A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population

Mansfield, Kathryn E.; Sim, Julius; Jordan, Joanne L.; Jordan, Kelvin

doi:10.1097/j.pain.0000000000000314

Cited by 308 publications

(259 citation statements)

References 32 publications

(79 reference statements)

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“…10,16 The combined 5-year prevalence of recurrent regional pain consultation ("unrecognized" CWP) and nonspecific pain complaints ("recognized" CWP), after excluding specific generalized musculoskeletal diagnoses, was slightly higher, at 13%, than general population point prevalence estimates for CWP (10%). 26 Combined with our findings from Phase 2, this indicates that prevalence of widespread pain based on consultation data may give similar prevalence estimates to general population surveys based on strict CWP criteria, but will not represent an identical group of people.…”

Section: Nonmutually Exclusive Groupssupporting

confidence: 52%

“…26 Threequarters of recurrent regional pain consulters did not have a code recorded for generalized pain conditions related to CWP (eg, fibromyalgia). They therefore had widespread pain potentially unrecognized as such by their GP.…”

Section: Nonmutually Exclusive Groupsmentioning

confidence: 99%

“…CWP is common, with an estimated general population point prevalence of 10%. 26 In the American College of Rheumatology 1990 (ACR-1990) definition, 42 CWP is the fundamental feature of fibromyalgia, defined as pain lasting $3 months, located axially, above and below the waist, and on both sides of the body. The updated definition (ACR-2010) 41 emphasizes additional physical symptoms (eg, fatigue, waking unrefreshed) associated with fibromyalgia and placed fibromyalgia at one extreme on a spectrum of polysymptomatic distress that includes CWP.…”

Section: Introductionmentioning

confidence: 99%

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Identifying patients with chronic widespread pain in primary care: Erratum.

2017

PAIN

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Chronic widespread pain (CWP) is common in the general population. It is unclear how people reporting this problem present in primary care; they may regularly consult for regional pains without being recognized as having a generalized condition. Our objectives were to determine the prevalence of people consulting in primary care for musculoskeletal conditions in different body regions on different occasions (recurrent regional pain consultation), the proportion with diagnosed generalized pain and surveyreported widespread pain, and if they have features characteristic of CWP. Phase 1 used electronic records from 12 general practices in North Staffordshire (Consultations in Primary Care Archive) from 2005 to 2009. Phase 2 used linked self-reported health and primary health care data from 8286 people aged .50 years in 8 general practices (North Staffordshire Osteoarthritis Project) between 2002 and 2005. In Phase 1, 11% of registered patients fulfilled criteria for recurrent regional pain consultation. Threequarters had no recorded CWP-related generalized pain condition (eg, fibromyalgia). In Phase 2, 53% of recurrent regional pain consulters had survey-reported widespread pain and 88% had consulted for somatic symptoms. Self-reported general health was worse in recurrent regional pain consulters than in single-region consulters and poorest in those who also reported persistent widespread pain. Recurrent regional pain consulters are a heterogeneous group of frequent consulters sharing features with CWP (eg, somatic symptoms) but including those less severely affected. They lie on the spectrum of polysymptomatic distress characteristic of CWP and represent a group whose needs may be better met by earlier diagnosis of multisite pain.

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Section: Nonmutually Exclusive Groupssupporting

confidence: 52%

Section: Nonmutually Exclusive Groupsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Identifying patients with chronic widespread pain in primary care: Erratum.

2017

PAIN

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“…Musculoskeletal pain affects about 12% of the general population, with the proportion of women being generally twice as high compared to men [2]. CWP is a diagnosis that challenges the social and cultural boundaries of current perception of illness and health in the Western world and the lack of a biomedical diagnosis denies the sufferer's legitimacy of the "sick role".…”

Section: Introductionmentioning

confidence: 99%

Are Epigenetic Factors Implicated in Chronic Widespread Pain?

et al. 2016

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BackgroundChronic widespread musculoskeletal pain (CWP) is the cardinal symptom of fibromyalgia and affects about 12% of the general population. Familial aggregation of CWP has been repeatedly demonstrated with estimated heritabilities of around 50%, indicating a genetic susceptibility. The objective of the study was to explore genome-wide disease-differentially methylated positions (DMPs) for chronic widespread pain (CWP) in a sample of unrelated individuals and a subsample of discordant monozygotic (MZ) twins.Methodology/Principle FindingsA total of N = 281 twin individuals from the TwinsUK registry, including N = 33 MZ twins discordant for self-reported CWP, were part of the discovery sample. The replication sample included 729 men and 756 women from a subsample of the KORA S4 survey–an independent population-based cohort from Southern Germany. Epigenome-wide analysis of DNA methylation was conducted using the Illumina Infinium HumanMethylation 450 DNA BeadChip in both the discovery and replication sample. Of our 40 main loci that were carried forward for replication, three CPGs reached significant p-values in the replication sample, including malate dehydrogenase 2 (MDH2; p-value 0.017), tetranectin (CLEC3B; p-value 0.039), and heat shock protein beta-6 (HSPB6; p-value 0.016). The associations between the collagen type I, alpha 2 chain (COL1A2) and monoamine oxidase B (MAOB) observed in the discovery sample–both of which have been previously reported to be biological candidates for pain–could not be replicated.Conclusion/SignificanceOur results may serve as a starting point to encourage further investigation in large and independent population-based cohorts of DNA methylation and other epigenetic changes as possible disease mechanisms in CWP. Ultimately, understanding the key mechanisms underlying CWP may lead to new treatments and inform clinical practice.

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“…According to ACR 1990 criteria, the prevalence of CWP is approximately 10% in the general population [25,26], with a 1.2-5.4% prevalence for the FM subgroup per the ACR 1990, 2010, and the modified 2010 criteria [27]. In 2010, The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) revealed that the Swedish population's prevalence for persistent pain to be about 40% and that about 5% of these people sought health care and about 1% sought specialist care.…”

Section: Chronic Pain Is a Public Health Challengementioning

confidence: 99%

Endocannabinoids and Related Lipids in Chronic Pain: Analytical and Clinical Aspects

Stensson¹

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A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population

Abstract: One in 10 adults report chronic widespread pain with potential sociocultural variation. Cultural differences in pain reporting should be considered in future research.Supplemental Digital Content is Available in the Text.

Cited by 308 publications

References 32 publications

Identifying patients with chronic widespread pain in primary care: Erratum.

Identifying patients with chronic widespread pain in primary care: Erratum.

Are Epigenetic Factors Implicated in Chronic Widespread Pain?

Endocannabinoids and Related Lipids in Chronic Pain: Analytical and Clinical Aspects

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