Chronic Pain and Poor Self-rated Health

Abstract

Context Chronic pain is common in Western societies. Self-rated health is an important indicator of morbidity and mortality, but little is known about the relation between chronic pain and self-rated health in the general population. Objective To analyze the association between chronic pain and self-rated health. Design, Setting, and Population A questionnaire survey carried out during the spring of 2002 of an age-and sex-stratified population sample of 6500 individuals in Finland aged 15 to 74 years, with a response rate of 71% (N=4542) after exclusion of those with unobtainable data (n=38). Chronic pain was defined as pain with a duration of at least 3 months and was graded by frequency: (1) at most once a week; (2) several times a week; and (3) daily or continuously. On the basis of a 5-item questionnaire on self-rated health, individuals were classified as having good, moderate, or poor health. Multinominal logistic regression analysis was used to assess the determinants of health. Analysis included sex, age, education, working status, chronic diseases, and mood. Main Outcome Measures Perceived chronic pain graded by frequency and selfrated health status. Results The prevalence of any chronic pain was 35.1%; that of daily chronic pain, 14.3%. The prevalence of moderate self-rated health was 26.6% and of poor health, 7.6%. For moderate self-rated health among individuals having chronic pain at most once a week compared with individuals having no chronic pain, the adjusted odds were 1.36 (95% confidence interval [CI], 1.05-1.76); several times a week, 2.41 (95% CI, 1.94-3.00); and daily, 3.69 (95% CI, 2.97-4.59). Odds for poor self-rated health were as follows: having chronic pain at most once a week, 1.16 (95% CI, 0.65-2.07); several times a week, 2.62 (95% CI, 1.76-3.90); and daily, 11.82 (95% CI, 8.67-16.10). Conclusion Chronic pain is independently related to low self-rated health in the general population.

Pain exacerbation as a major source of lost productive time in US workers with arthritis

“…Much is known about the independent impact of pain chronicity and intensity (12)(13)(14)(15), but not pain exacerbation. Clinically, pain exacerbations or flareups are known to occur independent of pain persistence or chronicity among a minority of individuals with arthritis (16,17).…”

Arthritis onset and worsening self-rated health: A longitudinal evaluation of the role of pain and activity limitations

“…More recently, interest in understanding the determinants of SRH has increased. Predictors of good SRH include younger age (15)(16)(17), male sex (15), higher socioeconomic status (15,16,18), social support (19,20), and absence of chronic conditions and pain (15)(16)(17)(21)(22)(23). Although physiologic and psychological determinants of good SRH have been documented, the main determinant appears to be physical health (15,24,25).…”

“…However, population-based and clinical studies indicate that 30 -80% of persons with at least 1 chronic condition report good health (15)(16)(17). This raises questions about the distinction between individuals' perceptions of their health status and a diagnosed medical condition.…”

“…It has been suggested that some individuals think about specific health problems when asked to rate their health, whereas others think in terms of general physical functioning or health behaviors (27). Pain is a common reason for seeking medical care around the world (28 -30), and is associated with poor SRH (15)(16)(17)23). Studies indicate that chronic pain seems to relate to poor health more strongly than chronic diseases or age, and the significant association persists even when sociodemographic and relevant health factors are considered (16,17).…”

“…Pain is a common reason for seeking medical care around the world (28 -30), and is associated with poor SRH (15)(16)(17)23). Studies indicate that chronic pain seems to relate to poor health more strongly than chronic diseases or age, and the significant association persists even when sociodemographic and relevant health factors are considered (16,17). One possible explanation is that pain is a mediator between chronic conditions and SRH.…”