The link between chronic pain and mental health has long been recognized.22,29 Their association can be acknowledged at a biological, psychological and social level, as they are thought to share common neural mechanisms,36,70 interact in their development over time18,80 and have a bidirectional relationship with environmental factors (e.g. social support, work-related factors).6,24,45 In particular, states of emotional distress in the form of anxiety or depression seem to be associated with the development and maintenance of chronic musculoskeletal pain,7,50 as well as with the outcomes of surgery34,78 or rehabilitation programs.
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