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Song S, Graham-Engeland JE, Kim J. Associations Between Psychological Stress and Hand Pain Among Rural and Urban Adults: Findings From the KoGES Community Cohort Study. J Pain 2024; 25:362-375. [PMID: 37659447 DOI: 10.1016/j.jpain.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/17/2023] [Accepted: 08/28/2023] [Indexed: 09/04/2023]
Abstract
Despite known health disparities in chronic pain conditions between rural and urban adults, few studies have examined whether longitudinal associations between psychological stress and hand pain differ. Utilizing community-based cohort data, this study examined whether rural and urban adults differed in the extent to which psychological distress was associated with hand osteoarthritis (OA) symptoms and later functional limitations related to hand pain. Community-dwelling adults (mean age = 51.97, 52.3% women) in a rural (n = 2,971) and urban area (n = 2,782) provided demographic data at baseline and, at a 4-year follow-up, responded to questionnaires about psychological distress and clinical symptoms of hand OA. Levels of functional limitations in hands were assessed at an 8-year follow-up. Ordinal logistic and linear regression were conducted to examine the effects of psychological distress on hand OA symptoms and functional limitations, and whether associations between psychological distress and these pain outcomes were moderated by residential area. The results showed that psychological distress was associated with a higher risk for hand OA symptoms and functional limitations, even after adjusting for demographic and health covariates. There was significant moderation by residential area, such that the association between psychological distress and hand OA was significant only among rural adults and the association with functional limitations was stronger in rural adults than urban adults. Findings suggest greater vulnerability to hand arthritis and hand-related functional limitations among rural adults and the potential for tailored intervention programs to help resolve health disparities among rural communities. PERSPECTIVE: This study compares the association between psychological distress and hand pain outcomes between rural and urban adults using community-based cohort data and suggests that rural adults are more vulnerable to experiencing negative effects of psychological distress on concurrent hand OA symptoms and longitudinal functional limitations in hands.
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Affiliation(s)
- Sunmi Song
- Rehabilitation Science Program, Department of Health Science, Graduate School, Korea University, Seoul, South Korea; Department of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea; Department of Physical Therapy, College of Health Science, Korea University, Seoul, South Korea
| | | | - Junesun Kim
- Rehabilitation Science Program, Department of Health Science, Graduate School, Korea University, Seoul, South Korea; Department of Health and Environmental Science, College of Health Science, Korea University, Seoul, South Korea; Department of Physical Therapy, College of Health Science, Korea University, Seoul, South Korea; BK21FOUR Program: Learning Health Systems, College of Health Science, Korea University, Seoul, South Korea
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Lynch M, Peat G, Jordan K, Yu D, Wilkie R. Where does it hurt? Small area estimates and inequality in the prevalence of chronic pain. Eur J Pain 2023; 27:1177-1186. [PMID: 37345222 PMCID: PMC10947147 DOI: 10.1002/ejp.2148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 05/05/2023] [Accepted: 06/07/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Chronic pain affects up to half of UK adults, impacting quality of life and demand on local health services. Whilst local health planning is currently based on subnational prevalence estimates, associations between pain and sociodemographic characteristics suggest that inequalities in the prevalence of chronic and high-impact chronic pain between neighbourhoods within local authorities are likely. We aimed to derive lower super output area (LSOA) estimates of the prevalence of chronic and high-impact chronic pain. METHODS Presence of self-reported chronic and high-impact chronic pain were measured in adults aged 35+ in North Staffordshire and modelled using multilevel regression as a function of demographic and geographic predictors. Multilevel model predictions were post-stratified using the North Staffordshire age-sex population structure and LSOA demographic characteristics to estimate the prevalence of chronic and high-impact chronic pain in 298 LSOAs, corrected for ethnic diversity underrepresented in the data. Confidence intervals were generated for high-impact chronic pain using bootstrapping. RESULTS Data were analysed from 4162 survey respondents (2358 women, 1804 men). The estimated prevalence of chronic and high-impact chronic pain in North Staffordshire LSOAs ranged from 18.6% to 50.1% and 6.18 [1.71, 16.0]% to 33.09 [13.3, 44.7]%, respectively. CONCLUSIONS Prevalence of chronic and high-impact chronic pain in adults aged 35+ varies substantially between neighbourhoods within local authorities. Further insight into small-area level variation will help target resources to improve the management and prevention of chronic and high-impact chronic pain to reduce the impact on individuals, communities, workplaces, services and the economy. SIGNIFICANCE Post-stratified multilevel model predictions can produce small-area estimates of pain prevalence and impact. The evidence of substantial variation indicates a need to collect local-level data on pain and its impact to understand health needs and to guide interventions.
