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Anttila S, Määttä J, Heikkala E, Arokoski J, Karppinen J, Oura P. Associations of socioeconomic and lifestyle characteristics, psychological symptoms, multimorbidity, and multisite pain with sciatica - a 15-year longitudinal study. Spine J 2024; 24:842-850. [PMID: 38211903 DOI: 10.1016/j.spinee.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 12/03/2023] [Accepted: 12/27/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND CONTEXT Sciatica is defined as pain radiating from the low back to the leg, usually below the knee. It is a disabling condition that causes a major burden to health care and society. Previous evidence of the multifactorial etiology of sciatica comes mostly from cross-sectional studies. Larger, longitudinal studies with a multidimensional set of variables are needed. PURPOSE To examine how socioeconomic and lifestyle characteristics, psychological symptoms, multimorbidity, and multisite pain are associated with sciatica. STUDY DESIGN A longitudinal study of the Northern Finland Birth Cohort 1966. PATIENT SAMPLE In total 6,683 working-aged members of the Northern Finland Birth Cohort 1966. OUTCOME MEASURES Self-reported sciatic pain status over a 15-year study period. METHODS We conducted a 15-year longitudinal study from the age of 31 to 46. We used multivariable generalized estimation equations analysis to examine how socioeconomic characteristics (low education, unemployment, and living alone), lifestyle characteristics (overweight, obesity, current smoking, and physical inactivity), psychological symptoms (depression, anxiety), multimorbidity, and multisite pain were associated with sciatica. RESULTS At the age of 31, 21.1% of the study population reported sciatic pain and at the age of 46, 36.7%. Multisite pain was clearly the strongest factor associated with sciatica (odds ratio [OR] 2.61, 95% confidence interval [CI] 2.34‒2.92). In descending order of effect size, older age, low education, psychological symptoms, multimorbidity, overweight, obesity, physical inactivity and current smoking were positively associated with sciatica. Their ORs varied between 1.17 and 2.18. Living alone was negatively associated with sciatica (OR 0.81, 95% CI 0.72‒0.90). CONCLUSIONS Multisite pain had the strongest association with sciatica. The effect sizes of the other factors were clearly smaller. To our knowledge this is the first study to evaluate the association of multisite pain with sciatica. This finding may have considerable implications for clinical work treating patients with sciatica.
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Affiliation(s)
- Sanna Anttila
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland; Research Unit of Health Sciences and Technology, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland.
| | - Juhani Määttä
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland; Research Unit of Health Sciences and Technology, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland
| | - Eveliina Heikkala
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland; Research Unit of Population Health, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland
| | - Jari Arokoski
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, University of Helsinki, P.O. Box 4, FI-00014, Helsinki, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland; Research Unit of Health Sciences and Technology, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland; Finnish Institute of Occupational Health, FI-90032, Oulu, Finland; Rehabilitation Services of Wellbeing Services County of South Karelia, FI-53130, Lappeenranta, Finland
| | - Petteri Oura
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland; Research Unit of Health Sciences and Technology, University of Oulu, P.O. Box 8000, FI-90014, Oulu, Finland; Department of Forensic Medicine, University of Helsinki, P.O. Box 21, FI-00014, Helsinki, Finland; Forensic Medicine Unit, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland
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Mundal I, Schei J, Lydersen S, Thomsen PH, Nøvik TS, Kvitland LR. Prevalence of chronic and multisite pain in adolescents and young adults with ADHD: a comparative study between clinical and general population samples (the HUNT study). Eur Child Adolesc Psychiatry 2024; 33:1433-1442. [PMID: 37386203 PMCID: PMC11098922 DOI: 10.1007/s00787-023-02249-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/19/2023] [Indexed: 07/01/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) and chronic pain are prevalent and associated. We examined the prevalence and distribution of chronic pain in adolescents and young adults with ADHD using 9-years longitudinal data (from T1:2009-2011 to T3:2018-2019) with three time points from a clinical health survey compared to two age-matched reference population-based samples. Mixed-effect logistic regression and binary linear regression were used to estimate the probability for chronic and multisite pain at each time point and to compare the prevalence of chronic pain with the reference populations. The prevalence of chronic and multisite pain was high in those with ADHD, especially in female young adults, with highly prevalent chronic pain at 9 years of follow-up (75.9%) compared to 45.7% in females in the reference population. The probability of having pain was only statistically significant for chronic pain in males at 3 years of follow-up (41.9%, p = 0.021). Those with ADHD were at higher risk of reporting single-site and multisite pain compared to the general population at all measurement points. Longitudinal studies should be tailored to further understand the complex sex differences of comorbid chronic pain and ADHD in adolescents, exploring predictive factors of pain assessing long-term associations with bodyweight, psychiatric comorbidities, and possible mechanisms of stimulant use effects on pain.
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Affiliation(s)
- Ingunn Mundal
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
- Department of Health and Social Sciences, Molde University College, Molde, Norway.
