scholarly journals SAT0397 Risk factors for development and persistence of chronic widespread pain, in ankylosing spondylitis and undifferentiated spondyloarthritis

Author(s):  
E Mogard ◽  
E Lindqvist ◽  
A Bremander ◽  
S Bergman
2012 ◽  
Vol 3 (4) ◽  
pp. 210-217 ◽  
Author(s):  
Anne K. Nitter ◽  
Are H. Pripp ◽  
Karin Ø. Forseth

AbstractIntroductionChronic musculoskeletal pain represents a significant health problem among adults in Norway. The prevalence of chronic pain can be up to 50% in both genders. However, the prevalence of chronic widespread pain is significantly higher in females than in males. Chronic widespread pain is seen as the end of a continuum of pain. There is rather sparse knowledge about the incidence of pain in initially pain free individuals and the course of self-reported pain over time. Moreover, little is known about risk factors for incidence of chronic pain or prognostic factors for the course of self-reported pain. We believe that such knowledge may contribute to develop strategies for treatment at an early stadium of the pain condition and thereby reduce the prevalence of chronic pain included chronic widespread pain.Aims of the studyThe aims of this study were threefold: (1) to calculate the incidence of self-reported musculoskeletal pain in a female cohort, (2) to describe the course of pain and (3) to investigate whether or not health complaints and sleep problems are predictive factors for onset of pain or prognostic factors for the course of pain.MethodsThis is a prospective population-based study of all women between 20 and 50 years who were registered in Arendal, Norway, in 1989 (N = 2498 individuals). A questionnaire about chronic pain (pain >3 months duration in muscles, joints, back or the whole body), modulating factors for pain, sleep problems and seven non-specific health complaints was mailed to all traceable women, in 1990 (N =2498), 1995 (n = 2435) and 2007 (n = 2261). Of these, 1338 responded on all three occasions. Outcome measures were presence and extent of chronic pain.ResultsThe prevalence of chronic pain was 57% in 1990 and 61% in 2007. From 1990 to 2007, 53% of the subjects changed pain category. The incidence of chronic pain in initially pain free individuals during follow-up was 44%, whereas the recovery rate was 25%. Impaired sleep quality predicted onset of chronic pain. There was a linear association between the number of health complaints and the incidence of chronic pain in initially pain free individuals. Equivalent results were found for persistence of pain and worsening of pain.ConclusionThe prevalence of chronic pain was rather stable throughout the follow-up period, but the prevalence of chronic widespread pain increased. Individual changes in pain extent occurred frequently. The presence of sleep disturbances and number of health complaints predicted onset, persistence and worsening of pain.ImplicationsSleep problems must be thoroughly addressed as a possible risk factor for onset or worsening of pain. Elimination of sleep problems in an early phase is an interesting approach in treating chronic pain. More research is needed to illuminate the possible pathogenetic relations between pain, non-specific health complaints, sleep problems and also depression.


Spine ◽  
2015 ◽  
Vol 40 (15) ◽  
pp. E890-E899 ◽  
Author(s):  
Annika Viniol ◽  
Nikita Jegan ◽  
Markus Brugger ◽  
Corinna Leonhardt ◽  
Jürgen Barth ◽  
...  

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Georgia Ntani ◽  
Stefania D'Angelo ◽  
Clare Harris ◽  
Cathy Linaker ◽  
Karen Walker-Bone

Abstract Background Incident chronic widespread pain (CWP) is associated with demographic and personal risk factors such as low mood and somatisation. More recently, there has been increased focus on the role of workplace factors on CWP. However, evidence from studies exploring the interaction of demographic, personal risk factors, job activities and psychosocial aspects of work on pain in older workers is limited. We assessed several potential determinants of the onset of CWP among participants in the HEAF study, a prospective UK cohort. Methods A cohort of participants aged 50-64 years were recruited from 24 English general practices in 2013-14 and have been followed-up annually by postal questionnaire. At baseline, information was collected about demographic and employment circumstances, physical workload, psychosocial aspects of work and their general health, mood and well-being. At three years of follow-up, information about pain was also obtained by reporting painful sites on a body mannikin, and CWP was defined according to the ACR criteria. Associations between potential risk factors and the onset of new CWP were explored using logistic regression modelling. Effect estimates were summarised by odds ratios (OR) and 95% confidence intervals (CIs). Results HEAF recruited a total of 8,134 people aged 50-64 years at baseline. Among the N = 3,909 still at work at three years’ follow-up, N = 3,873 did not report CWP in the first two years of follow-up. The incidence of CWP at three years follow-up was 7.4% (males: 5.7%; females: 8.9%). Multivariate analyses showed that the strongest predictors of the onset of new CWP were: female sex (OR(95% CI): 1.7(1.2-2.3)), reporting that they have low expectations of coping with physical demands of the job (OR (95%CI): 2.1 (1.5-3.0)); somatisation (OR(95%CI): 2.1(1.3-3.2)) and poor self-rated health (OR(95%CI): 2.3(1.7-3.2)). Physical workload and other psychosocial aspects of work were also significantly associated with onset of CWP but with relatively smaller effect sizes (physical workload OR(95%CI): 1.2(1.1-1.3)); lack of appreciation OR (95% CI): 1.6(1.1-2.5)) Conclusion Our results complement previous findings that physical loading at work independently predicts the onset of CWP. However, personal risk factors like self-rated health and work-related expectations demonstrated stronger effects. These findings can inform future interventions for prevention of CWP. Disclosures G. Ntani None. S. D'Angelo None. C. Harris None. C. Linaker None. K. Walker-Bone None.


2015 ◽  
Vol 18 (2) ◽  
pp. 188-197 ◽  
Author(s):  
Andrea Burri ◽  
Genevieve Lachance ◽  
Frances Williams

Chronic widespread pain (CWP) is a common disorder affecting up to 15% of the general population. The objective of the present study was to explore the role of previously reported psychosocial and interpersonal risk factors on variation in CWP by investigating CWP discordant monozygotic (MZ) twins. This approach allows separation of cause and effect relationships, albeit imperfectly, as well the control for critical confounding variables such as common environment or genetics. In a total sample of N = 3,266 female twins aged 18–89 years, MZ (113 full pairs) and DZ twins (180 full pairs) discordant for CWP were selected. Items from the London fibromyalgia symptom screening questionnaire were used to discriminate cases from controls. To assess potential risk factors, including body mass index, anxiety sensitivity (AS), emotional intelligence, personality, obsessive-compulsive behavior, and coping, validated questionnaires were used. A set of univariate and multivariate logistic regression analyses were conducted. Of the variables showing significant links with CWP in the univariate individual-level analyses, including age, AS, and emotional intelligence, only emotional intelligence turned out to an independent predictor to the pathogenesis of CWP in both the individual level and discordant MZ analyses. These data indicate that in women having identical genetic risk, emotional intelligence seems to play a key role, although of small effect, in the development and/or maintenance of CWP. It further seems that many of the previously reported risk factors for CWP suffer from genetic confounding.


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