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Affiliation(s)
| | - George Peat
- School of MedicineKeele UniversityKeeleUK
- The Centre for Applied Health & Social Care ResearchSheffield Hallam UniversitySheffieldUK
| | | | - Dahai Yu
- School of MedicineKeele UniversityKeeleUK
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Álvarez-gálvez J, Carretero-bravo J, Suárez-lledó V, Ortega-martín E, Ramos-fiol B, Lagares-franco C, O'ferrall-gonzález C, Almenara-barrios J, González-caballero JL. Social inequalities in multimorbidity patterns in Europe: A multilevel latent class analysis using the European Social Survey (ESS). SSM Popul Health 2022; 20:101268. [DOI: 10.1016/j.ssmph.2022.101268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/16/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022] Open
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Emerson AJ, Chandler LE, Oxendine RH, Huff CM, Harris GM, Baxter GD, Wonsetler Jones EC. Systematic review of clinical decision-makers’ attitudes, beliefs, and biases that contribute to a marginalized process of care in persistent musculoskeletal pain. Part II: case vignettes. Physical Therapy Reviews 2021. [DOI: 10.1080/10833196.2021.2000289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Alicia J. Emerson
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
- Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - Lauren E. Chandler
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
| | - Riley H. Oxendine
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
| | - Corey M. Huff
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
| | - Gabrielle M. Harris
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
| | - G. David Baxter
- Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - Elizabeth C. Wonsetler Jones
- Department of Physical Therapy, Congdon School of Health Sciences, High Point University, High Point, NC, USA
- Department of Public Health and Community Medicine, Tufts University, Boston, MA, USA
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Rajan P, Hiller C, Lin J, Refshauge K, Lincoln M, Leaver A. Community-based interventions for chronic musculoskeletal health conditions in rural and remote populations: A systematic review. Health Soc Care Community 2021; 29:1621-1631. [PMID: 33368791 DOI: 10.1111/hsc.13263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/15/2020] [Accepted: 11/19/2020] [Indexed: 06/12/2023]
Abstract
Chronic musculoskeletal health conditions are highly prevalent in rural and remote areas, globally. It is unknown, however, whether interventions shown to be effective for urban populations are also effective for rural and remote populations. The purpose of the review was to evaluate the effectiveness of community-based interventions for management of chronic musculoskeletal health conditions in rural and remote populations. A systematic review was undertaken of the major databases: Medline, Scopus, Web of Science, Rural and Remote Health, Embase and PEDro to April 2020 with no restrictions on language or publication date. Odds Ratios were calculated to report differences between intervention and control groups. Risk of bias was assessed using the PEDro scale. Meta-analysis was not conducted, given the high heterogeneity among studies. From a total of 3,219 articles identified from the title search, five studies were eligible, with a total of 2,831 participants. Interventions evaluated included education alone, exercise with education and ergonomic modifications. Community-based education and exercise led to significantly reduced chronic musculoskeletal pain [OR = 1.85 (95% CI 1.22, 2.82)] compared with controls. Ergonomic stove installation significantly reduced average prevalence of back pain (0.25% reduction in pain prevalence; p < .05); however, no significant effect [OR = 1.02 (0.63, 1.65)] was found when transformed to Odds Ratio. There were divergent findings for education programmes alone: one study reported a positive effect [OR = 1.78 (1.27, 2.49)], while another reported no significant effect [delivered either in home [OR: 1.21 (0.78, 1.86)] or in small groups [OR = 0.95 (0.60, 1.51)]. A significant improvement in knowledge was found with community-based education delivered in participants' homes [SMD: 1.27 (1.01, 1.54)], in small groups [SMD: 0.79 (0.53, 1.06)], using traditional puppetry [SMD: 4.79 (4.51, 5.06)], and with education and exercise [SMD: 0.29 (0.06, 0.52)]. There is low quality evidence that education and/or exercise improves knowledge of arthritis, and the effectiveness of ergonomic interventions on pain was unclear.