- Kristiansund Community Mental Health Centre, Division of Psychiatry, Møre and Romsdal Hospital Trust, Kristiansund, Norway.
| | - Jorun Schei
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Per Hove Thomsen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Aarhus N, Denmark
| | - Torunn Stene Nøvik
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Levi R Kvitland
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- St. Olavs University Hospital, Trondheim, Norway
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You T, Leveille SG, Yeh GY, Wayne PM. Is Tai Chi beneficial for multisite pain syndrome in older adults? Aging Clin Exp Res 2023; 35:1443-1448. [PMID: 37256489 PMCID: PMC10428171 DOI: 10.1007/s40520-023-02439-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/08/2023] [Indexed: 06/01/2023]
Abstract
Chronic musculoskeletal pain is prevalent and undertreated in older adults. In particular, multisite pain is associated with serious functional consequences and falls and appears to be a novel geriatric syndrome. The causes of multisite pain are often multifactorial, and emerging evidence supports a complex pathway whereby multisite pain leads to cognitive problems, mobility decline, fear of falling, falls, and reduced participation in life roles. A few pharmacologic approaches are safe and effective for older adults with chronic multisite pain and evidence for effectiveness of non-pharmacologic treatments for this common condition is very limited. Compared to light physical exercise, mind-body exercise may prove to be more beneficial for older adults living with chronic pain. Tai Chi, as a movement-based mind-body exercise, can relieve pain symptoms, improve cognition and physical function, and lower risk for falls in older adults. However, little is known about the potential benefits of Tai Chi for older adults with multisite pain syndrome. Future large-scale randomized-controlled trials are needed to investigate the effectiveness of Tai Chi in alleviating pain and lowering fall risk in older adults with multisite pain, and the biological mechanisms that underlie its potential benefits to chronic pain, physical and cognitive functions, and falls in this at-risk population.
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Affiliation(s)
- Tongjian You
- Department of Exercise and Health Sciences, Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA.
| | - Suzanne G Leveille
- Department of Nursing, Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - Gloria Y Yeh
- Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Fagerlund P, Shiri R, Suur-Uski J, Kaartinen S, Rahkonen O, Lallukka T. Separate and joint associations of chronic pain, multisite pain and mental health with sickness absence among younger employees: a register based longitudinal study. Arch Public Health 2023; 81:97. [PMID: 37248528 DOI: 10.1186/s13690-023-01115-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Pain conditions and poorer mental health are associated with work disability. However, few studies have examined the association of concurrent pain and poorer mental health with sickness absence among younger employees. We examined separate and joint associations of chronic pain, multisite pain, and mental health with total and long-term all-cause sickness absence days among younger Finnish municipal employees. METHODS The Young Helsinki Health-study data were collected in 2017 from 19-39-year-old employees of the City of Helsinki, Finland. Chronic (≥ 3 months) and multisite (≥ 2 body sites) pain and mental health (RAND-36 emotional wellbeing subscale dichotomized by median score) were self-reported (n = 3911). Chronic pain, multisite pain and mental health were analyzed separately and combined. Register data on total (≥ 1 workdays) and long-term (≥ 11 workdays) sickness absence days during the following year were obtained. Negative binomial regression analyses were performed with sociodemographic, socioeconomic, and health-related factors as confounders. Gender interaction and synergistic indices were examined. RESULTS Chronic multisite pain was associated with long-term sickness absence days (rate ratio [RR] 2.51, 95% CI 1.17-5.42). Chronic pain (RR 5.04, 95% CI 2.14-11.87) and multisite pain (RR 4.88, 95% CI 2.30-10.33) were associated with long-term sickness absence days among employees with poorer mental health. There was a synergistic interaction between gender and multisite pain for total sickness absence days (synergy index 1.80, 95% CI 1.27-2.54), with stronger associations among women. CONCLUSIONS Chronic and multisite pain are associated with long-term sickness absence among younger employees, particularly among women and employees with concurrent poorer mental health. Consideration of this knowledge at workplaces and in healthcare could help to identify and support employees at increased risk of later sickness absence.
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Affiliation(s)
- Pi Fagerlund
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland.
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Johanna Suur-Uski
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
| | - Sara Kaartinen
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Hyvinkää, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland
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Tian J, Jones G, Lin X, Zhou Y, King A, Vickers J, Pan F. Association between chronic pain and risk of incident dementia: findings from a prospective cohort. BMC Med 2023; 21:169. [PMID: 37143042 PMCID: PMC10161483 DOI: 10.1186/s12916-023-02875-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Chronic musculoskeletal pain has been linked to dementia; however, chronic pain typically occurs in multiple sites; therefore, this study was to investigate whether greater number of chronic pain sites is associated with a higher risk of dementia and its subtypes. METHODS Participants (N = 356,383) in the UK Biobank who were dementia-free at baseline were included. Pain in the hip, knee, back, and neck/shoulder or 'all over the body' and its duration were assessed. Participants were categorised into six groups: no chronic pain; chronic pain in 1, 2, 3, and 4 sites, and 'all over the body'. All-cause dementia and its subtypes were ascertained using hospital inpatient and death registry records. Cox regression was used to investigate the associations between the number of chronic pain sites and the incidence of all-cause dementia and its subtypes. RESULTS Over a median follow-up of 13 years, 4959 participants developed dementia. After adjustment for sociodemographic, lifestyle, comorbidities, pain medications, psychological problems, and sleep factors, greater number of chronic pain sites was associated with an increased risk of incident all-cause dementia (hazard ratio [HR] = 1.08 per 1 site increase, 95% CI 1.05-1.11) and Alzheimer's disease (AD) (HR = 1.09 per 1-site increase, 95% CI 1.04-1.13) in a dose-response manner but not vascular and frontotemporal dementia. No significant association was found between the number of chronic pain sites and the risk of incident all-cause dementia among a subsample that underwent a fluid intelligence test. CONCLUSIONS Greater number of chronic pain sites was associated with an increased risk of incident all-cause dementia and AD, suggesting that chronic pain in multiple sites may contribute to individuals' dementia risk and is an underestimated risk factor for dementia.
