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Published in: BMC Musculoskeletal Disorders 1/2020

Open Access 01-12-2020 | Research article

The impact of chronic widespread pain on health status and long-term health predictors: a general population cohort study

Authors: Charlotte Sylwander, Ingrid Larsson, Maria Andersson, Stefan Bergman

Published in: BMC Musculoskeletal Disorders | Issue 1/2020

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Abstract

Background

Chronic widespread pain (CWP) has a negative impact on health status, but results have varied regarding gender-related differences and reported health status. The aim was to study the impact of CWP on health status in women and men aged 35–54 years in a sample of the general population. The aim was further to investigate lifestyle-related predictors of better health status in those with CWP in a 12- and 21-year perspective.

Method

A general population cohort study including 975 participants aged 35–54 years, with a 12- and 21-year follow-up. CWP was measured with a pain mannequin, and the questionnaire included questions on lifestyles factors with SF-36 for measurement of health status. Differences in health status were analysed with independent samples t-test and health predictors with logistic regression analysis.

Results

The prevalence of CWP was higher in women at all time points, but health status was reduced in both women and men with CWP (p < 0.001) with no gender differences of clinical relevance. At the 12-year follow-up, a higher proportion of women than men had developed CWP (OR 2.04; CI 1.27–3.26), and at the 21-year follow-up, a higher proportion of men had recovered from CWP (OR 3.79; CI 1.00–14.33). In those reporting CWP at baseline, a better SF-36 health status (Physical Functioning, Vitality or Mental Health) at the 12-year follow-up was predicted by male gender, having personal support, being a former smoker, and having no sleeping problems. In the 21-year follow-up, predictors of better health were male gender, a weekly intake of alcohol, and having no sleeping problems.