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Affiliation(s)
- Pavithra Rajan
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Claire Hiller
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Jianhua Lin
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Kathryn Refshauge
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Lincoln
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Andrew Leaver
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
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Emerson AJ, Oxendine RH, Chandler LE, Huff CM, Harris GM, Baxter GD, Jones ECW. Patient and Provider Attitudes, Beliefs, and Biases That Contribute to a Marginalized Process of Care and Outcomes in Chronic Musculoskeletal Pain. A Systematic Review. Part I: Clinical Care. Pain Med 2021; 23:655-668. [PMID: 34297104 DOI: 10.1093/pm/pnab195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Chronic musculoskeletal pain (CMP) outcomes are affected by numerous variables including the clinical conversation. When good therapeutic/working alliances are formed, congruent clinical conversations can lead to improved CMP outcomes. Identifying patient/provider attitudes, beliefs, and biases in CMP that can influence the clinical conversation, and thus clinical management decisions, is foundationally important. DESIGN The aims of this systematic review were to 1) summarize the evidence of the attitudes and beliefs of patients and healthcare providers (HCPs) involved in the clinical conversation of CMP; 2) examine if/how these perceptions impacted the process of care. METHODS A systematic search of CINAHL, PubMed, Scopus, Sociology Database in ProQuest, and Web of Science used PRISMA guidelines. Included studies: vulnerable adult populations with chronic pain. Study bias was examined using the Downs and Black tool. RESULTS Seven retrospective studies were included. HCPs demonstrated negative implicit biases toward minorities and women when making pharmaceutical management decisions. HCPs demonstrated negative implicit biases toward lower educated women when making referrals to multidisciplinary care. Unmet patient expectations resulted in higher drop-out rates at multidisciplinary pain management programs. Patients' trust was influenced by healthcare setting and patients often had limited options secondary to health insurance type/status. CONCLUSION These findings suggest that patients with CMP may experience a marginalized process of care due to HCPs' negative implicit biases, unmet patient expectations, and healthcare setting. Results suggest several factors may contribute to inequitable care and the recalcitrant nature of CMP, particularly in vulnerable populations with limited healthcare choices.
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Affiliation(s)
- Alicia J Emerson
- High Point University, Department of Physical Therapy, Congdon School of Health Sciences, One University Parkway, High Point, NC, 27268.,Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin 9056, New Zealand
| | - Riley H Oxendine
- High Point University, Department of Physical Therapy, Congdon School of Health Sciences, One University Parkway, High Point, NC, 27268
| | - Lauren E Chandler
- High Point University, Department of Physical Therapy, Congdon School of Health Sciences, One University Parkway, High Point, NC, 27268
| | - Corey M Huff
- High Point University, Department of Physical Therapy, Congdon School of Health Sciences, One University Parkway, High Point, NC, 27268
| | - Gabrielle M Harris
- High Point University, Department of Physical Therapy, Congdon School of Health Sciences, One University Parkway, High Point, NC, 27268
| | - G David Baxter
- Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin 9056, New Zealand
| | - Elizabeth C Wonsetler Jones
- High Point University, Department of Physical Therapy, Congdon School of Health Sciences, One University Parkway, High Point, NC, 27268.,Tufts University, Department of Public Health and Community Medicine, 136 Harrison Avenue, Boston, MA, 02111
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Mandrekar S, Venkatesan P, Nagaraja R. Prevalence of musculoskeletal chest pain in the emergency department: a systematic review and meta-analysis. Scand J Pain 2021; 21:434-444. [PMID: 33838099 DOI: 10.1515/sjpain-2020-0168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/21/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Our objective was to systematically review and meta-analyse relevant studies to determine the prevalence of musculoskeletal chest pain in the emergency department. METHODS This review was constructed while confirming to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed, Cochrane Library, SCOPUS, Science Direct, and OVID were systematically searched from their inception to January 19, 2020, to identify observational studies, where the prevalence of musculoskeletal causes of chest pain was reported in isolation or in combination with other causes or could be calculated from the available data. RESULTS A meta-analysis of the nine included studies, having a total of 14,743 participants, showed the global pooled prevalence of musculoskeletal chest pain in the emergency department to be 16% (10-22%) [I 2=99.24%]. The pooled prevalence for the European continent was 17% (9-25%) [I 2=99.51%] and that for the urban areas was 13% (7-19%) [I 2=99.00%]. CONCLUSIONS This review provides a reliable estimate of the prevalence of musculoskeletal chest pain in the emergency department. More studies providing age and gender-specific data for the prevalence of musculoskeletal chest pain in the emergency department should be carried out. A paucity of such data from rural areas also needs to be addressed in future research work. The prevalence values from this study will be useful in the application of Bayesian reasoning utilised in diagnosing patients, where the process of Bayesian arguing begins by knowing pre-test probabilities of different differential diagnosis, in this case that of musculoskeletal chest pain in the emergency department.