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Affiliation(s)
- Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, TAS, Hobart, 7000, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, TAS, Hobart, 7000, Australia
| | - Xin Lin
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, TAS, Hobart, 7000, Australia
| | - Yuan Zhou
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, TAS, Hobart, 7000, Australia
| | - Anna King
- Wicking Dementia Research and Education Centre, University of Tasmania, Private Bag 23, TAS, Hobart, 7000, Australia
| | - James Vickers
- Wicking Dementia Research and Education Centre, University of Tasmania, Private Bag 23, TAS, Hobart, 7000, Australia
| | - Feng Pan
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, TAS, Hobart, 7000, Australia.
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You T, Koren Y, Butts WJ, Moraes CA, Yeh GY, Wayne PM, Leveille SG. Pilot studies of recruitment and feasibility of remote Tai Chi in racially diverse older adults with multisite pain. Contemp Clin Trials 2023; 128:107164. [PMID: 36940813 PMCID: PMC10164103 DOI: 10.1016/j.cct.2023.107164] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Multisite musculoskeletal pain is highly prevalent among older adults yet undertreated. Studies support the promise of Tai Chi for managing pain and lowering fall risk. Since the COVID-19 pandemic, effective alternatives to classroom-based exercise programming are warranted. AIMS To recruit 100 racially diverse older adults with multisite pain and increased fall risk, who are interested in participating in a future Tai Chi clinical trial, and to evaluate the feasibility and acceptability of a short-term, remotely delivered home-based Tai Chi program. METHODS A random sample of adults aged 65 years or older living in diverse Boston neighborhoods were sent mailed invitations to participate in a telephone screening survey. Eligible adults were invited to join a 4-week Tai Chi program offered online via Zoom. Primary outcomes were class attendance, experience, and program safety. RESULTS Among 334 survey respondents, 105 were eligible for the intervention. Average age of eligible participants was 74 years, 75% were women, and 62% were Black. We assigned 32 participants to 4 Tai Chi or 2 light exercise groups conducted via Zoom; of these, 24 (75%) completed the program and 79% attended ≥6 of 8 classes. There were no adverse events reported. Two-thirds reported it was very easy to join the online classes and 88%, very easy to see the instructor. CONCLUSION Mailed invitations were effective for recruiting a racially diverse sample. Remote exercise programming delivered online via live Zoom sessions is safe and feasible for diverse older adults who have multisite pain and risk of falls.
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Affiliation(s)
- Tongjian You
- Department of Exercise and Health Sciences, Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA.
| | - Yael Koren
- Department of Nursing, Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - William J Butts
- Department of Exercise and Health Sciences, Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - Catarina Ambrizzi Moraes
- Department of Exercise and Health Sciences, Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
| | - Gloria Y Yeh
- Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Suzanne G Leveille
- Department of Nursing, Robert and Donna Manning College of Nursing and Health Sciences, University of Massachusetts, Boston, MA, USA
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Heikkala E, Merikanto I, Tanguay-Sabourin C, Karppinen J, Oura P. Eveningness is associated with persistent multisite musculoskeletal pain: a 15-year follow-up study of Northern Finns. The Journal of Pain 2022; 24:679-688. [PMID: 36513241 DOI: 10.1016/j.jpain.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
Chronotype, a phenotype representing a person's 24-hour circadian rhythm, has been increasingly acknowledged as playing a role in musculoskeletal (MSK) pain. Most prior research on chronotype and MSK pain have been based on cross-sectional data, and no study has explored multisite MSK pain (two or more pain locations) as the outcome. We drew the study sample from the 31- and 46-year data collections (baseline and follow-up, respectively) of the Northern Finland Birth Cohort 1966 and collected self-reported data on chronotype at follow-up (morning [M]-type, intermediate [I]-type, and evening [E]-type) and longitudinal multisite MSK pain trajectories (n=3,294). Multinomial logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) in multisite MSK pain trajectories between the chronotypes. We conducted additional sensitivity analyses that 1) accounted for several confounders, and 2) examined the potential moderating role of sex, mental distress, and sleep disturbance status in the chronotype-multisite MSK pain associations. The E-types had two-and-a-half-times higher odds of multisite MSK pain at baseline and follow-up (OR 2.47, 95% CI 1.84-3.32) than the M-types. Having severe mental distress or poor sleep at baseline and follow-up, or sex did not change the strength of this association. Our examination of this longitudinal birth cohort study suggested that evening types, in comparison to morning types, are more likely to experience multisite MSK pain between ages 31 and 46 years. Chronotype should be recognized as a predictor of multisite pain and thus taken into account in the evaluation of a patient's risk for multisite pain. Perspective: This longitudinal study shows that evening types, compared to morning types, have higher odds of experiencing multisite MSK pain between ages 31 and 46 years. Chronotype should be considered while evaluating MSK patient's risk for persistent multisite pain symptoms.
