal","author":"International Association for the Study of Pain","year":"2025"},{"key":"2026041221041077900_rkag034-B6","doi-asserted-by":"publisher","first-page":"1406","DOI":"10.1097\/J.PAIN.0000000000002855","article-title":"What is known and what is still unknown within chronic musculoskeletal pain? 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