Abstract
Emerging evidence suggests that some individuals with regional pain disorders go on
to develop chronic widespread pain (CWP). However, the mechanism behind this transition
and the nature of risk factors that predispose a person to develop CWP remain to be
elucidated. The purpose of this study was to describe the frequency with which participants
with chronic back or neck pain develop CWP and to determine the risk factors associated
with this development. In a sample of 512 individuals, we found that nearly a quarter
(22.6%) of subjects who presented with regional back or neck pain in 2001/2002 had
developed CWP by 2007. Logistic regression indicated that 7 factors were associated
with the transition to CWP: moderate or severe pain intensity, female gender, history
of abuse, family history of CWP, severe interference with general activity, having
1 or more central sensitivity syndromes, and using more pain management strategies.
History of abuse was not significant in multivariate analysis. Notably, number of
depressive symptoms endorsed, pain duration, age, body mass index, number of medication
classes used, and receipt of disability benefits were not significantly associated
with this transition.
Perspective
This study offers insight into risk factors associated with the development of CWP.
This information not only offers clues as to the mechanism behind the expansion of
pain sensitivity from a regional pain locus to a widespread pain disorder but also
provides insight as to how clinicians might mitigate this transition.
Key words
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Article info
Publication history
Published online: May 20, 2010
Accepted:
March 9,
2010
Received in revised form:
February 17,
2010
Received:
September 24,
2009
Footnotes
L.L. Kindler was supported by the NINR (1 F31 NR010301-01 and 5 T32 NR007061-15) and the University Club Foundation Fellowship Award. She is currently supported by NINDS training grant NS045551 to the Comprehensive Center for Pain Research at the University of Florida.
Identification
Copyright
© 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.
