Epidemiology of chronic musculoskeletal pain. Best practice and research
The rate of musculoskeletal pain in adolescent and adult populations is examined, with a focus on three commonly reported pain disorders: shoulder pain, low back pain and fibromyalgia/chronic widespread pain. There is a paucity of data on musculoskeletal pain in adolescent populations. Those studies available suggest that pain is common, although the actual rates are unclear. This is probably due to differences in study methodologies and populations. Pain is commonly reported among adult populations, with almost one fifth reporting widespread pain, one third shoulder pain, and up to one half reporting low back pain in a 1-month period. The prevalence of pain varies within specific population subgroups; group factors (including socioeconomic status, ethnicity and race) and individual factors (smoking, diet, and psychological status) are all associated with the reporting of musculoskeletal pain. However, the precise nature of these relationships, and particularly the mechanisms of association, are unclear and require further investigation.
Available from: Martin Descarreaux
- "The socioeconomic status, not evaluated in the present study, may be considered as a potential confounder in the assessment of adolescent musculoskeletal health. However, as described by Mcbeth et al. (2007), the association between socioeconomic factors and adolescent musculoskeletal health remains unclear. Assessment by self-reported questionnaires has certain limitation such as response bias caused by either acquiescence , socially desirable responding, or extreme responding  . "
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ABSTRACT: Musculoskeletal pain, symptoms or injuries are prevalent in the adolescent athlete population as well as in the general adolescent population, and often have significant consequences on their future musculoskeletal health. However, differences between these two populations in regards to their musculoskeletal health are not known and have not yet been explored. Therefore, the main objectives of this study are to 1) compare the 6-month prevalence of musculoskeletal symptoms and their impact on school attendance and reduction in sport or leisure activity between a group of adolescent athletes and a group of control adolescents, and 2) determine if gender has different effects on the prevalence of musculoskeletal symptoms in these two populations.
Among adolescents who participated in the 2012 Québec summer games, 1,865 agreed to participate and constituted the adolescent athletes group (mean age:14.12 ± 1.22). An additional cohort of 707 adolescents from two schools was also recruited to form the comparison control group (mean age: 14.69 ± 1.38). Anthropometric data were collected, and the musculoskeletal 6-month prevalence of symptoms and their related impacts were assessed using the Teen Nordic Musculoskeletal Screening Questionnaire (TNMQ-S). Participants' characteristics as well as symptoms prevalence for the nine anatomical regions as well as their impact on school/work absence and reduction in physical/leisure activities were compared between athletes and control adolescents.
When compared to athlete adolescents, significantly more controls had a positive 6-month prevalence of symptoms affecting the neck (48.8 % vs 26.3 %), upper back (41.3 % vs 18.1 %) and low back (45.4 % vs 35.8 %) when compared to athlete. Symptoms affecting the spine led to significantly more school absence and reduction in physical activity in the control group. Controls also showed higher prevalence of shoulder (37.1 % vs 28.3 %) and wrist/hand (23.8 % vs 17.4 %) symptoms, while athletes had a higher prevalence of elbow symptoms (8.7 % vs 11.4 %).
Despite their higher risk of injuries related to high levels of competition or sport participation, adolescent athletes have fewer symptoms affecting the spine than "typical adolescents", and similar prevalence of symptoms affecting the body's extremities. Further investigations are necessary to understand the differences between athletes and non-athletes in regard to disability and long-term complications associated to musculoskeletal pain or symptoms.
Available from: Grethe Myklebust
- "Among step aerobics instructors, 73.5% reported chronic lower extremity injuries, and among others working hours and instructor experience were factors explaining the injury prevalence (Malliou et al., 2014). Musculoskeletal pain is common among athletes (Foss, Holme, & Bahr, 2012; Jacobsson et al., 2012) and in the general population (McBeth & Jones, 2007). In the study by Foss et al. (2012), high training loading and sports with specific back loading increased risk of low back pain. "
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ABSTRACT: To examine the prevalence and factors associated with instruction-related injuries and musculoskeletal pain among group fitness instructors.
Descriptive epidemiology study.
Group fitness instructors from three fitness centre companies in Norway (n = 1473). Assessment of independent variables: questions regarding duration of working as a group fitness instructor, weekly instruction and exercise loading and modality, instruction-related injuries, musculoskeletal pain, use of alcohol, tobacco, snuff, menstrual dysfunction and disordered eating (Eating Disorder Inventory, EDI). The respondents were divided into high instruction loading (HIL), ≥5 h/w with instruction; and low instruction loading (LIL), <5 h/w with instruction).
The response rate was 57% (n = 837). Mean total loading (instruction and exercise) was 11.8 h/w and 6.3 h/w in the HIL and LIL groups (p < .001), respectively. The prevalence of acute (9% vs. 6%, p < .05), overuse (38% vs. 24%, p < .001) and both acute and overuse injuries (25% vs. 10%, p < .001) was higher in the HIL than in the LIL group (OR: 3.9, CI: 2.7, 5.5). The most prevalent injury locations were ankle and lower leg. The most frequent location for musculoskeletal pain was the shoulder/neck region. Factors associated with injury were instruction loading (h/w), years working as an instructor and EDI score. A high total EDI score predicted musculoskeletal pain.
The high prevalence of injuries and musculoskeletal pain suggests a need for prevention strategies in the fitness industry. There is a need for limits regarding weekly instruction loading, especially for classes with high metabolic and/or mechanical loading.
Available from: James R. Churilla
- "The prevalence of chronic pain is increasing, imposing a financial burden that exceeds heart disease, cancer, and diabetes (Gaskin and Richard, 2012). The cost of chronic pain goes well beyond paying for treatment and work missed, as there are generally social and personal ramifications including reduced quality of life, reduced physical activity (PA) levels, negative impact on relationships , job loss, and depression (McBeth and Jones, 2007; Perquin et al., 2001). The symptom of pain accounts for over 80% of all physician visits (Gatchel et al., 2007). "
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ABSTRACT: Chronic non-specific pain (CNSP) and physical inactivity have become increasingly prevalent in the United States; however, the associations between the two remain unclear. The lack of clarity may be due to the presence of a third variable, the individual's pain coping strategy.
We had three specific aims. 1) To review the associations between fear-avoidance beliefs and behaviors, and levels of physical activity and disability. 2) To review the theoretical mechanisms behind chronic non-specific pain and the potential mediating role of physical activity. 3) Finally, to report the most commonly recommended interventions for fear-avoidant individuals suffering with chronic pain.
Further investigation is needed to fully understand the associations between physical activity, chronic non-specific pain, and fear avoidant beliefs and behaviors. Precise relationships notwithstanding, there is strong evidence to suggest that physical activity is an integral piece to the chronic non-specific pain puzzle. For this reason, it is incumbent upon clinicians to strongly recommend participation in regular, yet properly progressed, physical activity to chronic non-specific pain sufferers.
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