Highlights
- •Having no or few pain sites may not differ in its risk factors compared with multiple pain.
- •Anxiety, depression, insomnia, and obesity are key predictors of increasing pain sites.
- •Associations of lifestyle factors attenuated in the within-subject analysis.
- •We found a substantial stability of number of pain sites within individuals over time.
- •Our study adds valued input to the ongoing debate regarding the course of multisite pain.
Abstract
In a Norwegian prospective population-based cohort study, we examined whether the
number of chronic musculoskeletal pain sites changed over an 11-year period, and if
the number of pain sites at follow-up was associated with health-related and lifestyle
factors at baseline. The study included data on 78,973 adults participating in the
Nord-Trøndelag Health Study (HUNT) in 1995 to 1997 (HUNT2) and 2006 to 2008 (HUNT3).
On the basis of 3 categories of baseline pain sites, associations between baseline
health-related, lifestyle, and demographic factors and number of pain sites at follow-up
were analyzed with linear regression models adjusted for age, sex, marital status,
physical activity, education, and other chronic diseases. We also estimated within-subject
associations. Regardless of pain extent at baseline, anxiety and/or depression, sleeping
problems, smoking, and obesity were positively associated with number of pain sites
at follow-up, whereas education and physical activity were inversely associated with
number of pain sites. The within-subject analyses showed largely similar associations
for the health-related factors, whereas associations of lifestyle factors were attenuated.
The mean number of pain sites remained unchanged between the 2 surveys. Overall, our
study revealed prospective associations between several factors and pain sites 11 years
later, regardless of the number of pain sites at baseline.
Perspective
This prospective study examined the association between development of pain and risk
factors in the general population, on the basis of 3 categories of baseline pain sites.
It also examined how these factors influence possible long-term changes in pain within
individuals. We showed that having no or few baseline pain sites may not differ in
its risk factors compared with having multiple pain sites. This article provides an
important contribution to the ongoing debate regarding the association between lifestyle,
demographic, and psychosocial risk factors, versus the course of multisite chronic
pain. Additionally, we provide discussion on potential directions for clinical relevance
and further research.
Key words
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Article info
Publication history
Published online: August 27, 2016
Footnotes
The authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2016 by the American Pain Society
