The association between neighbourhood socio‐economic status and the onset of chronic widespread pain: Results from the EPIFUND study

Davies, Kelly; Silman, Alan J.; Macfarlane, Gary J.; Nicholl, Barbara I; Dickens, Chris; Morriss, Richard; Ray, David; McBeth, John

doi:10.1016/j.ejpain.2008.07.003

Cited by 63 publications

(62 citation statements)

References 24 publications

(34 reference statements)

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“…This claim neither refutes the importance of lifestyle factors nor does it exclude the participation of yet additional risk factors, such as the adverse effects of non-steroidal anti-inflammatory drugs and other medications commonly used in this clinical context. The socioeconomic context also continues to deserve attention as it has been associated with both the prevalence of CWP47 48 and with higher overall cardiovascular and cancer mortality 49. Similar observations apply to sleep deprivation 50…”

Section: Discussionmentioning

confidence: 88%

Chronic widespread pain and increased mortality: biopsychosocial interconnections

2017

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Chronic widespread pain (CWP) is associated with excess mortality. Robust evidence is provided in ARD by a study that included over half a million participants and a meta-analysis.1 This adds to the (already overwhelming) recognised burden of CWP and imposes an additional urgency in improving our understanding and management of the condition. Reducing excess mortality in patients with chronic pain requires an accurate knowledge of relevant mechanisms and mediators. Previous research and this new study indicate that this excess mortality is, to a large extent, explained by lifestyle factors such as decreased physical activity, increased body mass index, unhealthy diets and smoking. In this editorial, we will offer arguments and evidence emphasising the need to also take account of psychological factors to explain the link between CWP and early death.

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Section: Discussionmentioning

confidence: 88%

Chronic widespread pain and increased mortality: biopsychosocial interconnections

2017

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“…A total of 10% of patients developed CP over 1 year and 15% of patients developed CP over 3 years. Both found an effect of SES on the development of CP but, for Davies et al, this effect disappeared after controlling for psycho logical factors, such as anxiety and depression, illness beliefs, symptoms and threatening life events [17]. The study by Jordan et al identified an effect of neighborhood general health on the likelihood of developing pain, and suggested that part of this was attributable to shared poor services, such as healthcare [18].…”

Section: What Factors Mediate An Association Between Cp and Ses?mentioning

confidence: 99%

“…These studies are supplemented by two prospective studies that took both area-and individuallevel measurements of SES at baseline [17,18]. A total of 10% of patients developed CP over 1 year and 15% of patients developed CP over 3 years.…”

Section: What Factors Mediate An Association Between Cp and Ses?mentioning

confidence: 99%

Socioeconomic Status and the Course and Consequences of Chronic Pain

Bonathan¹,

Hearn

Williams

2013

Pain Manage.

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This article consists of a brief overview of the relationship between chronic pain (CP) and socioeconomic status (SES), a review of recent studies conducted in 2010 and then a discussion of the psychological meaning of the findings in light of wider understanding about SES and health [Bonathan C, Unpublished Data]. Chronic or persistent pain affects people across their lifespan, with significant impact on all aspects of life. It is associated with economic and social disadvantage [1], loss of work [2] and reduced work effectiveness [3].The risk factors for CP are similar to those for many chronic health conditions [4], but while sex and age are routinely considered, less attention is paid to unhealthy behaviors, such as smoking [5], and to other markers of SES. The biopsycho social model describes interacting factors in the onset, experience and outcome of CP. It pays particular attention to the role of emotional states, health beliefs and pain-related behaviors [6]. The social aspects are arguably the least explored [3], and this article focuses on an important aspect of the social environment; SES. There are two dimensions: economic (financial and material wealth) and social (such as education and community standing). Socioeconomic factors, such as lower levels of education, low income and unemployment are associated with higher rates of chronic and disabling pain [7]. However, the nature of the relationship between chronic pain and SES is unclear. Review methodsGiven that a thorough review was conducted in 1998 [8], we searched for papers examining the link between chronic pain and SES dated from 1998 to the present time. Databases such as PsycINFO, MEDLINE and Embase were used. Searches for references of relevant papers, combining terms, such as chronic and persistent pain, and all categories of SES were carried out. Of the 143 studies retrieved, 75 measured only partial aspects of SES and/or did not explore its relationship with chronic pain, 39 described treatment outcome, and 22 fell short of the inclusion criteria in other ways. This left seven studies, to which six were added from reference lists of reviews. Adjusting and rerunning the search with terms used in these studies (e.g., 'disabling pain') produced no new studies.