Conclusion

Women and men with CWP have the same worsening of health status, but men recover from CWP to a greater extent in the long-term. Being male, having social support, being a former smoker, and having no sleeping problems were associated with better health status in those with CWP.
Literature
1.
go back to reference Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10:287–333.PubMedCrossRef Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10:287–333.PubMedCrossRef
2.
go back to reference Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the international classification of diseases:(: ICD-11:). Pain. 2019;160:19–27. Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: the IASP classification of chronic pain for the international classification of diseases:(: ICD-11:). Pain. 2019;160:19–27.
3.
go back to reference Ohayon MM, Stingl JC. Prevalence and comorbidity of chronic pain in the German general population. J Psychiatr Res. 2012;46:444–50.PubMedCrossRef Ohayon MM, Stingl JC. Prevalence and comorbidity of chronic pain in the German general population. J Psychiatr Res. 2012;46:444–50.PubMedCrossRef
4.
go back to reference Rustøen T, Wahl AK, Hanestad BR, Lerdal A, Paul S, Miaskowski C. Gender differences in chronic pain—findings from a population-based study of Norwegian adults. Pain Manag Nurs. 2004;5:105–17.PubMedCrossRef Rustøen T, Wahl AK, Hanestad BR, Lerdal A, Paul S, Miaskowski C. Gender differences in chronic pain—findings from a population-based study of Norwegian adults. Pain Manag Nurs. 2004;5:105–17.PubMedCrossRef
5.
go back to reference Dureja GP, Jain PN, Shetty N, Mandal SP, Prabhoo R, Joshi M, et al. Prevalence of chronic pain, impact on daily life, and treatment practices in India. Pain Pract. 2013;14:E51–62.PubMedCrossRef Dureja GP, Jain PN, Shetty N, Mandal SP, Prabhoo R, Joshi M, et al. Prevalence of chronic pain, impact on daily life, and treatment practices in India. Pain Pract. 2013;14:E51–62.PubMedCrossRef
6.
go back to reference Arvidsson S, Arvidsson B, Fridlund B, Bergman S. Health predicting factors in a general population over an eight-year period in subjects with and without chronic musculoskeletal pain. Health Qual Life Outcomes. 2008;6:98.PubMedPubMedCentralCrossRef Arvidsson S, Arvidsson B, Fridlund B, Bergman S. Health predicting factors in a general population over an eight-year period in subjects with and without chronic musculoskeletal pain. Health Qual Life Outcomes. 2008;6:98.PubMedPubMedCentralCrossRef
7.
go back to reference Bergman S, Jacobsson LT, Herrström P, Petersson IF. Health status as measured by SF-36 reflects changes and predicts outcome in chronic musculoskeletal pain: a 3-year follow up study in the general population. Pain. 2004;108:115–23.PubMedCrossRef Bergman S, Jacobsson LT, Herrström P, Petersson IF. Health status as measured by SF-36 reflects changes and predicts outcome in chronic musculoskeletal pain: a 3-year follow up study in the general population. Pain. 2004;108:115–23.PubMedCrossRef
8.
go back to reference Harker J, Reid KJ, Bekkering GE, Kellen E, Bala MM, Riemsma R, et al. Epidemiology of chronic pain in Denmark and Sweden. Pain Res Treat. 2012;2012:371248.PubMedPubMedCentral Harker J, Reid KJ, Bekkering GE, Kellen E, Bala MM, Riemsma R, et al. Epidemiology of chronic pain in Denmark and Sweden. Pain Res Treat. 2012;2012:371248.PubMedPubMedCentral
9.
go back to reference Järemo P, Arman M, Gerdle B, Larsson B, Gottberg K. Illness beliefs among patients with chronic widespread pain-associations with self-reported health status, anxiety and depressive symptoms and impact of pain. BMC Psychol. 2017;5:24.PubMedPubMedCentralCrossRef Järemo P, Arman M, Gerdle B, Larsson B, Gottberg K. Illness beliefs among patients with chronic widespread pain-associations with self-reported health status, anxiety and depressive symptoms and impact of pain. BMC Psychol. 2017;5:24.PubMedPubMedCentralCrossRef
10.
go back to reference Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis Rheum. 1990;33:160–72.PubMedCrossRef Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Arthritis Rheum. 1990;33:160–72.PubMedCrossRef
11.
go back to reference Andrews P, Steultjens M, Riskowski J. Chronic widespread pain prevalence in the general population: a systematic review. Eur J Pain. 2018;22:5–18.PubMedCrossRef Andrews P, Steultjens M, Riskowski J. Chronic widespread pain prevalence in the general population: a systematic review. Eur J Pain. 2018;22:5–18.PubMedCrossRef
12.
