Number of musculoskeletal pain sites leads to increased long-term healthcare contacts and healthcare related costs – a Danish population-based cohort study

Mose, Søren; Smith, Anne; Andersen, Johan Hviid; Christiansen, David Høyrup

doi:10.1186/s12913-021-06994-0

Cited by 22 publications

(12 citation statements)

References 63 publications

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“…Pain sites served as a covariate for global pain severity in the model since the other pain measures were limited to the knee 45 . Increasing number of pain sites has been linked to worse health outcomes and three or more pain sites are considered widespread pain 46 , 47 .…”

Section: Methodsmentioning

confidence: 99%

Environmental and sociocultural factors are associated with pain-related brain structure among diverse individuals with chronic musculoskeletal pain: intersectional considerations

Domenico,

Tanner,

Mickle

et al. 2024

Sci Rep

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Chronic musculoskeletal pain including knee osteoarthritis (OA) is a leading cause of disability worldwide. Previous research indicates ethnic-race groups differ in the pain and functional limitations experienced with knee OA. However, when socioenvironmental factors are included in analyses, group differences in pain and function wane. Pain-related brain structures are another area where ethnic-race group differences have been observed. Environmental and sociocultural factors e.g., income, education, experiences of discrimination, and social support influence brain structures. We investigate if environmental and sociocultural factors reduce previously observed ethnic-race group differences in pain-related brain structures. Data were analyzed from 147 self-identified non-Hispanic black (NHB) and non-Hispanic white (NHW), middle and older aged adults with knee pain in the past month. Information collected included health and pain history, environmental and sociocultural resources, and brain imaging. The NHB adults were younger and reported lower income and education compared to their NHW peers. In hierarchical multiple regression models, sociocultural and environmental factors explained 6–37% of the variance in pain-related brain regions. Self-identified ethnicity-race provided an additional 4–13% of explanatory value in the amygdala, hippocampus, insula, bilateral primary somatosensory cortex, and thalamus. In the rostral/caudal anterior cingulate and dorsolateral prefrontal cortex, self-identified ethnicity-race was not a predictor after accounting for environmental, sociocultural, and demographic factors. Findings help to disentangle and identify some of the factors contributing to ethnic-race group disparities in pain-related brain structures. Numerous arrays of environmental and sociocultural factors remain to be investigated. Further, the differing sociodemographic representation of our NHB and NHW participants highlights the role for intersectional considerations in future research.

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Section: Methodsmentioning

confidence: 99%

Environmental and sociocultural factors are associated with pain-related brain structure among diverse individuals with chronic musculoskeletal pain: intersectional considerations

Domenico,

Tanner,

Mickle

et al. 2024

Sci Rep

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“…15 Identifying LBP phenotypes is relevant because co-occurring MSK pain is associated with more negative consequences, such as reduced workability, increased healthcare utilization, and poorer response to treatment compared with single-site MSK pain. 2,6,19,20,26,29,43,48 However, counting the number of pain sites may be too simplistic because certain pain sites or pain patterns among people with persistent LBP may have diverse consequences and affect prognosis or treatment outcomes differently. 27 Distinct LBP phenotypes may have features requiring a stratified care approach, 53 and including them in the management of LBP rather than approaching LBP as a single entity could offer the possibility of larger treatment effects.…”

Section: Introductionmentioning

confidence: 99%

“…15 Identifying LBP phenotypes is relevant because co-occurring MSK pain is associated with more negative consequences, such as reduced workability, increased healthcare utilization, and poorer response to treatment compared with single-site MSK pain. 2,6,19,20,26,29,43,48 However, counting the number of pain sites may be too simplistic because certain pain sites or pain patterns among people with persistent LBP may have diverse Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.…”

Section: Introductionmentioning

confidence: 99%

Temporal stability in the prevalence and pattern of co-occurring musculoskeletal pain among people with persistent low back pain: population-based data from the Norwegian HUNT Study, 1995 to 2019

