The Transition of Reported Pain in Different Body Regions
The Transition of Reported Pain in Different Body Regions
Background: The course of pain at a specific region such as the lower back has previously been shown as well as for generalized pain. However we have not found any report on the course of pain from various different specific regions. The aim of this investigation was to study the one-year transition of reported pain in different body locations.
Methods: From a general population 14 555 men and women, 46-68 years, responded to an extensive health questionnaire including the standardized Nordic questionnaire. The population represented 27% of the total population within the age group in Malmö, Sweden. At the one year follow-up 12 607 responded to the questionnaire, yielding a response rate of 87%. The one year prevalence of long-lasting pain and the pattern of pain reporting from different regions were studied for men and women.
Results : The one-year prevalence of long-lasting neck pain was 14% (95% CI 13-15) among men and 25% (95% CI 24-26) among women at baseline and 15% (95% CI 14-16) for the men and 23% (95% CI 22-24) for the women at follow-up. Of those reporting neck pain "all the time" at baseline, 48% of the men and 54% of the women also reported neck pain "all the time" at the one-year follow-up. At the follow-up neck pain was reported as present "often" by 43% of the men and 47% of the women who reported neck pain "often" at baseline. Similar transition pattern were found for neck, shoulders, elbow/wrist/hand and lower back symptoms, as well as consistent prevalence rates.
Conclusions: The one-year transition pattern of reported pain was similar in different body regions and among men and women. Furthermore the prevalence rates of long-lasting pain in the population were consistent at baseline and the follow-up. The findings of similar transition patterns support the interpretation of long-lasting pain as a generalized phenomenon rather than attributed to specific exposure. This may have implications for future pain research.
Musculoskeletal pain is common in the adult population and one of the most common reasons to seek primary care. The prevalence of long-lasting pain has been described according to specific locations or as regional and widespread pain. In cross-sectional general population studies it has been recognized that 67%-91% of the participants reporting long-lasting pain report more than one location. However, specific locations and associated other pain locations have been sparsely investigated. In one general population study, 81% of those reporting long-lasting upper extremity pain also reported long-lasting neck, low back and/or lower extremity pain, indicating that long-lasting pain was often not localized to one region only. Pain in several regions has been recognized as a risk factor for more or long-lasting pain. Long-lasting pain may be attributed to specific exposure or interpreted as a generalized phenomenon. Considering possibly similar risk factors for persistence of pain in different locations, similar transition of pain reporting in different body locations could be expected.
To provide further insight in pain transition pattern and persistence, different approaches have been used. Longitudinal general population studies of long-lasting pain have indicated a variation in symptoms between chronic, recurrent or transient when studying pain at one specific region or generalized pain. For example, at a one-year follow-up of participants reporting chronic widespread pain at baseline, 56% remained classified as having chronic widespread pain. Similar results were found at a 3-year follow-up among responders reporting chronic widespread pain, where 45% were still classified as having chronic widespread pain. Even in a study of chronic widespread pain with a 7-year follow-up, the finding was similar. Thirty-four percent were still classified as having chronic widespread pain. However, widespread pain classification is dependent on the definition used. Mainly it is based on the American College of Rheumatology classification criteria which require pain to be present in at least two contra-lateral body quadrants and the axial skeleton. By this definition these results mainly imply that the number of reported painful regions fluctuate at least in some locations, however it does not give any information on the course of specific pain.
In studies focusing on a single location also a transition of pain reporting has been noted. At a 2-year follow-up in a population reporting long-lasting neck/shoulder pain, 63% still reported neck/shoulder pain or generalized pain. Of those initially classified as having generalized pain, 85% remained classified having generalized pain. A 5-year follow-up study describing the reporting and transition of low back pain revealed a large fluctuation of the reporting of pain among the individuals. Of those reporting long-lasting/recurrent low back pain at baseline, 39% still reported long-lasting symptoms at the follow-up.
It seems well established that the prevalence of long-lasting pain is higher among women than men. Though, we have not found any study on if transition patterns and persistence of pain are different or similar in different locations, among men and women.
The aim of this investigation was to study the one year transition of reported pain at different body locations.