go back to reference Mansfield KE, Sim J, Jordan JL, Jordan KP. A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population. Pain. 2016;157:55.PubMedCrossRef Mansfield KE, Sim J, Jordan JL, Jordan KP. A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population. Pain. 2016;157:55.PubMedCrossRef
13.
go back to reference Cimmino MA, Ferrone C, Cutolo M. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2011;25:173–83.PubMedCrossRef Cimmino MA, Ferrone C, Cutolo M. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2011;25:173–83.PubMedCrossRef
14.
go back to reference Bergman S. Psychosocial aspects of chronic widespread pain and fibromyalgia. Disabil Rehabil. 2005;27:675–83.PubMedCrossRef Bergman S. Psychosocial aspects of chronic widespread pain and fibromyalgia. Disabil Rehabil. 2005;27:675–83.PubMedCrossRef
15.
go back to reference Pisinger C, Aadahl M, Toft U, Birke H, Zytphen-Adeler J, Jørgensen T. The association between active and passive smoking and frequent pain in a general population. Eur J Pain. 2011;15:77–83.PubMedCrossRef Pisinger C, Aadahl M, Toft U, Birke H, Zytphen-Adeler J, Jørgensen T. The association between active and passive smoking and frequent pain in a general population. Eur J Pain. 2011;15:77–83.PubMedCrossRef
16.
go back to reference Mundal I, Gråwe RW, Bjørngaard JH, Linaker OM, Fors EA. Prevalence and long-term predictors of persistent chronic widespread pain in the general population in an 11-year prospective study: the HUNT study. BMC Musculoskelet Disord. 2014;15:213.PubMedPubMedCentralCrossRef Mundal I, Gråwe RW, Bjørngaard JH, Linaker OM, Fors EA. Prevalence and long-term predictors of persistent chronic widespread pain in the general population in an 11-year prospective study: the HUNT study. BMC Musculoskelet Disord. 2014;15:213.PubMedPubMedCentralCrossRef
17.
go back to reference Arranz L-I, Rafecas M, Alegre C. Effects of obesity on function and quality of life in chronic pain conditions. Curr Rheumatol Rep. 2014;16:390.PubMedCrossRef Arranz L-I, Rafecas M, Alegre C. Effects of obesity on function and quality of life in chronic pain conditions. Curr Rheumatol Rep. 2014;16:390.PubMedCrossRef
18.
go back to reference Aili K, Andersson M, Bremander A, Haglund E, Larsson I, Bergman S. Sleep problems and fatigue as predictors for the onset of chronic widespread pain over a 5- and 18-year perspective. BMC Musculoskelet Disord. 2018;19:390.PubMedPubMedCentralCrossRef Aili K, Andersson M, Bremander A, Haglund E, Larsson I, Bergman S. Sleep problems and fatigue as predictors for the onset of chronic widespread pain over a 5- and 18-year perspective. BMC Musculoskelet Disord. 2018;19:390.PubMedPubMedCentralCrossRef
19.
go back to reference Davies KA, Macfarlane GJ, Nicholl BI, Dickens C, Morriss R, Ray D, et al. Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study. Rheumatology. 2008;47:1809–13.PubMedCrossRefPubMedCentral Davies KA, Macfarlane GJ, Nicholl BI, Dickens C, Morriss R, Ray D, et al. Restorative sleep predicts the resolution of chronic widespread pain: results from the EPIFUND study. Rheumatology. 2008;47:1809–13.PubMedCrossRefPubMedCentral
20.
go back to reference Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009;10:447–85.PubMedPubMedCentralCrossRef Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009;10:447–85.PubMedPubMedCentralCrossRef
21.
go back to reference Gran JT. The epidemiology of chronic generalized musculoskeletal pain. Best Pract Res Clin Rheumatol. 2003;17:547–61.PubMedCrossRef Gran JT. The epidemiology of chronic generalized musculoskeletal pain. Best Pract Res Clin Rheumatol. 2003;17:547–61.PubMedCrossRef
22.
go back to reference Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choinière M. A systematic literature review of 10years of research on sex/gender and experimental pain perception – part 1: are there really differences between women and men? Pain. 2012;153:602–18.PubMedCrossRef Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choinière M. A systematic literature review of 10years of research on sex/gender and experimental pain perception – part 1: are there really differences between women and men? Pain. 2012;153:602–18.PubMedCrossRef
24.
go back to reference Defrin R, Shramm L, Eli I. Gender role expectations of pain is associated with pain tolerance limit but not with pain threshold. Pain. 2009;145:230–6.PubMedCrossRef Defrin R, Shramm L, Eli I. Gender role expectations of pain is associated with pain tolerance limit but not with pain threshold. Pain. 2009;145:230–6.PubMedCrossRef
25.
