<p>The impact of multisite pain on functional outcomes in older adults: biopsychosocial considerations</p>

Abstract

Multisite pain, or pain that occurs simultaneously at >1 anatomical site, is more prevalent than single-site pain. While multisite pain affects over half of older adults, it remains an understudied pain entity that may have important functional implications in an aging population. Greater understanding of this complex pain entity from a biopsychosocial perspective is critical for optimizing clinical and functional outcomes in older adults with pain. Therefore, the primary purpose of this review is to summarize the relationship between multisite pain and functional outcomes in older adults to further elucidate the impact of multisite pain as a distinct entity within this population. A comprehensive literature search revealed 17 peer-reviewed articles. Multisite pain in older individuals is associated with reductions in several physical function domains: 1) lower-extremity mobility; 2) upper-extremity impairments; 3) balance and increased fall risk; and 4) general disability and poor physical function. Further, multisite pain in older individuals is associated with psychological dysfunction (eg, anxiety and depressive symptoms) and social factors (eg, income and education). Overall, this review highlights the scant literature investigating the functional implications of multisite pain in an aging population. Further, while multisite pain appears to have functional consequences, the neurobiological mechanisms contributing to this relationship are unknown. Thus, how this pain characteristic may contribute to the variability in pain-related functional outcomes among older adults is not clear. Future investigations are strongly warranted to advance the understanding of multisite pain and its broad impact on physical and psychosocial function in older adults.

Musculoskeletal pain in other body sites is associated with new-onset low back pain: a longitudinal study among survivors of the great East Japan earthquake

“…Risk factors for LBP include age, sex, obesity, smoking, psychological distress, and sleep disturbance in the adult population [3,[5][6][7][8]. Further, musculoskeletal pain often occurs at multiple sites, and single-site pain has been shown to increase the risk of pain at other sites [9]. Indeed, some reports have found that LBP occurs concurrently with other musculoskeletal pain [10][11][12].…”

Trajectories of multisite musculoskeletal pain in midlife: Associations with common mental disorders

“…Low back pain and neck pain are the most prevalent and affect people of all age groups (GBD 2017 Disease and Injury Incidence and Prevalence Collaborators, ). Musculoskeletal pain occurs in several body sites concurrently more often than in a single site only in the general population (Carnes et al, ; Schmidt & Baumeister, ), among the occupationally active (Melkevik et al, ; Saastamoinen, Leino‐Arjas, Laaksonen, Martikainen, & Lahelma, ) and among older adults (Butera et al, ). While musculoskeletal pain in adolescence often persists to midlife (Leino‐Arjas et al, ) and midlife pain to old age (Neupane et al, ), the widespreadness of pain may decrease with retirement from work (Neupane et al, ).…”

Other musculoskeletal pain is associated with new-onset low back pain: A longitudinal study among survivors of the Great East Japan Earthquake

“…The rate of musculoskeletal pain was higher in participants aged ≥ 65 years compared with those aged < 65 years and the association between the other musculoskeletal pain and LBP was stronger in those aged ≥ 65 years. Generally, musculoskeletal pain, especially multisite pain, is more common among older adults [6,19], and they are considered to be more vulnerable to such pain. Conversely, the rate of musculoskeletal pain was higher in females as compared with males; however, the association of musculoskeletal pain with LBP was stronger in males.…”

“…Risk factors of LBP include age, sex, obesity, smoking, psychological distress, and sleep disturbance [2][3][4][5]. Further, musculoskeletal pain often occurs at multiple sites, and single-site pain is considered to increase the risk for pain at other sites [6]. Indeed, some reports have found that LBP occurs concurrently with other musculoskeletal pain [7][8][9].…”