Fatigue Links Sociodemographic Risk to Pain Intensity and Spread in Two Surgical Cohorts

Michael Sun; Briha Ansari; Daniel Clauw; Richard E Harris; Kathleen A Sluka; Chelsea M Kaplan; Chad M Brummet; Martin A Lindquist; Tor D Wager

doi:10.64898/2026.02.02.26345387

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Fatigue Links Sociodemographic Risk to Pain Intensity and Spread in Two Surgical Cohorts

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Fatigue Links Sociodemographic Risk to Pain Intensity and Spread in Two Surgical Cohorts

Michael Sun, Briha Ansari, Daniel Clauw, Richard E Harris, Kathleen A Sluka, Chelsea M Kaplan, Chad M Brummet, Martin A Lindquist and Tor D Wager

medRxiv : the preprint server for health sciences

Cold Spring Harbor Laboratory

02/04/2026

DOI: 10.64898/2026.02.02.26345387

PMID: 41674598

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https://doi.org/10.64898/2026.02.02.26345387View

Preprint (Author's original)This preprint has not been evaluated by subject experts through peer review. Preprints may undergo extensive changes and/or become peer-reviewed journal articles. Open Access

Abstract

Why some surgical participants experience pain that extends beyond the original site of injury while others do not remains poorly understood. Both pain intensity and widespread pain contribute to recovery and quality of life, yet their psychosocial correlates are often examined separately. Using data from two large pre-surgical cohorts-participants preparing for knee replacement or thoracic surgery-we examined associations between sociodemographic and psychosocial factors, pain intensity at surgical and non-surgical sites, and widespread chronic pain. Across cohorts and outcomes, fatigue showed the strongest and most consistent associations with pain intensity and widespread pain, independent of other measured factors. Fatigue also occupied a central position in statistical association networks and accounted for substantial shared variance among multiple psychosocial variables, including sleep disturbance, depression, stress, and socioeconomic disadvantage. Pain at non-surgical sites was strongly associated with widespread pain and frequently accounted for observed associations between surgical-site pain and widespread pain. Together, these findings highlight robust patterns of association linking fatigue, pain intensity, and widespread pain in pre-surgical populations.

Details

Title: Subtitle: Fatigue Links Sociodemographic Risk to Pain Intensity and Spread in Two Surgical Cohorts
Creators: Michael Sun - Dartmouth College
Briha Ansari - Johns Hopkins University
Daniel Clauw - University of Michigan
Richard E Harris - University of California, Irvine
Kathleen A Sluka - University of Iowa
Chelsea M Kaplan - University of Michigan
Chad M Brummet - University of Michigan
Martin A Lindquist - Johns Hopkins University
Tor D Wager - Dartmouth College
Resource Type: Preprint
Publication Details: medRxiv : the preprint server for health sciences
DOI: 10.64898/2026.02.02.26345387
PMID: 41674598
Publisher: Cold Spring Harbor Laboratory; United States
Grant note: UM1 NS118922 / NINDS NIH HHS U54 DA049116 / NIDA NIH HHS U54 DA049115 / NIDA NIH HHS U24 NS112873 / NINDS NIH HHS U54 DA049113 / NIDA NIH HHS UM1 NS112874 / NINDS NIH HHS U54 DA049110 / NIDA NIH HHS
Language: English
Date posted: 02/04/2026
Academic Unit: Iowa Neuroscience Institute; Nursing; Physical Therapy and Rehabilitation Science; Neuroscience and Pharmacology
Record Identifier: 9985139274002771

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