Associations of psychosocial factors and chronic musculoskeletal pain in professional dancers.

Primary aim was to investigate the relationship between psychosocial factors and the development and persistence of CMP in dance professionals, providing insights for more tailored prevention and rehabilitation strategies for this population. Secondary aim was to explore potential differences between professional and semi-professional dancers and to examine the relationship between pain and central sensitisation.

38 dance professionals from 204 dance schools in Greece, with at least 2 years of dance experience and 3 months of CMP, participated. Individuals with vestibular disorders or autoimmune diseases were excluded. Participants completed the validated questionnaires· Multidimensional Pain Questionnaire in Professional Dance, Self-Estimated Functional Inability because of Pain for Dancers, Depression Anxiety Stress Scale, Pain Catastrophizing Scale, Central Sensitization Inventory, Pittsburgh Sleep Quality Index, Tampa Scale for Kinesiophobia, and Pain Self-Efficacy Questionnaire. Data were gathered through an anonymous online survey using Microsoft Forms.

63.1% of participants exhibited central sensitisation and moderate overall psychological distress, while 94.7% showed high levels of self-efficacy. A positive correlation was found between the number of prior injuries per dancer and both PCS (r=0.505, p0.01) and CSI (r=0.362, p0.05). Dancers' experience negatively correlated with DASS-21 (r=-0.442, p0.01), PCS (r=-0.353, p0.05), and average pain intensity (r=-0.402, p0.05). Correlations were observed between TSK-17 and both CSI (r=0.375, p0.05) and PCS (r=0.378, p0.05), while PSQI correlated with CSI (r=0.566, p0.01), PCS (r=0.331, p0.05), and the DASS-21 S-sub (r=0.342, p0.05).

A vicious cycle of fear of movement, pain catastrophizing, and central sensitization is revealed as a possible mechanism of CMP in dancers, reinforced by frequent injuries, the normalization of pain and distorted pain perception, with a bidirectional link with poor sleep quality. Self-efficacy, arising from experience, acts as a coping mechanism for CMP. Factors such as injury frequency, pain intensity, dancer status and type of employment significantly impact the mental well-being of dance professionals. Future research should involve larger sample sizes to enhance understanding of the relationships between CMP and psychosocial factors, dancers' perceptions of pain and management strategies. Utilizing diverse communication methods (social media, partnerships with psychological support centers) is recommended to engage dancers who are hesitant to share their experiences.

Dancers are predisposed to CMP due to the psychosocial factors, central sensitization, and the adaptation of a “pain is normal” concept in the profession. This makes it necessary to treat both the physical and psychological aspects of CMP dancers holistically and towards a precision treatment approach.