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Affiliation(s)
- Eveliina Heikkala
- Research Unit of Population Health, University of Oulu, 90014 Oulu, Finland; Medical Research Center Oulu, University of Oulu and Oulu University Hospital, 90014 Oulu, Finland; Rovaniemi Health Center, 96200 Rovaniemi, Finland.
| | - Ilona Merikanto
- Research Unit of Population Health, University of Oulu, 90014 Oulu, Finland; SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland; Orton Orthopaedics Hospital, Helsinki, Finland
| | - Christophe Tanguay-Sabourin
- Alan Edwards Pain Centre for Research on Pain, McGill University, Montreal, QC H3A 0G1, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Jaro Karppinen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, 90014 Oulu, Finland; Research Unit of Health Sciences and Technology, University of Oulu, 90014 Oulu, Finland; Rehabilitation Services of South Karelia Social and Health Care District, 53130 Lappeenranta, Finland
| | - Petteri Oura
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, 90014 Oulu, Finland; Research Unit of Health Sciences and Technology, University of Oulu, 90014 Oulu, Finland
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Ogliari G, Ryg J, Andersen-Ranberg K, Scheel-Hincke LL, Collins JT, Cowley A, Di Lorito C, Howe L, Robinson KR, Booth V, Walsh DA, Gladman JRF, Harwood RH, Masud T. Association of pain and risk of falls in community-dwelling adults: a prospective study in the Survey of Health, Ageing and Retirement in Europe (SHARE). Eur Geriatr Med 2022; 13:1441-1454. [PMID: 36227460 PMCID: PMC9722814 DOI: 10.1007/s41999-022-00699-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/12/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE To investigate the longitudinal associations between pain and falls risks in adults. METHODS Prospective cohort study on data from 40,636 community-dwelling adults ≥ 50 years assessed in Wave 5 and 6 in the Survey of Health, Ageing and Retirement in Europe (SHARE). Socio-demographic and clinical information was collected at baseline (Wave 5). At 2-year follow-up (Wave 6), falls in the previous 6 months were recorded. The longitudinal associations between pain intensity, number of pain sites and pain in specific anatomic sites, respectively, and falls risk were analysed by binary logistic regression models; odds ratios (95% confidence intervals) were calculated. All analyses were adjusted for socio-demographic and clinical factors and stratified by sex. RESULTS Mean age was 65.8 years (standard deviation 9.3; range 50-103); 22,486 (55.3%) participants were women. At follow-up, 2805 (6.9%) participants reported fall(s) in the previous 6 months. After adjustment, participants with moderate and severe pain at baseline had an increased falls risk at follow-up of 1.35 (1.21-1.51) and 1.52 (1.31-1.75), respectively, compared to those without pain (both p < 0.001); mild pain was not associated with falls risk. Associations between pain intensity and falls risk were greater at younger age (p for interaction < 0.001). Among participants with pain, pain in ≥ 2 sites or all over (multisite pain) was associated with an increased falls risk of 1.29 (1.14-1.45) compared to pain in one site (p < 0.001). CONCLUSIONS Moderate, severe and multisite pain were associated with an increased risk of subsequent falls in adults.
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Affiliation(s)
- Giulia Ogliari
- Department of Health Care for Older People (HCOP), Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Karen Andersen-Ranberg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Lasse Lybecker Scheel-Hincke
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
| | - Jemima T. Collins
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Alison Cowley
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Claudio Di Lorito
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Louise Howe
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Katie R. Robinson
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Vicky Booth
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- Research and Innovation, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - David A. Walsh
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Pain Centre Versus Arthritis, University of Nottingham, Nottingham, UK
- Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK
| | - John R. F. Gladman
- Department of Health Care for Older People (HCOP), Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- Centre for Rehabilitation and Ageing Research, Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Applied Research Collaboration—East Midlands, Nottingham, UK
| | - Rowan H. Harwood
- Department of Health Care for Older People (HCOP), Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire UK
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Tahir Masud
- Department of Health Care for Older People (HCOP), Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, Nottinghamshire UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- NIHR Applied Research Collaboration—East Midlands, Nottingham, UK
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Abrahamyan A, Lucas R, Soares S, Talih M, Fraga S. Adverse childhood experiences and bodily pain at 10 years of age: Findings from the Generation XXI cohort. Child Abuse Negl 2022; 128:105620. [PMID: 35366413 DOI: 10.1016/j.chiabu.2022.105620] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/12/2022] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Youth and young adults with pain conditions report having a history of adverse childhood experiences (ACEs) more frequently than their healthy peers. The relationship between ACEs and pain before adolescence in population-based settings is not extensively researched. OBJECTIVE To examine the association between the history of ACEs and bodily pain at 10 years of age. PARTICIPANTS AND SETTING Cross-sectional analysis of 4738 participants of Generation XXI population-based birth cohort, recruited in 2005-06 in Porto, Portugal. METHODS Study includes self-reported data on ACEs exposures and bodily pain (pain presence, sites, and intensity a week prior to the interview). Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were obtained from binary and multinomial logistic regression analyses to estimate the likelihood of various pain features according to the extent of exposure to ACEs (i.e., 0 ACEs, 1-3 ACEs, 4-5 ACEs, and ≥ 6 ACEs). RESULTS Prevalence of pain, multisite, and high-intensity pain a week prior to the interview increased with increasing exposure to ACEs. After controlling for sociodemographic characteristics, children who had experienced ≥6 ACEs were more likely to report pain [AOR 3.18 (95% CI 2.19, 4.74)], multisite pain [AOR 2.45 (95% CI 1.37, 4.40)], and high-intensity pain [AOR 4.27 (95% CI 2.56, 7.12)] compared with children with no ACEs. CONCLUSIONS A dose-response association was observed between the cumulative number of ACEs and reports of pain in 10-year-old children, suggesting that embodiment of ACEs starts as early as childhood and that pain related to ACEs begins earlier than previously reported.
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Affiliation(s)
- Armine Abrahamyan
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal; ITR- Laboratório para a Investigação Integrativa e Translacional, Porto, Portugal
| | - Raquel Lucas
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal; ITR- Laboratório para a Investigação Integrativa e Translacional, Porto, Portugal
| | - Sara Soares
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal; ITR- Laboratório para a Investigação Integrativa e Translacional, Porto, Portugal
| | - Makram Talih
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal; ITR- Laboratório para a Investigação Integrativa e Translacional, Porto, Portugal
| | - Sílvia Fraga
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal; ITR- Laboratório para a Investigação Integrativa e Translacional, Porto, Portugal.
