Highlights
- •This study describes patterns in prevalence and comorbidity of pain at various anatomical sites.
- •All pain sites were associated with all other pain sites as well as with anxious depression.
- •Relationships with sex and age depended strongly on the pain site.
- •These findings suggest shared as well as specific mechanisms involved in pain at different sites.
Abstract
Most studies on pain focus on specific disorders, which makes it difficult to compare
characteristics across different types of pain symptoms. In this large population-based
study, we examine the prevalence and comorbidity patterns among pain symptoms across
a wide range of anatomic sites (back, neck, head, abdomen, joints, chest, face, teeth,
and “other”) in relation to anxious depression and a range of demographic, health,
and lifestyle variables. Self-report data were collected in 11,787 adult participants
of The Netherlands Twin Registry (mean age 44.5 years, 62% female), including twins
and relatives of twins. Headache and abdominal pain were strongly associated with
female sex, whereas chest pain and toothache were not. Joint pain strongly increased
with age, whereas headache and abdominal pain decreased with age. Most other pain
sites were only weakly associated with age. A highly consistent pattern of comorbidity
was observed: All pain symptoms were correlated with all other pain symptoms, as well
as with anxious depression. Frequent and widespread pain (ie, pain at multiple sites)
was most strongly associated with anxious depression. These observations reflect important
differences between specific pain symptoms, suggesting partly separate etiologies,
but also highlight the importance of shared mechanisms underlying pain symptoms in
general.
Perspective
The association of pain with sex and age strongly depends on pain location. However,
all pain sites are consistently associated with other pain sites as well as with anxious
depression. This provides important clues with respect to both similarities and differences
in the mechanisms underlying different types of pain.
Key words
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Article info
Publication history
Published online: June 26, 2014
Accepted:
June 17,
2014
Received in revised form:
June 16,
2014
Received:
April 15,
2014
Footnotes
This study was supported by the European Research Council (ERC-230374 and ERC-284167), the EMGO+ Institute for Health and Care research, and the Neuroscience Campus Amsterdam (NCA). L.L. is supported by an EFIC-Grünenthal Grant.
The authors declare no conflict of interest.
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© 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.