Abstract and Background
Abstract
Background: The course of pain at a specific region such as the lower back has previously been shown as well as for generalized pain. However we have not found any report on the course of pain from various different specific regions. The aim of this investigation was to study the one-year transition of reported pain in different body locations.
Methods: From a general population 14 555 men and women, 46-68 years, responded to an extensive health questionnaire including the standardized Nordic questionnaire. The population represented 27% of the total population within the age group in Malmö, Sweden. At the one year follow-up 12 607 responded to the questionnaire, yielding a response rate of 87%. The one year prevalence of long-lasting pain and the pattern of pain reporting from different regions were studied for men and women.
Results : The one-year prevalence of long-lasting neck pain was 14% (95% CI 13-15) among men and 25% (95% CI 24-26) among women at baseline and 15% (95% CI 14-16) for the men and 23% (95% CI 22-24) for the women at follow-up. Of those reporting neck pain "all the time" at baseline, 48% of the men and 54% of the women also reported neck pain "all the time" at the one-year follow-up. At the follow-up neck pain was reported as present "often" by 43% of the men and 47% of the women who reported neck pain "often" at baseline. Similar transition pattern were found for neck, shoulders, elbow/wrist/hand and lower back symptoms, as well as consistent prevalence rates.
Conclusions: The one-year transition pattern of reported pain was similar in different body regions and among men and women. Furthermore the prevalence rates of long-lasting pain in the population were consistent at baseline and the follow-up. The findings of similar transition patterns support the interpretation of long-lasting pain as a generalized phenomenon rather than attributed to specific exposure. This may have implications for future pain research.
Background
Musculoskeletal pain is common in the adult population and one of the most common reasons to seek primary care. The prevalence of long-lasting pain has been described according to specific locations or as regional and widespread pain. In cross-sectional general population studies it has been recognized that 67%-91% of the participants reporting long-lasting pain report more than one location. However, specific locations and associated other pain locations have been sparsely investigated. In one general population study, 81% of those reporting long-lasting upper extremity pain also reported long-lasting neck, low back and/or lower extremity pain, indicating that long-lasting pain was often not localized to one region only. Pain in several regions has been recognized as a risk factor for more or long-lasting pain. Long-lasting pain may be attributed to specific exposure or interpreted as a generalized phenomenon. Considering possibly similar risk factors for persistence of pain in different locations, similar transition of pain reporting in different body locations could be expected.
To provide further insight in pain transition pattern and persistence, different approaches have been used. Longitudinal general population studies of long-lasting pain have indicated a variation in symptoms between chronic, recurrent or transient when studying pain at one specific region or generalized pain. For example, at a one-year follow-up of participants reporting chronic widespread pain at baseline, 56% remained classified as having chronic widespread pain. Similar results were found at a 3-year follow-up among responders reporting chronic widespread pain, where 45% were still classified as having chronic widespread pain. Even in a study of chronic widespread pain with a 7-year follow-up, the finding was similar. Thirty-four percent were still classified as having chronic widespread pain. However, widespread pain classification is dependent on the definition used. Mainly it is based on the American College of Rheumatology classification criteria which require pain to be present in at least two contra-lateral body quadrants and the axial skeleton. By this definition these results mainly imply that the number of reported painful regions fluctuate at least in some locations, however it does not give any information on the course of specific pain.
In studies focusing on a single location also a transition of pain reporting has been noted. At a 2-year follow-up in a population reporting long-lasting neck/shoulder pain, 63% still reported neck/shoulder pain or generalized pain. Of those initially classified as having generalized pain, 85% remained classified having generalized pain. A 5-year follow-up study describing the reporting and transition of low back pain revealed a large fluctuation of the reporting of pain among the individuals. Of those reporting long-lasting/recurrent low back pain at baseline, 39% still reported long-lasting symptoms at the follow-up.
It seems well established that the prevalence of long-lasting pain is higher among women than men. Though, we have not found any study on if transition patterns and persistence of pain are different or similar in different locations, among men and women.
The aim of this investigation was to study the one year transition of reported pain at different body locations.