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10
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Garnaes KK, Mørkved S, Salvesen Ø, Tønne T, Furan L, Grønhaug G, Vasseljen O, Johannessen HH. What factors are associated with health-related quality of life among patients with chronic musculoskeletal pain? A cross-sectional study in primary health care. BMC Musculoskelet Disord 2021; 22:102. [PMID: 33482782 PMCID: PMC7825159 DOI: 10.1186/s12891-020-03914-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/23/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Chronic musculoskeletal pain (CMP) affects daily life function and is the most prevalent disorder in primary health care. The primary objective was to examine demographic factors and pain characteristics associated with reduced health-related quality of life (HRQoL) among patients in primary care reporting CMP. Our secondary objective was to compare HRQoL in patients with and without CMP. METHOD This cross-sectional study was conducted in Trondheim, Norway. Twenty randomly selected GPs, and their listed patients aged 21-58 were invited to participate. Self-reported CMP data was collected using online questionnaires. HRQoL was measured by the 15D questionnaire, total score of 0.9 was used as cut-off for clinical reduced HRQoL. RESULTS A total of 969 patients (650 females) were recruited from six GPs' patient lists, mean age 45.6 (SD 10.1). CMP was reported by 517 (53%). Factors significantly associated with reduced HRQoL were gender (OR 2.0, 95% CI 1.2, 3.4), disability pension (OR 26.6, 95% CI 3.1, 228.0), mood (OR 1.3, 95% CI 1.1, 1.6), relations with other people (OR 0.8, 95% CI 0.6, 0.9), sleep (OR 1.2, 95% CI 1.0, 1.3) and enjoyment (OR 1.2, 95% CI 1.0). CMP patients had significantly lower total HRQoL score compared to patients without CMP (Between group difference 0.08, 95% CI 0.07-0.09). Half of the CMP patients reported a HRQoL score < 0.9 compared to 14% in the no CMP group. CONCLUSIONS Being female, receiving disability pension, and several psychosocial factors were found highly associated with reduced HRQoL in CMP patients, whereas pain characteristics were not. Patients with CMP reported statistically and clinically significant lower HRQoL than patients without CMP. Due to low response rate the conclusions must be handled with caution. TRIAL REGISTRATION Clinicaltrials.gov (NCT02020772).
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Affiliation(s)
- Kirsti Krohn Garnaes
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), P.O. Box 8905, 7491, Trondheim, Norway. .,Department of Obstetrics and Gynaecology, St. Olavs Hospital, Trondheim University Hospital, P.O Box 3250, Trondheim, Norway.
| | - Siv Mørkved
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), P.O. Box 8905, 7491, Trondheim, Norway.,Clinical Services, St. Olavs Hospital, Trondheim University Hospital, P.O Box 3250, Trondheim, Norway
| | - Øyvind Salvesen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), P.O. Box 8905, 7491, Trondheim, Norway
| | - Torgrim Tønne
- Tiller Physiotherapy and Manual Therapy, Ivar Lykkes veg 9, 7075, Tiller, Norway
| | - Lars Furan
- Stokmoen Physiotherapy, Wergelandsveien 27, 7504, Stjørdal, Norway
| | - Gudmund Grønhaug
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), P.O. Box 8905, 7491, Trondheim, Norway
| | - Ottar Vasseljen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), P.O. Box 8905, 7491, Trondheim, Norway
| | - Hege Hølmo Johannessen
- Department of Health and Welfare, Østfold University College, Kobberslagerstredet 5, Fredrikstad, Norway.,Department of Physical Medicine and Rehabilitation, Østfold Hospital Trust, P.O. Box 300, Sarpsborg, Norway
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11
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Pan F, Tian J, Cicuttini F, Jones G. Sleep Disturbance and Its Association with Pain Severity and Multisite Pain: A Prospective 10.7-Year Study. Pain Ther 2020; 9:751-763. [PMID: 33085011 PMCID: PMC7648801 DOI: 10.1007/s40122-020-00208-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/06/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Sleep disturbance is often comorbid with chronic pain disorders, with emerging evidence suggesting a stronger effect of sleep disturbance on pain than vice versa; however, few studies have evaluated the long-term associations between sleep disturbance and pain. This study was to examine the associations of sleep disturbance with knee pain severity, number of painful sites (NPS) and persistent pain in a 10.7-year cohort study. METHODS A total of 1099 community-dwelling older adults (age mean ± SD, 63 ± 7.5 years; 51% female) were recruited and followed up at 2.6, 5.1 and 10.7 years later. Data on demographics, body mass index, physical activity and comorbidities were collected. At each time point, sleep disturbance, knee pain severity and NPS were assessed by using questionnaires. Multisite pain (MSP) was defined as NPS ≥ 2. Persistent knee pain or MSP was defined as having knee pain or MSP at all time points, respectively. Multivariable mixed-effects models and log-binomial regression were applied. RESULTS In multivariable analyses, sleep disturbance was associated with greater knee pain severity (β 0.91/unit, 95% CI 0.70-1.11) and more NPS [(relative risk (RR) 1.10/unit, 95% CI 1.07-1.14] in a dose-response manner. Persistent sleep disturbance was associated with persistent knee pain (RR 1.90, 1.26-2.87) and MSP (RR 1.29, 1.07-1.56). Persistent knee pain and MSP were also associated with persistent sleep disturbance (knee pain: RR = 1.99; MSP: RR = 2.71, both P < 0.05). CONCLUSIONS Sleep disturbance was independently associated with greater pain severity and NPS in a dose-response manner. A reciprocal relationship between persistent sleep disturbance and persistent pain suggests treating either problem could help the other.
