How are socio-demographic and psycho-social factors associated with the prevalence and chronicity of severe pain in 14 different body sites? A cross-sectional population-based survey

Abstract

SummaryBackgroundSevere pain and chronic pain have a high impact on individuals and society. Body location of pain is important with regard to perception, articulation, and underlying biological, mental or social causes of pain.MethodsA cross-sectional survey was performed in the general Austrian population with 15,474 personally interviewed subjects aged 15 years and older.ResultsThe 1‑year period prevalence of severe pain in any body site was 38.6% and of chronic pain 24.9%. In all, 8.1% had pain in at least three body sites. Subjects aged 65 years and older (52.2%), those with low education (43.4%), unemployed subjects (50.4%), retired subjects (52.4%), those with anxiety/depression (67.7%), and subjects with lack of social support (49.6%) were sub-populations with high pain prevalence. In multivariate analyses, depression/anxiety was associated with prevalence and chronicity of severe pain in all body sites (range of ORs 1.89–5.01), while such associations were found for lack of social support (range of ORs 1.33–1.65), female sex (range of ORs 1.38–2.34), higher age (range of ORs 1.09–1.18 for 5 year intervals), as well as low educational (range of ORs 1.47–2.06 primary vs. tertiary education) and unemployment status (range of ORs 1.50–2.62) in most body sites. Being born in non-EU or EFTA states was associated with pain in many body sites (range of ORs 1.38–2.10).ConclusionsPsychosocial factors are associated with pain presence in similar ways irrespective of location. Regarding socio-demographic factors, differences towards the magnitude and the direction in the association with pain frequency and chronicity in different body sites emerged.

Pain and chronic pain epidemiology

“…A publication on pain and chronic pain epidemiology in this edition also reveals that low education, unemployment status, lack of social support, and especially depression and anxiety are associated with pain prevalence and with chronicity [3]. This is in line with previous epidemiological studies on chronic pain where modifiable and unmodifiable risk factors for chronic pain were found [7].…”

“…Therefore, epidemiology is necessary to quantify a health hazard in a certain population, to prioritize efforts in health care, and to improve preventive and clinical management, limit disease severity and minimize disability. This edition of the "Wiener klinische Wochenschrift" presents one of the very few population-based studies showing the epidemiology of pain and chronic pain in the general Austrian population, based on the Austrian Health Interview Survey, which is composed of a remarkable sample size of more than 15,000 subjects [3]. This study shows a 1-year prevalence of severe pain of 38.6% and of chronic pain of 24.9% in the general Austrian population older than 15 years [3].…”

“…Does every patient affected with chronic pain need to be treated in specialized or highly specialized health care settings, such as interdisciplinary pain centers or university clinics? The data presented in the study published in this issue [3] are population-based, and population-based data on chronic pain usually show a higher prevalence than routinely collected clinical data. This is due to the fact that pain is a feature of many health-related conditions that are coded and classified as separate diseases, although pain, especially chronic pain is acknowledged as a condition in its own right.…”

Depression and Functional Outcomes in Patients Presenting to the Emergency Department With Low Back Pain

“…All models were run both unadjusted and adjusted for potential confounders, including race, ethnicity, age, sex, and education, which have been associated with pain and disability outcomes. [18][19][20] Models testing the 3-month change in PHQ-9 as a predictor were also adjusted for baseline PHQ-9 score. While not strictly continuous, we assume that the NRS, RMDQ, and PHQ-9 are each an approximation of a continuous scale for regression analysis.…”

Bi-directional relation between effort‒reward imbalance and risk of neck-shoulder pain: assessment of mediation through depressive symptoms using occupational longitudinal data

“…There is also some indication of mediation by psychological strain in terms of worry, fatigue or sleep problems (12), and anger, frustration, anxiety or depression (13). Regarding ERI and pain, a recent review concluded that there is an association between ERI and depressive disorders (14), and depressive disorders have further been linked to an increased risk of neck and shoulder pain (15,16). There is also evidence in support of neck-shoulder pain being a risk factor for depressive symptoms (17), and as depression can decrease focus on work tasks (18), it may further increase perceived ERI at work.…”