Characteristics of Subjects with Chronic Pain, in Relation to Local and Widespread Pain Report: A prospective study of symptoms, clinical findings and blood tests in subgroups of a geographically defined population

Abstract

The relation between reported chronic pain and clinical findings was studied by comparing survey data six months before and eighteen months after a clinical examination. Studied individuals (n = 165) were randomly selected from subsamples of an initial survey (n = 1806) to a general population. Among individuals reporting chronic pain 85% were assessed to have chronic pain at the examination. Diagnoses were found in 22% of examined pain individuals. Myofascial pain syndrome and myalgia were the most common findings. Compared with located neck-shoulder pain, widespread pain had a greater impact on the individual, a worse prognosis regarding pain duration and working capacity, and revealed a raised serum urate level of unclear significance. Although no specific cause of pain is found in individuals with widespread pain it is important to identify and treat this group due to the great effects on functional capacity and the worse prognosis.

Different outcomes in subgroups of patients with long-term musculoskeletal pain

“…Poor pretreatment prognosis means that patients have problems with coping of pain, have low motivation and low scores on physical variables, which is common for patients with chronic widespread pain (CWP) (Andersson et al 1996, Croft 1999. Women diagnosed with CWP according to ICD-9 returned more often to work after treatment in the extensive multidisciplinary treatment program, compared to the treatment- as-usual (Skouen et al 2006).…”

“…It is hard to explain why higher age significantly increased the number of days absent from work only for women and not for men. One explanation could be that women with CWP are suffering more from CWP compared to men, and that this difference is more pronounced at higher age (Andersson et al 1996, Croft 1999.…”

Prevalência de dor crônica e identificação de fatores associados em um segmento da população da cidade de São Paulo

“…A dor crônica pode ser classificada de acordo com sua localização anatômica em dor crônica regional (DCR) e dor crônica disseminada (DCD) (Chronic Widespread Pain) (Andersson et al, 1996;Bergman et al, 2001). A definição de DCD, proposta pelo Colégio Americano de Reumatologia, inclui presença de dor no lado direito e esquerdo do corpo, acima e abaixo da cintura e presença de dor no esqueleto axial (Wolfe et al, 1990).…”

“…Estudos sugerem que a prevalência é de aproximadamente 50% para a DCR e entre 10% e 13% para a DCD na população geral (Croft et al, 1993;Andersson et al, 1996;Portenoy et al, 2004). Indivíduos com DCD diferem de indivíduos com DCR não somente pela localização da dor, como também por apresentarem dor de maior intensidade e maior incapacidade relacionada à dor.…”

Prevalência de algias vertebrais crônicas e identificação de fatores associados em uma população da cidade de São Paulo

“…A dor crônica disseminada está associada à depressão e aos sintomas psicossomáticos, bem como a maior incapacidade (Andersson et al, 1996).…”