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“…Nevertheless, only 3 patients had to be excluded after enrollment because their pain was found to be due to a specifi c condition, and in the remaining patients, physicians did not mention any specifi c relevant disease 6 or more months after inclusion. Depression, somatization, and other psychological causes of pain are probably not affected by vitamin D 3 but are likely prevalent in patients with chronic musculoskeletal pain [47][48][49] as well as in vitamin D defi ciency.…”

Section: Limitationsmentioning

confidence: 99%

Vitamin D Supplementation for Nonspecific Musculoskeletal Pain in Non-Western Immigrants: A Randomized Controlled Trial

Schreuder

Bernsen

Wouden

2012

The Annals of Family Medicine

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PURPOSE Many non-Western immigrants report musculoskeletal pains that are hard to treat. We studied the effect of high-dose vitamin D 3 on nonspecifi c persistent musculoskeletal complaints in vitamin D-defi cient non-Western immigrants and assessed correlation of pain patterns with benefi t. METHODSWe conducted a semi-crossover randomized controlled trial between February 2008 and February 2010 in primary care in 84 non-Western immigrants visiting their general practitioner for nonspecifi c musculoskeletal pain. At baseline, patients were randomized to placebo or vitamin D (150,000 IU vitamin D 3 orally); at week 6, patients in the original vitamin D group were randomized a second time to receive vitamin D (again) or to switch to placebo, whereas patients in the original placebo group were all switched to vitamin D. The main outcome was self-assessed change in pain after the fi rst 6 weeks. RESULTSPatients in the vitamin D group were signifi cantly more likely than their counterparts in the placebo group to report pain relief 6 weeks after treatment (34.9% vs 19.5%, P = .04). The former were also more likely to report an improved ability to walk stairs (21.0% vs 8.4%, P = .008). Pain pattern was not correlated with the success of treatment. In a nonsignifi cant trend, patients receiving vitamin D over 12 weeks were more likely to have an improvement than patients receiving it over 6 weeks.CONCLUSIONS There is a small positive effect 6 weeks after high-dose vitamin D 3 on persistent nonspecifi c musculoskeletal pain. Future research should focus on longer follow-up, higher supplementation doses, and mental health. Ann Fam Med 2012;10:547-555. doi:10.1370/afm.1402. INTRODUCTIONM any studies report a benefi cial effect of vitamin D supplementation on musculoskeletal diseases or complaints; they include not only well-described case reports, 1-3 but also large intervention studies. 4 Their fi ndings seem to be in line with several cross-sectional studies that have identifi ed a relationship between low serum vitamin D levels and musculoskeletal complaints [5][6][7] and muscle weakness. [8][9][10][11] It is not clear whether the pain associated with low vitamin D levels is mainly proximal (as in the case of osteomalacia), 12 is confi ned to the low back 4 or legs, 13 or is widespread.14,15 Other studies have not found any association with pain. 15,16 The discovery of vitamin D receptors in muscle cells [17][18][19] prompted investigators to look for a muscle analog of osteomalacia. Because vitamin D supplementation may enhance muscle strength, 9,20,21 supplementation could also be an easy and inexpensive way to manage nonspecifi c musculoskeletal pain. This intervention would be of special interest for non-Western immigrants in western Europe, who are prone to vitamin D defi ciency and also more often have musculoskeletal problems than white people. 27 as well as in 3 girls after several weeks to months of treatment with 2,000 to 3,000 IU vitamin D daily. 28 Eleven severely defi cient asylum-seeking women h...

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The association between neighbourhood socio‐economic status and the onset of chronic widespread pain: Results from the EPIFUND study

Cited by 63 publications

References 24 publications

Chronic widespread pain and increased mortality: biopsychosocial interconnections

Chronic widespread pain and increased mortality: biopsychosocial interconnections

Socioeconomic Status and the Course and Consequences of Chronic Pain

Vitamin D Supplementation for Nonspecific Musculoskeletal Pain in Non-Western Immigrants: A Randomized Controlled Trial

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