Biological, psychological, social and often lifestyle-related factors underlie musculoskeletal disorders. Considering these influences in isolation is probably responsible for a large part of the disappointing treatment effects. A networked view is needed to understand the complexity of these diseases.
Klyne et al. 2021 present a hypothesis that aims to provide a basis for understanding the interaction and integration between these domains. Psychological and lifestyle factors are discussed in their effects on the tissue level (e.g. dysregulation/accumulation of the connective tissue). Musculoskeletal diseases are attributed in particular to molecular mechanisms of action of systemic and local inflammatory processes.
Perspectives on the biology and pathology of connective tissue (fibrosis), the role of inflammation at the local level (tissue level), and how this inflammation is shaped by systemic inflammation are discussed, particularly with regard to
psychological and lifestyle factors through their impact on systemic inflammation.