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Affiliation(s)
- Feng Pan
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia.
| | - Jing Tian
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University Medical School, Commercial Road, Melbourne, VIC, 3181, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, TAS, 7000, Australia
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12
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Arvidsson I, Gremark Simonsen J, Lindegård-Andersson A, Björk J, Nordander C. The impact of occupational and personal factors on musculoskeletal pain - a cohort study of female nurses, sonographers and teachers. BMC Musculoskelet Disord 2020; 21:621. [PMID: 32948157 PMCID: PMC7501652 DOI: 10.1186/s12891-020-03640-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 09/10/2020] [Indexed: 12/23/2022] Open
Abstract
Background Musculoskeletal pain is common in the general population and constitutes a major public health problem. A large proportion of these conditions may be work related. The aim of this study was to explore the relative importance of physical, psychosocial and personal factors, in number of pain sites and in five specific pain sites, among women in common professions with a broad variety of occupational exposures. Methods A cohort of 1115 women responded to a questionnaire on ergonomic, psychosocial, personal and life-style factors, and the outcome measure of musculoskeletal pain (based on frequency and intensity of complaints at nine anatomical sites), at baseline and at follow-up. Sum scores of ergonomic and psychosocial factors were created. The importance of exposure at baseline for the number of pain sites at follow-up were estimated using ordinal regression. The importance of exposure at baseline for pain in the neck, shoulders, hands, lower back and feet at follow-up were estimated using multi-exposure Poisson regression models. Results High sum scores for ergonomic and psychosocial factors were of importance for a high number of pain sites, although the strongest risk factor was a high number of pain sites already at baseline. On the individual level, there was a large fluctuation in number of pain sites between the two time points. Eighteen percent reported persistent (or recurrent) ≥ four pain sites, while only 11 % did not report any pain at baseline or at follow-up. Among the specific pain sites, a high sum score of ergonomic factors was associated with pain in the neck, hands and feet. A high sum score of psychosocial factors was associated with neck and shoulder pain. The strongest risk factor was, however, pain at that specific anatomical site at baseline. Only a few of the personal and life-style factors were associated with pain. Conclusions An overwhelming majority of the women in common occupations were affected by musculoskeletal pain. Both ergonomic and psychosocial factors were predictive of a high number of pain sites and of specific pain sites. These findings indicate the need for preventive measures on the individual, organizational and societal level.
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Affiliation(s)
- Inger Arvidsson
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden.
| | - Jenny Gremark Simonsen
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | | | - Jonas Björk
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
| | - Catarina Nordander
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85, Lund, Sweden
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13
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Lallukka T, Hiilamo A, Oakman J, Mänty M, Pietiläinen O, Rahkonen O, Kouvonen A, Halonen JI. Recurrent pain and work disability: a record linkage study. Int Arch Occup Environ Health 2019; 93:421-432. [PMID: 31781902 PMCID: PMC7118055 DOI: 10.1007/s00420-019-01494-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 11/19/2019] [Indexed: 12/31/2022]
Abstract
Purpose We examined the associations between recurrent single- and multisite pain and incident sickness absence (SA) of different lengths and the risk of disability pension (DP). Methods The data were derived from the Finnish Helsinki Health Study. Pain measures were recorded for panel 1 in 2000/2 and 2007, and for panel 2 in 2007 and 2012 (altogether 3191 employees). SA data were obtained from the employer’s personnel register and DP events from the Finnish Centre for Pensions. Negative binomial regression models with generalized estimation equations were used to model the incidence of self-certified short- (1–3 days), and medically certified medium- (4–14 days) and long-term (more than 14 days) SA episodes. Cox regression models were fitted for the associations between pain and all-cause DP and competing risk models for DP by diagnostic groups. Social and health-related covariates were adjusted for. Results Recurrent pain was associated with short-, medium- and long-term SA. Additionally, recurrent single- and multisite pain increased the risk of long-term SA. Recurrent single or multisite pain was further associated with an increased risk of DP, while a single instance of pain did not increase the risk. Conclusions These results suggest that recurrent pain is a robust determinant of subsequent SA and DP risk. Improved understanding of determinants of recurrent pain is needed to inform the development of targeted measures to reduce SA and premature exit from employment. Electronic supplementary material The online version of this article (10.1007/s00420-019-01494-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tea Lallukka
- Finnish Institute of Occupational Health, Helsinki, Finland. .,Department of Public Health, University of Helsinki, Helsinki, Finland.
