TY - JOUR
T1 - Patterns of change of multisite pain over 1 year of follow-up and related risk factors
AU - Ntani, Georgia
AU - Coggon, David
AU - Felli, Vanda E.
AU - Harari, Florencia
AU - Barrero, Lope H.
AU - Felknor, Sarah A.
AU - Rojas, Marianela
AU - Serra, Consol
AU - Bonzini, Matteo
AU - Merisalu, Eda
AU - Habib, Rima R.
AU - Sadeghian, Farideh
AU - Wickremasinghe, A. Rajitha
AU - Matsudaira, Ko
AU - Nyantumbu-Mkhize, Busisiwe
AU - Kelsall, Helen L.
AU - Harcombe, Helen
AU - Walker-Bone, Karen
N1 - Funding Information:
We thank the following who in various ways contributed to data collection for the CUPID study: Leila M M Sarquis and Maria H Marziale (Brazil); Raul Harari, Rocio Freire, Natalia Harari, Pietro Muñoz, Patricio Oyos, Gonzalo Albuja, María Belduma and Francisco Lara (Ecuador); Leonardo A Quintana and Magda V Monroy (Colombia); David Gimeno (Costa Rica and Nicaragua); Eduardo J. Salazar Vega, Patricia Monge, Melania Chaverri and Freddy Brenes (Costa Rica); Aurora Aragón, Alberto Berríos, Samaria Balladares, Martha Martínez and Alfredo José Jirón (Nicaragua); Keith T Palmer and E Clare Harris (UK); Sergio Vargas-Prada, J Miguel Martinez, George Delclos, Fernando G Benavides, Catalina Torres, Ben and Marie Carmen Coggon, Cynthia Alcantara, Xavier Orpella, Josep Anton Gonzalez, Joan Bas, Pilar Peña, Elena Brunat, Vicente San José, Anna Sala March, Anna Marquez, Josefina Lorente, Cristina Oliva, Montse Vergara and Eduard Gaynés (Spain); Marco M Ferrario, Michele Carugno, Angela C Pesatori, Natale Battevi, Lorenzo Bordini, Marco Conti, Luciano Riboldi and Paul Maurice Conway (Italy); Manolis Kogevinas, Leda Chatzi, Eleni Solidaki and Panos Bitsios (Greece); Kristel Oha, Tiina Freimann and Tuuli Sirk (Estonia); Ali Sadeghian (Iran); Asad Ali Khan, Masood Kadir and Khalil Qureshi (Pakistan); Sudath SP Warnakulasuriya, Nalini Sathiakumar and Roshini J Peiris-John (Sri Lanka); Noriko Yoshimura, Masami Hirai, Tatsuya Isomura, Norimasa Kikuchi, Akiko Ishizuka and Takayuki Sawada (Japan); Malcolm Sim, Victor C W Hoe and Donna M Urquhart (Australia); Sarah Derrett, David McBride, Peter Herbison and Andrew Grey (New Zealand). Ken Cox collated the dataset and prepared files for statistical analysis. We thank all of the organizations that allowed us to approach their employees; and all of the workers who kindly participated in the study.
Funding Information:
Georgia Ntani, David Coggon and Karen Walker‐Bone were supported by funding from the Medical Research Council and Versus Arthritis. Monash University funded data collection in Australia. NHMRC (Australia) supported Helen Kelsall through a fellowship. Data collection in Central America and Colombia was supported by a research training grant to Southwest Center for Occupational and Environmental Health at the University of Texas Health Science Center from the NIH Fogarty International Center. The Deputy for Training and Research, Shahroud University of Medical Sciences provided financial support for data collection in Iran. Institute of Health Carlos III (ISCIII) funded data collection in Spain. The Health Research Council of New Zealand funded data collection in New Zealand. We are particularly grateful to the Colt Foundation, which funded data collection in Brazil, Ecuador, Costa Rica, Nicaragua, United Kingdom, Greece, Estonia, Lebanon, Pakistan and South Africa. Funding information
Publisher Copyright:
© 2022 European Pain Federation - EFIC.