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Affiliation(s)
- Shivani Mandrekar
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Bengaluru, Karnataka, India
| | - Prem Venkatesan
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Bengaluru, Karnataka, India
| | - Ravishankar Nagaraja
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India
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El-Tallawy SN, Nalamasu R, Salem GI, LeQuang JAK, Pergolizzi JV, Christo PJ. Management of Musculoskeletal Pain: An Update with Emphasis on Chronic Musculoskeletal Pain. Pain Ther 2021; 10:181-209. [PMID: 33575952 PMCID: PMC8119532 DOI: 10.1007/s40122-021-00235-2] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/09/2021] [Indexed: 12/28/2022] Open
Abstract
Musculoskeletal pain is a challenging condition for both patients and physicians. Many adults have experienced one or more episodes of musculoskeletal pain at some time of their lives, regardless of age, gender, or economic status. It affects approximately 47% of the general population. Of those, about 39–45% have long-lasting problems that require medical consultation. Inadequately managed musculoskeletal pain can adversely affect quality of life and impose significant socioeconomic problems. This manuscript presents a comprehensive review of the management of chronic musculoskeletal pain. It briefly explores the background, classifications, patient assessments, and different tools for management according to the recently available evidence. Multimodal analgesia and multidisciplinary approaches are fundamental elements of effective management of musculoskeletal pain. Both pharmacological, non-pharmacological, as well as interventional pain therapy are important to enhance patient’s recovery, well-being, and improve quality of life. Accordingly, recent guidelines recommend the implementation of preventative strategies and physical tools first to minimize the use of medications. In patients who have had an inadequate response to pharmacotherapy, the proper use of interventional pain therapy and the other alternative techniques are vital for safe and effective management of chronic pain patients.
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Affiliation(s)
- Salah N El-Tallawy
- Anesthesia and Pain Management Department, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia. .,Faculty of Medicine, Minia University and NCI, Cairo University, Cairo, Egypt.
| | - Rohit Nalamasu
- Department of Physical Medicine and Rehabilitation, University of Nebraska Medical Center, Omaha, NE, USA
| | - Gehan I Salem
- Rheumatology, Rehabilitation and Physical Medicine Department, Assiut University Hospital, Assiut, Egypt.,Rehabilitation Medicine Department, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Paul J Christo
- Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Emerson AJ, Hegedus T, Mani R, Baxter GD. Chronic musculoskeletal pain experiences in marginalized populations: a mixed methods study protocol to understand the influence of geopolitical, historical, and societal factors. Physical Therapy Reviews 2020. [DOI: 10.1080/10833196.2020.1807803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Alicia J. Emerson
- High Point University, High Point, NC, USA
- Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | | | - Ramakrishnan Mani
- Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - G. David Baxter
- Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
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Emerson AJ, Hegedus T, Mani R, Baxter GD. Chronic musculoskeletal pain. Discordant management conversations: the influencing factor of polarized politics. Physical Therapy Reviews 2019. [DOI: 10.1080/10833196.2019.1701762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Alicia J. Emerson
- High Point University, One University Parkway, High Point, NC, USA
- Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | | | - Ramakrishnan Mani
- Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - G. David Baxter
- Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
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Shade MY, Herr K, Kupzyk K. Self-Reported Pain Interference and Analgesic Characteristics in Rural Older Adults. Pain Manag Nurs 2019; 20:232-238. [PMID: 31080145 DOI: 10.1016/j.pmn.2019.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pain impacts the lives of millions of community-dwelling older adults. An important characteristic of pain is "pain interference" which describes the influence of pain on function. A description of pain interference is limited in rural settings where the number of older adults is expected to increase, and health disparities exist. AIMS The purpose of this study was to describe pain interference and analgesic medication use, highlighting those that may be potentially inappropriate in a sample of rural community-dwelling older adults. DESIGN This secondary analysis was from a cross sectional study. SAMPLE AND SETTINGS Data were analyzed from a sample of 138 rural community-dwelling older adults. METHODS Statistical analyses were performed on demographics, health characteristics, pain interference, and potentially inappropriate analgesic medication data. RESULTS Pain interference with work activity was reported by 76% of older adults overall, with 23% reporting moderate and 4% extreme interference, and 41% reported sleep difficulty due to pain. Higher pain interference was significantly associated with higher body mass index, more health providers, and the daily use of non-steroidal anti-inflammatory drugs (NSAIDs). Older women experienced more sleep difficulties due to pain. Over-the-counter analgesics were used most frequently by rural older adults to manage pain. Of most risk was the daily use of NSAIDs, in which only 30% used medications to protect the gastrointestinal system. CONCLUSIONS Older adults in rural settings experience pain interference and participate in independent-medicating behaviors that may impact safety.