go back to reference Civardi G, Mordenti P, Gussoni G, Politi C, Seghini P, Pasquini MC, et al. Gender differences in pain prevalence, characteristics, assessment and treatment in internal medicine patients: a post-hoc analysis of the FADOI-DOMINO study. Ital J Med. 2018;12(3):213–8.CrossRef Civardi G, Mordenti P, Gussoni G, Politi C, Seghini P, Pasquini MC, et al. Gender differences in pain prevalence, characteristics, assessment and treatment in internal medicine patients: a post-hoc analysis of the FADOI-DOMINO study. Ital J Med. 2018;12(3):213–8.CrossRef
26.
go back to reference Rovner GS, Sunnerhagen KS, Björkdahl A, Gerdle B, Börsbo B, Johansson F, et al. Chronic pain and sex-differences; women accept and move, while men feel blue. PLoS One. 2017;12:e0175737.PubMedPubMedCentralCrossRef Rovner GS, Sunnerhagen KS, Björkdahl A, Gerdle B, Börsbo B, Johansson F, et al. Chronic pain and sex-differences; women accept and move, while men feel blue. PLoS One. 2017;12:e0175737.PubMedPubMedCentralCrossRef
27.
go back to reference Skillgate E, Pico-Espinosa OJ, Hallqvist J, Bohman T, Holm LW. Healthy lifestyle behavior and risk of long duration troublesome neck pain or low back pain among men and women: results from the Stockholm public health cohort. Clin Epidemiol. 2017;9:491–500.PubMedPubMedCentralCrossRef Skillgate E, Pico-Espinosa OJ, Hallqvist J, Bohman T, Holm LW. Healthy lifestyle behavior and risk of long duration troublesome neck pain or low back pain among men and women: results from the Stockholm public health cohort. Clin Epidemiol. 2017;9:491–500.PubMedPubMedCentralCrossRef
28.
go back to reference Bergman S, Herrström P, Högström K, Petersson IF, Svensson B, Jacobsson LT. Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study. J Rheumatol. 2001;28:1369–77.PubMed Bergman S, Herrström P, Högström K, Petersson IF, Svensson B, Jacobsson LT. Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study. J Rheumatol. 2001;28:1369–77.PubMed
29.
go back to reference Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. PLoS Med. 2007;4:e297.PubMedPubMedCentralCrossRef Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. PLoS Med. 2007;4:e297.PubMedPubMedCentralCrossRef
30.
go back to reference Ware JE, Gandek B. Overview of the SF-36 health survey and the international quality of life assessment (IQOLA) project. J Clin Epidemiol. 1998;51:903–12.PubMedCrossRef Ware JE, Gandek B. Overview of the SF-36 health survey and the international quality of life assessment (IQOLA) project. J Clin Epidemiol. 1998;51:903–12.PubMedCrossRef
31.
go back to reference Sullivan M, Karlsson J, Ware JE Jr. The Swedish SF-36 health survey—I. evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med. 1995;41:1349–58.PubMedCrossRef Sullivan M, Karlsson J, Ware JE Jr. The Swedish SF-36 health survey—I. evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med. 1995;41:1349–58.PubMedCrossRef
32.
go back to reference Haskell WL, Lee I-M, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116:1081.PubMedCrossRef Haskell WL, Lee I-M, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116:1081.PubMedCrossRef
33.
go back to reference World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Jama. 2013;310:2191.CrossRef World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Jama. 2013;310:2191.CrossRef
34.
go back to reference Lindgren H, Gottsäter A, Qvarfordt P, Bergman S. All cause chronic widespread pain is common in patients with symptomatic peripheral arterial disease and is associated with reduced health related quality of life. Eur J Vasc Endovasc Surg. 2016;52:205–10.PubMedCrossRef Lindgren H, Gottsäter A, Qvarfordt P, Bergman S. All cause chronic widespread pain is common in patients with symptomatic peripheral arterial disease and is associated with reduced health related quality of life. Eur J Vasc Endovasc Surg. 2016;52:205–10.PubMedCrossRef
35.
go back to reference Cohen J. Statistical power calculations for the behavioral sciences. Hillsdale: Lawrence Erlbaum Associates; 1988. Cohen J. Statistical power calculations for the behavioral sciences. Hillsdale: Lawrence Erlbaum Associates; 1988.
36.
go back to reference Bergman S, Herrström P, Jacobsson LT, Petersson IF. Chronic widespread pain: a three year followup of pain distribution and risk factors. J Rheumatol. 2002;29:818–25.PubMed Bergman S, Herrström P, Jacobsson LT, Petersson IF. Chronic widespread pain: a three year followup of pain distribution and risk factors. J Rheumatol. 2002;29:818–25.PubMed
37.
38.
go back to reference Schaefer C, Mann R, Masters ET, Cappelleri JC, Daniel SR, Zlateva G, et al. The comparative burden of chronic widespread pain and fibromyalgia in the United States. Pain Pract. 2016;16:565–79.PubMedCrossRef Schaefer C, Mann R, Masters ET, Cappelleri JC, Daniel SR, Zlateva G, et al. The comparative burden of chronic widespread pain and fibromyalgia in the United States. Pain Pract. 2016;16:565–79.PubMedCrossRef
