Patterns of Multi-Site Pain and Associations With Risk Factors.

Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. Electronic address: .
Pain (Impact Factor: 5.21). 05/2013; 154(9). DOI: 10.1016/j.pain.2013.05.039
Source: PubMed


To explore definitions for multi-site pain, and compare associations with risk factors for different patterns of musculoskeletal pain, we analysed cross-sectional data from the Cultural and Psychosocial Influences on Disability (CUPID) study. The study sample comprised 12,410 adults aged 20-59 years from 47 occupational groups in 18 countries. A standardised questionnaire was used to collect information about pain in the past month at each of 10 anatomical sites, and about potential risk factors. Associations with pain outcomes were assessed by Poisson regression, and characterised by prevalence rate ratios (PRRs). Extensive pain, affecting 6-10 anatomical sites, was reported much more frequently than would be expected if the occurrence of pain at each site were independent (674 participants v 41.9 expected). In comparison with pain involving only 1-3 sites, it showed much stronger associations (relative to no pain) with risk factors such as female sex (PRR 1.6 v 1.1), older age (PRR 2.6 v 1.1), somatising tendency (PRR 4.6 v 1.3) and exposure to multiple physically stressing occupational activities (PRR 5.0 v 1.4). After adjustment for number of sites with pain, these risk factors showed no additional association with a distribution of pain that was widespread according to the frequently used American College of Rheumatology (ACR) criteria. Our analysis supports the classification of pain at multiple anatomical sites simply by the number of sites affected, and suggests that extensive pain differs importantly in its associations with risk factors from pain that is limited to only a small number of anatomical sites.

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Available from: Leonardo A Quintana, Feb 17, 2015
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    • "Because the limitation of the present study was that the psychosocial factors were not examined, further study should be performed to clarify the effects of these factors on the chronic musculoskeletal pain in the future. Taken together, consistent with the previous studies [9–12], the relationship between musculoskeletal pain and the identified factors such as female gender, high BMI and smoking may be explained in part by shared risk factors, both physical and psychosocial [13, 14]. The mechanism involved in the current identification of alcohol use as a risk factor for new development of chronic pain is unknown. "
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