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Rheumatology Advance Access originally published online on May 7, 2007
Rheumatology 2007 46(7):1168-1170; doi:10.1093/rheumatology/kem118
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Chronic musculoskeletal pain rarely presents in a single body site: results from a UK population study

D. Carnes, S. Parsons, D. Ashby1, A. Breen2, N. E. Foster3, T. Pincus4, S. Vogel5 and M. Underwood

Centre for Health Sciences, Barts and The London, Queen Mary School of Medicine and Dentistry, London, 1Wolfson Institute of Preventive Medicine, Barts and The London, Queen Mary School of Medicine and Dentistry, London, 2Institute of Musculoskeletal Research and Implementation, Anglo-European College of Chiropractic, Bournemouth, 3Primary Care Musculoskeletal Research Centre, Keele University, Keele., 4Department of Psychology, Royal Holloway, University of London. Egham. and 5Research Centre, The British School of Osteopathy, London.

Correspondence to: Dawn Carnes, Centre for Health Sciences, Barts and The London, Queen Mary School of Medicine and Dentistry, 2 Newark St, London, E1 2AT, UK. E-mail: d.carnes{at}qmul.ac.uk


  Abstract

Objective. To investigate the frequency and health impact of chronic multi-site musculoskeletal pain, in a representative UK sample.

Method. Population postal questionnaire survey, using 16 general practices in the southeast of England, nationally representative urban/rural, ethnic and socioeconomic mix. A random selection of 4049 registered patients, aged 18 or over, were sent a questionnaire. The main outcome measures were chronic pain location, identified using a pain drawing; distress, pain intensity and disability as measured by the GHQ12 and the Chronic Pain Grade.

Results. A total of 2445 patients (60%) responded to the survey (44% male, mean age 52 yrs); 45% had chronic musculoskeletal pain. Of those with chronic pain, three quarters had pain in multiple sites (two or more sites). Variables significantly predicting this were: age under 55, [odds ratio (OR) 0.5, 95% confidence interval (CI) 0.4, 0.6]; psychological distress (OR 1.8, CI at 95% 1.4, 2.2) and high pain intensity (OR 5.2, CI at 95% 4.1, 6.7). Only 33% of multi-site pain distributions conformed to the American College of Rheumatology definition of chronic widespread pain.

Conclusions. Multi-site chronic pain is more common than single-site chronic pain and is commonly associated with other problems. Indiscriminate targeting of research and care for chronic musculoskeletal pain on single sites may often be inappropriate.

KEY WORDS: Chronic, Multi-site, Musculoskeletal, Pain, Community survey, Prevalence, Treatment, Planning

Submitted 26 October 2006; revised version accepted 27 March 2007.
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