PY - 2022/8
Y1 - 2022/8
N2 - Background: Multisite musculoskeletal pain is common and disabling. This study aimed to prospectively investigate the distribution of musculoskeletal pain anatomically, and explore risk factors for increases/reductions in the number of painful sites. Methods: Using data from participants working in 45 occupational groups in 18 countries, we explored changes in reporting pain at 10 anatomical sites on two occasions 14 months apart. We used descriptive statistics to explore consistency over time in the number of painful sites, and their anatomical distribution. Baseline risk factors for increases/reductions by ≥3 painful sites were explored by random intercept logistic regression that adjusted for baseline number of painful sites. Results: Among 8927 workers, only 20% reported no pain at either time point, and 16% reported ≥3 painful sites both times. After 14 months, the anatomical distribution of pain often changed but there was only an average increase of 0.17 painful sites. Some 14% workers reported a change in painful sites by ≥3. Risk factors for an increase of ≥3 painful sites included female sex, lower educational attainment, having a physically demanding job and adverse beliefs about the work-relatedness of musculoskeletal pain. Also predictives were as follows: older age, somatizing tendency and poorer mental health (each of which was also associated with lower odds of reductions of ≥3 painful sites). Conclusions: Longitudinally, the number of reported painful sites was relatively stable but the anatomical distribution varied considerably. These findings suggest an important role for central pain sensitization mechanisms, rather than localized risk factors, among working adults. Significance: Our findings indicate that within individuals, the number of painful sites is fairly constant over time, but the anatomical distribution varies, supporting the theory that among people at work, musculoskeletal pain is driven more by factors that predispose to experiencing or reporting pain rather than by localized stressors specific to only one or two anatomical sites.
AB - Background: Multisite musculoskeletal pain is common and disabling. This study aimed to prospectively investigate the distribution of musculoskeletal pain anatomically, and explore risk factors for increases/reductions in the number of painful sites. Methods: Using data from participants working in 45 occupational groups in 18 countries, we explored changes in reporting pain at 10 anatomical sites on two occasions 14 months apart. We used descriptive statistics to explore consistency over time in the number of painful sites, and their anatomical distribution. Baseline risk factors for increases/reductions by ≥3 painful sites were explored by random intercept logistic regression that adjusted for baseline number of painful sites. Results: Among 8927 workers, only 20% reported no pain at either time point, and 16% reported ≥3 painful sites both times. After 14 months, the anatomical distribution of pain often changed but there was only an average increase of 0.17 painful sites. Some 14% workers reported a change in painful sites by ≥3. Risk factors for an increase of ≥3 painful sites included female sex, lower educational attainment, having a physically demanding job and adverse beliefs about the work-relatedness of musculoskeletal pain. Also predictives were as follows: older age, somatizing tendency and poorer mental health (each of which was also associated with lower odds of reductions of ≥3 painful sites). Conclusions: Longitudinally, the number of reported painful sites was relatively stable but the anatomical distribution varied considerably. These findings suggest an important role for central pain sensitization mechanisms, rather than localized risk factors, among working adults. Significance: Our findings indicate that within individuals, the number of painful sites is fairly constant over time, but the anatomical distribution varies, supporting the theory that among people at work, musculoskeletal pain is driven more by factors that predispose to experiencing or reporting pain rather than by localized stressors specific to only one or two anatomical sites.
UR - http://www.scopus.com/inward/record.url?scp=85131726578&partnerID=8YFLogxK
U2 - 10.1002/ejp.1978
DO - 10.1002/ejp.1978
M3 - Article
C2 - 35598315
AN - SCOPUS:85131726578
SN - 1090-3801
VL - 26
SP - 1499
EP - 1509
JO - European Journal of Pain
JF - European Journal of Pain
IS - 7
ER -