Øverås

Nilsen

Søgaard

et al. 2023

Pain

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People with persistent low back pain (LBP) often report co-occurring persistent musculoskeletal (MSK) pain in other body regions that may influence prognosis as well as treatment approaches and outcomes. This study describes the prevalence and patterns of co-occurring persistent MSK pain among people with persistent LBP based on consecutive cross-sectional studies over 3 decades in the population-based HUNT Study, Norway. The analyses comprised 15,375 participants in HUNT2 (1995-1997), 10,024 in HUNT3 (2006-2008), and 10,647 in HUNT4 (2017-2019) who reported persistent LBP. Overall, ∼90% of participants in each of the HUNT surveys with persistent LBP reported persistent co-occurring MSK pain in other body sites. The age-standardized prevalence of the most common co-occurring MSK pain sites was consistent across the 3 surveys: 64% to 65% report co-occurring neck pain, 62% to 67% report shoulder pain, and 53% to 57% report hip or thigh pain. Using latent class analysis (LCA), we identified 4 distinct patterns of persistent LBP phenotypes that were consistent across the 3 surveys: (1) “LBP only,” (2) “LBP with neck or shoulder pain,” (3) “LBP with lower extremity or wrist or hand pain,” and (4) “LBP with multisite pain,” with conditional item response probabilities of 34% to 36%, 30% to 34%, 13% to 17%, and 16% to 20%, respectively. In conclusion, 9 of 10 adults in this Norwegian population with persistent LBP report co-occurring persistent MSK pain, most commonly in the neck, shoulders, and hips or thighs. We identified 4 LCA-derived LBP phenotypes of distinct MSK pain site patterns. In the population, both the prevalence and pattern of co-occurring MSK pain and the distinct phenotypic MSK pain patterns seem stable over decades.

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“…Musculoskeletal pain frequently affects multiple anatomical sites in the same individual (Carnes et al, 2007; Hartvigsen, Davidsen, et al, 2013; Hartvigsen, Natvig, & Ferreira, 2013), impacting importantly on daily functioning (Kamaleri et al, 2008a; Saastamoinen et al, 2006), work ability, healthcare seeking (Mose et al, 2021) and sickness absence (Neupane et al, 2015). We have previously shown large international differences in the prevalence of multi‐site pain among working populations (Coggon et al, 2013), while other research has suggested that within individuals, the extent of musculoskeletal pain (as indicated by the number of anatomical sites affected) remains fairly constant over periods of 2 years or longer (Christensen et al, 2017; Kamaleri et al, 2008b).…”

Section: Introductionmentioning

confidence: 99%

Patterns of change of multisite pain over 1 year of follow‐up and related risk factors

Ntani

Coggon

Felli

et al. 2022

European Journal of Pain

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Background Multisite musculoskeletal pain is common and disabling. This study aimed to prospectively investigate the distribution of musculoskeletal pain anatomically, and explore risk factors for increases/reductions in the number of painful sites. Methods Using data from participants working in 45 occupational groups in 18 countries, we explored changes in reporting pain at 10 anatomical sites on two occasions 14 months apart. We used descriptive statistics to explore consistency over time in the number of painful sites, and their anatomical distribution. Baseline risk factors for increases/reductions by ≥3 painful sites were explored by random intercept logistic regression that adjusted for baseline number of painful sites. Results Among 8927 workers, only 20% reported no pain at either time point, and 16% reported ≥3 painful sites both times. After 14 months, the anatomical distribution of pain often changed but there was only an average increase of 0.17 painful sites. Some 14% workers reported a change in painful sites by ≥3. Risk factors for an increase of ≥3 painful sites included female sex, lower educational attainment, having a physically demanding job and adverse beliefs about the work‐relatedness of musculoskeletal pain. Also predictives were as follows: older age, somatizing tendency and poorer mental health (each of which was also associated with lower odds of reductions of ≥3 painful sites). Conclusions Longitudinally, the number of reported painful sites was relatively stable but the anatomical distribution varied considerably. These findings suggest an important role for central pain sensitization mechanisms, rather than localized risk factors, among working adults. Significance Our findings indicate that within individuals, the number of painful sites is fairly constant over time, but the anatomical distribution varies, supporting the theory that among people at work, musculoskeletal pain is driven more by factors that predispose to experiencing or reporting pain rather than by localized stressors specific to only one or two anatomical sites.

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Number of musculoskeletal pain sites leads to increased long-term healthcare contacts and healthcare related costs – a Danish population-based cohort study

Cited by 22 publications

References 63 publications

Environmental and sociocultural factors are associated with pain-related brain structure among diverse individuals with chronic musculoskeletal pain: intersectional considerations

Environmental and sociocultural factors are associated with pain-related brain structure among diverse individuals with chronic musculoskeletal pain: intersectional considerations

Temporal stability in the prevalence and pattern of co-occurring musculoskeletal pain among people with persistent low back pain: population-based data from the Norwegian HUNT Study, 1995 to 2019

Patterns of change of multisite pain over 1 year of follow‐up and related risk factors

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