39.
go back to reference Gerdle B, Björk J, Cöster L, Henriksson K-G, Henriksson C, Bengtsson A. Prevalence of widespread pain and associations with work status: a population study. BMC Musculoskelet Disord. 2008;9:102.PubMedPubMedCentralCrossRef Gerdle B, Björk J, Cöster L, Henriksson K-G, Henriksson C, Bengtsson A. Prevalence of widespread pain and associations with work status: a population study. BMC Musculoskelet Disord. 2008;9:102.PubMedPubMedCentralCrossRef
40.
go back to reference Weingarten TN, Moeschler SM, Ptaszynski AE, Hooten WM, Beebe TJ, Warner DO. An assessment of the association between smoking status, pain intensity, and functional interference in patients with chronic pain. Pain Physician. 2008;11:643–53.PubMedCrossRef Weingarten TN, Moeschler SM, Ptaszynski AE, Hooten WM, Beebe TJ, Warner DO. An assessment of the association between smoking status, pain intensity, and functional interference in patients with chronic pain. Pain Physician. 2008;11:643–53.PubMedCrossRef
41.
go back to reference Shi Y, Weingarten TN, Mantilla CB, Hooten WM, Warner DO. Smoking and pain pathophysiology and clinical implications. Anesthesiology. 2010;113:977–92.PubMedCrossRef Shi Y, Weingarten TN, Mantilla CB, Hooten WM, Warner DO. Smoking and pain pathophysiology and clinical implications. Anesthesiology. 2010;113:977–92.PubMedCrossRef
42.
go back to reference Dean E, Söderlund A. What is the role of lifestyle behaviour change associated with non-communicable disease risk in managing musculoskeletal health conditions with special reference to chronic pain? BMC Musculoskelet Disord. 2015;16:87.PubMedPubMedCentralCrossRef Dean E, Söderlund A. What is the role of lifestyle behaviour change associated with non-communicable disease risk in managing musculoskeletal health conditions with special reference to chronic pain? BMC Musculoskelet Disord. 2015;16:87.PubMedPubMedCentralCrossRef
43.
go back to reference Kim CH, Vincent A, Clauw DJ, Luedtke CA, Thompson JM, Schneekloth TD, et al. Association between alcohol consumption and symptom severity and quality of life in patients with fibromyalgia. Arthritis Res Ther. 2013;15:R42.PubMedPubMedCentralCrossRef Kim CH, Vincent A, Clauw DJ, Luedtke CA, Thompson JM, Schneekloth TD, et al. Association between alcohol consumption and symptom severity and quality of life in patients with fibromyalgia. Arthritis Res Ther. 2013;15:R42.PubMedPubMedCentralCrossRef
44.
go back to reference Scott JR, Hassett AL, Schrepf AD, Brummett CM, Harris RE, Clauw DJ, et al. Moderate alcohol consumption is associated with reduced pain and fibromyalgia symptoms in chronic pain patients. Pain Med. 2018;19:2515–27.PubMedCrossRef Scott JR, Hassett AL, Schrepf AD, Brummett CM, Harris RE, Clauw DJ, et al. Moderate alcohol consumption is associated with reduced pain and fibromyalgia symptoms in chronic pain patients. Pain Med. 2018;19:2515–27.PubMedCrossRef
45.
go back to reference Chan AM, von Mühlen D, Kritz-Silverstein D, Barrett-Connor E. Regular alcohol consumption is associated with increasing quality of life and mood in older men and women: the rancho Bernardo study. Maturitas. 2009;62:294–300.PubMedPubMedCentralCrossRef Chan AM, von Mühlen D, Kritz-Silverstein D, Barrett-Connor E. Regular alcohol consumption is associated with increasing quality of life and mood in older men and women: the rancho Bernardo study. Maturitas. 2009;62:294–300.PubMedPubMedCentralCrossRef
46.
go back to reference Larsson I, Andersson MLE. Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: a mixed-methods study. BMJ Open. 2018;8:e024367.PubMedPubMedCentralCrossRef Larsson I, Andersson MLE. Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: a mixed-methods study. BMJ Open. 2018;8:e024367.PubMedPubMedCentralCrossRef
47.
go back to reference Bergman S. Chronic musculoskeletal pain: a multifactorial process [PhD Thesis]. Lund: Lund University; 2001. Bergman S. Chronic musculoskeletal pain: a multifactorial process [PhD Thesis]. Lund: Lund University; 2001.
Metadata
Title
The impact of chronic widespread pain on health status and long-term health predictors: a general population cohort study
Authors
Charlotte Sylwander
Ingrid Larsson
Maria Andersson
Stefan Bergman
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2020
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-020-3039-5

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