| | - Aapo Hiilamo
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jodi Oakman
- Centre for Ergonomics, and Human Factors, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Minna Mänty
- Department of Public Health, University of Helsinki, Helsinki, Finland.,, City of Vantaa, Finland
| | - Olli Pietiläinen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,Research Institute of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,Administrative Data Research Centre-Northern Ireland (ADRC-NI), Queen's University Belfast, Belfast, UK
| | - Jaana I Halonen
- Finnish Institute of Occupational Health, Helsinki, Finland.,Finnish Institute for Health and Welfare, Helsinki, Finland
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14
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Neupane S, Karstad K, Hallman DM, Rugulies R, Holtermann A. Objectively measured versus self-reported occupational physical activity and multisite musculoskeletal pain: a prospective follow-up study at 20 nursing homes in Denmark. Int Arch Occup Environ Health 2019; 93:381-389. [PMID: 31760469 PMCID: PMC7078130 DOI: 10.1007/s00420-019-01495-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 11/19/2019] [Indexed: 12/21/2022]
Abstract
Purpose To explore the prospective association of objectively measured and self-reported occupational physical activity (OPA) with multisite musculoskeletal pain (MSP) among Danish eldercare workers. Methods The study population consisted of eldercare workers in 20 Danish nursing homes (N = 553, response rate 59%, 525 female). Baseline data were collected in 2013–2014 and the 1-year follow-up was completed in 2016. At baseline, we measured objective OPA by a thigh-worn ActiGraph GT3X + accelerometer during work and self-reported OPA by a questionnaire survey. Information on musculoskeletal pain during the past four weeks in seven different body sites was reported by a structured questionnaire at baseline (n = 389) and by SMS and telephone interview during follow-up (n = 284). MSP was defined as having pain in two or more body sites. Using log-binomial models we calculated risk ratios (RRs) with their 95% confidence intervals (CIs) to estimate the association between objectively measured and self-reported OPA and MSP. Results We found statistically significant positive associations between self-reported OPA (RR for high OPA 1.24, 95% CI 1.05–1.46) and MSP while there was no significant association found between objective OPA and MSP. Conclusion Our study indicates that self-reported, but not objectively measured OPA is positively associated with MSP. This finding highlights the need for better understanding, use, and interpretation of self-reported and objectively measured OPA in the study of MSP.
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Affiliation(s)
- Subas Neupane
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, 33014, Tampere, Finland. .,Gerontology Research Center, Tampere University, 33014, Tampere, Finland. .,Finnish Institute of Occupational Health, Helsinki, Finland.
| | - Kristina Karstad
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - David M Hallman
- Department of Occupational Health Sciences and Psychology, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
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15
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Haglund E, Bremander A, Bergman S. The StarT back screening tool and a pain mannequin improve triage in individuals with low back pain at risk of a worse prognosis - a population based cohort study. BMC Musculoskelet Disord 2019; 20:460. [PMID: 31638972 PMCID: PMC6805365 DOI: 10.1186/s12891-019-2836-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 09/16/2019] [Indexed: 01/15/2023] Open
Abstract
Background The STarT Back Screening Tool (SBT) identifies patients with low back pain (LBP) at risk of a worse prognosis of persistent disabling back pain, and thereby facilitates triage to appropriate treatment level. However, the SBT does not consider the pain distribution, which is a known predictor of chronic widespread pain (CWP). The aim of this study was to determine if screening by the SBT and screening of multisite chronic widespread pain (MS-CWP) could identity individuals with a worse prognosis. A secondary aim was to analyze self-reported health in individuals with and without LBP, in relation to the combination of these two screening tools. Methods One hundred and nineteen individuals (aged 40–71 years, mean (SD) 59 (8) years), 52 with LBP and 67 references, answered two screening tools; the SBT and a pain mannequin – as well as a questionnaire addressing self-reported health. The SBT stratifies into low, medium or high risk of a worse prognosis. The pain mannequin stratifies into either presence or absence of CWP in combination with ≥7 painful areas of pain (0–18), here defined as MS-CWP (high risk of worse prognosis). The two screening tools were studied one-by-one, and as a combined screening. For statistical analyses, independent t-tests and Chi-square tests were used. Results Both the SBT and the pain mannequin identified risk of a worse prognosis in individuals with (p = 0.007) or without (p = 0.001) LBP. We found that the screening tools identified partly different individuals at risk. The SBT identified one individual, while the pain mannequin identified 21 (19%). When combining the two screening methods, 21 individuals (17%) were at high risk of a worse prognosis. When analyzing differences between individuals at high risk (combined SBT and MS-CWP) with those at low risk, individuals at high risk reported worse health (p = 0.013 - < 0.001). Conclusions Both screening tools identified individuals at risk, but they captured different aspects, and also different number of individuals at high risk of a worse prognosis. Thus, using a combination may improve early detection and facilitate triage to appropriate treatment level with multimodal approach also in those otherwise missed by the SBT.
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Affiliation(s)
- Emma Haglund
- School of Business, Engineering and Science, Halmstad University, Halmstad, Sweden. .,Spenshult Research and Development Center, Halmstad, Sweden.
| | - Ann Bremander
- Spenshult Research and Development Center, Halmstad, Sweden.,Department of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund, Sweden.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
| | - Stefan Bergman
- Spenshult Research and Development Center, Halmstad, Sweden.,Department of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund, Sweden.,Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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16
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Rizzello E, Ntani G, Madan I, Coggon D. Multisite musculoskeletal pain in migrants from the Indian subcontinent to the UK: a cross-sectional survey. BMC Musculoskelet Disord 2019; 20:133. [PMID: 30922284 PMCID: PMC6440109 DOI: 10.1186/s12891-019-2494-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 03/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recent findings indicate that wide international variation in the prevalence of disabling regional musculoskeletal pain among working populations is driven by unidentified factors predisposing to pain at multiple anatomical sites. As a step towards identification of those factors, it would be helpful to know whether the prevalence of multisite pain changes when people migrate between countries with differing rates of symptoms; and if so, whether the change is apparent in first generation migrants, and by what age it becomes manifest. METHODS To address these questions, we analysed data from an earlier interview-based cross-sectional survey, which assessed the prevalence of musculoskeletal pain and risk factors in six groups of workers distinguished by the nature of their work (non-manual or manual) and their country of residence and ethnicity (UK white, UK of Indian subcontinental origin and Indian in India). Prevalence odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by logistic regression. RESULTS Among 814 participants (response rate 95.4%), 20.6% reported pain at ≥3 anatomical sites. This outcome was much less frequent in Indian manual workers than among white non-manual workers in the UK (adjusted OR 0.06, 95%CI 0.01-0.36), while rates in Indian non-manual workers were intermediate (OR 0.29, 95%CI 0.12-0.72). However, within the UK, there were only small differences between white non-manual workers and the other occupational groups, including those of Indian sub-continental origin. This applied even when analysis was restricted to participants aged 17 to 34 years, and when second and later generation migrants were excluded. CONCLUSIONS The observed differences in the prevalence of multisite pain seem too large to be explained by healthy worker selection or errors in recall, and there was no indication of bias from differences in understanding of the term, pain. Our findings suggest that whatever drives the higher prevalence of musculoskeletal pain in the UK than India is environmental rather than genetic, affects multiple anatomical sites, begins to act by fairly early in adult life, and has impact soon after people move from India to the UK.
