5Epidemiology of chronic musculoskeletal pain
Section snippets
Epidemiological definition of chronic widespread pain
Musculoskeletal conditions usually present with pain and loss of function. The patient complains of chronic musculoskeletal pain, which could be due to a number of different illnesses. The real frequency of the original musculoskeletal conditions, as a result, is difficult to assess because it is marred by case-definition uncertainties and differences in the methods adopted in the epidemiological studies [1]. Pain, an important symptom of joint diseases, is also an index of severity and
What to measure?
The goal of descriptive epidemiology is the measure of occurrence of a given disease. In our case, the number of patients affected by musculoskeletal conditions, both in terms of percentage of the general population (prevalence) and of new cases of the disease developing in a given time frame (incidence), is investigated. By convention, the usual time interval for expressing incidence is 1 year and the source population is considered to be 100,000 subjects. However, according to the disease and
Which methods to investigate pain?
To collect data from a population, two main methods are used: Health Interview Survey (HIS) and Health Examination Survey (HES) [7]. HIS is based on face-to-face, phone or postal questionnaires focussed on the main aspects of pain and of the underlying diseases. In a slightly more sophisticated procedure, subjects identified by their answers to the questionnaire as possible patients are subsequently invited to attend the clinic for a complete evaluation. The HES is based on the direct
Which questions?
Diseases associated with pain have a number of characteristics that can be investigated through questionnaires (Table 3). However, none of the questionnaires described in the previous paragraph has been specifically designed to assess musculoskeletal conditions. As a result, the information available for the rheumatologist is scarce. Designing a musculoskeletal conditions-oriented questionnaire could improve the knowledge of these conditions, but which questions should be included?
A first issue
Summary of results of population studies on musculoskeletal pain
Musculoskeletal pain is common to most people at some time of their life. A summary of articles reporting musculoskeletal pain in different geographical areas is described in Table 5. The methods used to ascertain the prevalence of pain are extremely different. Only in few cases was CWP investigated. In the remaining studies, pain located in different areas of the body was studied. In addition, the denominator population at risk could differ as could age range considered and the interview
Risk factors for musculoskeletal pain
Several socio-demographic factors have been associated with CWP in the literature. Knowing these risk factors could be important to understand the mechanisms at play in the associated conditions and to improve chronic pain through preventive measures. Women in most studies complain more often of CWP than men, and this is directly related with age [31], *[32], [33], [34], [35]. The prevalence of musculoskeletal pain increases up to nearly 65 years of age [19], [36], [37], an observation that has
Conclusion
Chronic widespread pain (CWP) is a significant medical and socioeconomic problem in the society. It causes suffering, drug consumption and high frequency of sick leave and disability pensions. To better understand the role of individual risk factors, social and cultural influences and the effect on the health systems, international epidemiological comparative studies are needed. A major effort in the EU will be the development of common strategies to investigate musculoskeletal pain through
References (63)
- et al.
Chronic widespread pain in the spectrum of rheumatological diseases
Best Practice & Research Clinical Rheumatology
(2011) - et al.
Value of epidemiological research for clinical practice
Best Practice & Research Clinical Rheumatology
(2002) - et al.
The epidemiology of soft tissue rheumatism
Best Practice & Research Clinical Rheumatology
(2002) The McGill pain questionnaire: major properties and scoring methods
Pain
(1975)- et al.
Measuring musculoskeletal pain by questionnaires: the manikin versus written questions
The European Journal of Pain
(2010) - et al.
The course of chronic pain in the community: results of a 4-year follow-up study
Pain
(2002) - et al.
The occurrence and impact of generalized pain
Baillieres Best Practice & Research Clinical Rheumatology
(1999) - et al.
Sickness absence for psychiatric illness: the Whitehall II study
Social Science & Medicine
(1995) - et al.
Does the number of musculoskeletal pain sites predict work disability? A 14-year prospective study
European Journal of Pain
(2009) - et al.
Prevalence of pain in the Spanish population: telephone survey in 5000 homes
European Journal of Pain
(2002)
Chronic widespread pain predicts physical inactivity: results from the prospective EPIFUND study
European Journal of Pain
Grading the severity of chronic pain
Pain
Chronic musculoskeletal pain and depressive symptoms in the general population. An analysis of the 1st National Health and Nutrition Examination Survey data
Pain
Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups: the DMC3-study
Pain
Epidemiology of chronic pain in Denmark: an update
European Journal of Pain
Chronic pain-time for epidemiology
Journal of the Royal Society of Medicine
The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the multicenter criteria committee
Arthritis & Rheumatism
The prevalence and associated features of chronic widespread pain in the community using the “Manchester” definition of chronic widespread pain
Rheumatology
Prevalence of rheumatoid arthritis in Italy: the Chiavari study
Annals of the Rheumatic Diseases
Methodology of an epidemiologic prevalence study in rheumatology: the Chiavari study
Reumatismo
The validity of self-reported diagnosis of rheumatoid arthritis: results from a population survey followed by clinical examination
The Journal of Rheumatology
Delays in seeking HIV care due to competing caregiver responsibilities
American Journal of Public Health
Is the course of steroid-treated polymyalgia rheumatica more severe in women?
Annals of the New York Academy of Sciences
International classification of functioning, disability and health
Pain patterns in Italian patients with osteoarthritis: preliminary results of the MI.D.A. study (Misurazione del Dolore nell’ Artrosi)
Reumatismo
Weekend headache: a retrospective study in migraine without aura and episodic tension-type headache
Headache
Seasonal variation in the onset of acute microcrystalline arthritis
Rheumatology (Oxford)
Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study
The Journal of Rheumatology
Widespread musculoskeletal pain and the progression of disability in older disabled women
Annals of Internal Medicine
Musculoskeletal complaints in population. Occurrence and localization
Tidsskrift for den Norske Laegeforening
Cited by (312)
Pain mechanisms for the practicing rheumatologist
2024, Best Practice and Research: Clinical RheumatologyThe effect of exercise and education combination via telerehabilitation in patients with chronic neck pain: A randomized controlled trial
2023, International Journal of Medical InformaticsDexmedetomidine alleviates anxiety-like behaviors in female mice with musculoskeletal pain through SIRT1/p53 axis
2023, Brain Research BulletinSpanish version of the pain beliefs questionnaire: Translation, cross-cultural adaptation, validation, and psychometric properties in a working population
2023, Musculoskeletal Science and PracticeThe impact of sex and physical activity on the local immune response to muscle pain
2023, Brain, Behavior, and Immunity