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Affiliation(s)
- Marcia Y Shade
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska; University of Iowa College of Nursing, Iowa City, Iowa.
| | - Keela Herr
- University of Iowa College of Nursing, Iowa City, Iowa
| | - Kevin Kupzyk
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska
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Park IY, Cho NH, Lim SH, Kim HA. Gender-specific associations between fat mass, metabolic syndrome and musculoskeletal pain in community residents: A three-year longitudinal study. PLoS One 2018; 13:e0200138. [PMID: 29985938 PMCID: PMC6037368 DOI: 10.1371/journal.pone.0200138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 06/20/2018] [Indexed: 12/14/2022] Open
Abstract
Increase in fat mass is correlated with musculoskeletal pain. The aim of this study was to examine the relationship between fat mass and the musculoskeletal pain prospectively in Korean community residents. In the Korean Health and Genome Study, participants (mean age 60.2 years, 56.2% women) completed pain questionnaires and underwent dual x-ray absorptiometry to calculate body composition. Three-year follow-up data on pain was available for 1,325 participants. Pain was categorized according to number of pain regions. At three years of follow-up, participants were classified as follows: 1) no pain both at baseline and at three years (no pain), 2) any pain (one, two or more, or widespread regions) at baseline and no pain at three years (transient pain), 3) no pain at baseline and any pain at three years (new pain) 4) any pain both at baseline and at 3 years (persistent pain). 1) and 2) were grouped as no/transient pain group (no pain) and 3) and 4) as new/persistent pain group (pain). Female gender and obesity were two significant factors associated with the persistence or development of pain. Total fat mass and fat:muscle mass ratio were associated with pain among female participants only, and the odds ratios for pain were significantly increased in female participants in the highest quartile of total fat mass and fat muscle ratio after adjustment. In conclusion, both female gender and obesity were two significant factors associated with pain. Fat mass parameters and pain were significantly associated only among females.
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Affiliation(s)
- In Young Park
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Nam Han Cho
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Seung Hun Lim
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Hyun Ah Kim
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
- Institute for Skeletal Aging, Hallym University, Chunchon, Korea
- * E-mail:
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Smith TO, Dainty JR, MacGregor AJ. Changes in social isolation and loneliness following total hip and knee arthroplasty: longitudinal analysis of the English Longitudinal Study of Ageing (ELSA) cohort. Osteoarthritis Cartilage 2017; 25:1414-1419. [PMID: 28445775 DOI: 10.1016/j.joca.2017.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 04/12/2017] [Accepted: 04/18/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the prevalence and change in social isolation and loneliness in people before and after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in England. DESIGN The English Longitudinal Study of Ageing (ELSA) dataset, a prospective study of community-dwelling older adults, was used to identify people who had undergone primary THA or TKA because of osteoarthritis. Social isolation was assessed using the ELSA Social Isolation Index. Loneliness was evaluated using the Revised University of California, Los Angeles (UCLA) Loneliness Scale. The prevalence of social isolation and loneliness were calculated and multilevel modelling was performed to assess the potential change of these measures before arthroplasty, within a two-year operative-recovery phase and a following two-year follow-up. RESULTS The sample consisted of 393 people following THA and TKA. The prevalence of social isolation and loneliness changed from 16.9% to 18.8% pre-operative to 21.8% and 18.9% at the final post-operative follow-up respectively. This was not a statistically significant change for either measure (P = 0.15; P = 0.74). There was a significant difference in social isolation at the recovery phase compared to the pre-operative phase (P = 0.01), where people following arthroplasty reported an increase in social isolation (16.9-21.4%). There was no significant difference between the assessment phases in respect to UCLA Loneliness Scale score (P ≥ 0.74). CONCLUSIONS Given the negative physical and psychological consequences which social isolation and loneliness can have on individuals following THA or TKA, clinicians should be mindful of this health challenge for this population. The reported prevalence of social isolation and loneliness suggests this is an important issue.
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Affiliation(s)
- T O Smith
- School of Health Sciences, University of East Anglia, Norwich, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK.
| | - J R Dainty
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - A J MacGregor
- Norwich Medical School, University of East Anglia, Norwich, UK
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Beasley MJ, Macfarlane TV, Macfarlane GJ. Is alcohol consumption related to likelihood of reporting chronic widespread pain in people with stable consumption? Results from UK biobank. Pain 2016; 157:2552-60. [DOI: 10.1097/j.pain.0000000000000675] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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