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Affiliation(s)
- E. Rizzello
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - G. Ntani
- MRC, Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD UK
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, Southampton, UK
| | - I. Madan
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, Southampton, UK
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - D. Coggon
- MRC, Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD UK
- Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, Southampton, UK
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17
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Vleeshouwers J, Knardahl S, Christensen JO. A prospective study of work-private life conflict and number of pain sites: moderated mediation by sleep problems and support. J Behav Med 2018; 42:234-245. [PMID: 30046973 DOI: 10.1007/s10865-018-9957-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 07/20/2018] [Indexed: 12/18/2022]
Abstract
The objective of the current study was to elucidate how work-private life conflict prospectively affects musculoskeletal pain complaints by exploring possible mediation through sleep problems. In addition, the study determined whether support from coworkers and superior moderate this mediated relationship. The study incorporated a two-wave full panel design and participants included 4681 Norwegian working men and women. Path analyses were performed to study direct and indirect effects of work-private life conflict on sleep problems and multisite musculoskeletal pain, moderated by support. This study suggested time-lagged relationships of work-private life conflict with number of pain sites. Furthermore, sleep problems may mediate the effects of work-private life conflict on number of pain sites. While support has been found to affect the direct relationship between work-private life conflict and number of pain sites, it does not significantly moderate the indirect mediation effect, i.e. no moderated mediation effect of support was established. Findings from the present study suggest sleep may be one explaining factor in the complex work-pain mechanism, and this may aid the development of theories on work-private life conflict and pain. Since both work-private life conflict and support are modifiable work factors, primary workplace interventions by the employer aiming to reduce sleep problems and musculoskeletal pain in employees could target these specific work factors, and help prevent work-related pain complaints.
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Affiliation(s)
- Jolien Vleeshouwers
- Department of Work Psychology and Physiology, The National Institute of Occupational Health, Oslo, Norway.
| | - Stein Knardahl
- Department of Work Psychology and Physiology, The National Institute of Occupational Health, Oslo, Norway
| | - Jan Olav Christensen
- Department of Work Psychology and Physiology, The National Institute of Occupational Health, Oslo, Norway
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18
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Fernandes RDCP, Burdorf A. Associations of multisite pain with healthcare utilization, sickness absence and restrictions at work. Int Arch Occup Environ Health 2016; 89:1039-46. [PMID: 27173450 PMCID: PMC5005403 DOI: 10.1007/s00420-016-1141-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 05/03/2016] [Indexed: 12/04/2022]
Abstract
Purpose Despite the apparent importance of multisite musculoskeletal pain (MMP) for functioning, there is still a lack of studies that have investigated the influence of MMP on healthcare utilization (HU), sickness absence (SA) and restrictions of work (RW). This study described the HU, SA and RW due to musculoskeletal pain (MP) in different body sites and according to number of pain sites and investigated associations between number of pain sites with these three outcomes in workers from Bahia, Brazil. Methods This study was based on two cross-sectional surveys carried out in 2010 and 2012. The response in the pooled data was 97 % (n = 1070, 228 women and 842 men). Interviewer-administered questionnaire was used with questions on HU, SA and RW due to MP. The number of pain sites is the sum score of eight body sites with pain in previous 12 months. Covariates were age, gender, physical and psychosocial work demands, leisure-time physical activities and body mass index. Cox regression models, properly applied to a cross-sectional study, determined the associations between number of pain sites with the three outcomes. Results Prevalence of MP in the previous 12 months is 81.2 %, and MMP accounted for two-thirds of pain. We found consistently increasing occurrence of HU, SA and RW with increasing number of pain sites. For individuals with pain in four or more body sites, the utilization of health care was 1.7-fold the utilization by workers with single-site pain. Having pain in four or more sites increased the prevalence of SA 3.6-fold and of RW 4.0-fold compared with having single-site pain, after adjustment by covariates. Conclusions The functional consequences of pain depend on how much body regions are affected, i.e., the more widespread pain, the higher the likelihood of medical consumption, sickness absence and restricted work. Given the high comorbidity, the number of pain sites, instead of specific body site of pain, seems to be a useful measure to anticipate interventions at workplaces for musculoskeletal disease prevention.
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Affiliation(s)
- Rita de Cássia Pereira Fernandes
- Department of Social and Preventive Medicine, School of Medicine, FMB, Federal University of Bahia, Largo do Terreiro de Jesus, s/n. Centro Histórico, Salvador, Bahia, 40026-010, Brazil
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
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