2Epidemiology of chronic musculoskeletal pain
Section snippets
Prevalence or incidence?
Before describing the epidemiology of chronic musculoskeletal pain, it is useful to briefly consider the different measures that are used to report rates. Musculoskeletal pain is difficult to accurately measure and study. While shoulder, low back and chronic widespread pain are common (see below), these symptoms often have a poorly defined onset. The first ever episode may have occurred early in childhood, the timing of which is difficult to recall – indeed, the best predictor of a new episode
The prevalence of musculoskeletal pain
There is a paucity of data on the rate of musculoskeletal pain in adolescents. Table 1, Table 2 summarize the results of those studies available. It is clear that the reported prevalence of pain differs markedly between studies. For example, reports of low back pain range from 8%3 to 44%4, while the prevalence of chronic widespread pain has been reported to lie between 1%5 and 15%.6 These differences in reports of pain prevalence are, at least in part, a consequence of the different definitions
Age and gender
Studies of pain in children and adolescents have found that the prevalence of musculoskeletal pain increases with age and is particularly prevalent amongst adolescents.33 A 4-year prospective study reported that the occurrence of new-onset low back pain increased with age from 12.5% in subjects aged 12 years to 24.1% in those aged 15 years.8 A study examining the prevalence of chronic pain (regardless of location) in children and adolescents (age birth to 18 years) reported that prevalence
Conclusion
The prevalence of musculoskeletal pain varies greatly across studies. This is probably due to a number of factors, including the different definitions of pain used. There are also a number of measurement issues which make it difficult to draw comparisons. Many of the studies examining pain in adolescents have only examined the occurrence/non-occurrence of pain, and have not examined duration, frequency or intensity. Furthermore, the majority of epidemiological studies of musculoskeletal pain
Acknowledgements
We would like to thank Barbara Nicholl for her help preparing the tables.
References (119)
- et al.
Classroom posture and self-reported back and neck pain in schoolchildren
Applied Ergonomics
(2004 Mar) - et al.
The prevalence of pain in a general population. The results of a postal survey in a county of Sweden
Pain
(1989 May) Epidemiological features of chronic low-back pain
Lancet
(1999)- et al.
Pain in children and adolescents: a common experience
Pain
(2000) - et al.
Gender differences in pressure pain threshold in healthy humans
Pain
(2003 Mar) - et al.
Women, work and musculoskeletal health
Social Science and Medicine
(2004 Mar) Relationships between physical symptoms and pubertal development
Journal of Pediatric Health Care
(2005)Comment on: Johns and Littlejohn, The role of sex hormones in pain response
Pain
(2000)Racial/ethnic differences in adolescents' physical symptoms
Journal of Pediatric Nursing
(2005 Jun)- et al.
Educational achievement and pain disability among women with chronic pelvic pain
Journal of Psychosomatic Research
(2001)
Population-based survey of pain in the United States: Differences among White, African American, and Hispanicsubjects
The Journal of Pain
Socio-economic differences in the prevalence of acute, chronic and disabling chronic pain among ageing employees
Pain
Epidemiologic evidence for the relation between socioeconomic status and depression, obesity, and diabetes
Journal of Psychosomatic Research
Illness perceptions and mood in chronic fatigue syndrome
Journal of Psychosomatic Research
Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches
Journal of the American Academy of Child and Adolescent Psychiatry
Comorbidity of pain problems and depressive symptoms in young women: results from a cross-sectional survey among women aged 15-24 in Hungary
European Journal of Pain: Ejp
Chronic pain syndromes and their relation to childhood abuse and stressful life events
Journal of Psychosomatic Research
Primary fibromyalgia (fibrositis): Clinical study of 50 patients with matched normal controls
Seminars in Arthritis and Rheumatism
Prospective study on the relationship between depressive symptoms and chronic musculoskeletal pain
Pain
Pain and musculoskeletal pain syndromes in adolescents
The Journal of Adolescent Health
Schoolbag weight and musculoskeletal symptoms in New Zealand secondary schools
Applied Ergonomics
Non-specific musculoskeletal pain in preadolescents. Prevalence and 1-year persistence
Pain
Prognosis of non-specific musculoskeletal pain in preadolescents: a prospective 4-year follow-up study till adolescence
Pain
The American College of Rheumatology 1990 Criteria for the Classification of fibromyalgia
Arthritis and Rheumatism
Predicting who develops chronic low back pain in primary care: a prospective study
British Medical Journal
Neck/shoulder, low back, and arm pain in relation to computer use, physical activity, stress, and depression among Dutch adolescents
Pediatrics
Prevalence of fibromyalgia in children: A clinical study of Mexican children
Journal of Rheumatology
Predicting the onset of widespread body pain among children
Arthritis and Rheumatism
Self-reported bodily pain in schoolchildren
Scandinavian Journal of Rheumatology
Predictors of low back pain in British schoolchildren: a population-based prospective cohort study
Pediatrics
Prevalence of shoulder pain in the community: the influence of case definition
Annals of the Rheumatic Diseases
Shoulder joint impairment among Finns aged 30 years or over: prevalence, risk factors and co-morbidity
Rheumatology (Oxford)
The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults
Spine
Prevalence of low back pain in the community: implications for service provision in Bradford, UK
Journal of Epidemiology and Community Health
Prevalence of low back pain and sickness absence: a ‘borderline’ study in Norway and Sweden
Scandinavian Journal of Public Health
Fibromyalgia in the adult Danish population: 1. A prevalence study
Scandinavian Journal of Rheumatology
The prevalence of fibromyalgia among women aged 20-49 years in Arendal, Norway
Scandinavian Journal of Rheumatology
The prevalence of chronic widespread pain in the general population
Journal of Rheumatology
The prevalence and characteristics of fibromyalgia in the general population
Arthritis and Rheumatism
Elements of fibromyalgia in an open population
Rheumatology (Oxford)
The incidence of fibromyalgia and its associated comorbidities: a population-based retrospective cohort study based on International Classification of Diseases, 9th Revision codes
Journal of Clinical Rheumatology
Features of somatization predict the onset of chronic widespread pain: results of a large population-based study
Arthritis and Rheumatism
Neck-and-shoulder pain, an increasing problem. Strategies for using insurance material to follow trends
Scandinavian Journal of Rehabilitation Medicine
Is back pain increasing? Results from national surveys in Finland during 1978/9-1992
Scandinavian Journal of Rheumatology
Trends of back pain in Eastern Finland, 1972-1992, in Relation to Socioeconomic status and behavioural risk factors
American Journal of Epidemiology
Health Needs Assessment for Musculoskeletal disease: the first step - estimating the number of incident and prevalence cases
Back pain in Britain: comparison of two prevalence surveys at an interval of 10 years
British Medical Journal
Life is as much a pain as it ever was
British Medical Journal
The prevalence and associated features of chronic widespread pain in the community using the ‘Manchester’ definition of chronic widespread pain
Rheumatology (Oxford)
Cited by (465)
Evaluation of the segmental distribution of pain sensitivity among patients with central sensitization associated with chronic subacromial pain syndrome: A cross-sectional study
2024, Journal of Bodywork and Movement TherapiesCervical sensitivity, range of motion and strength in individuals with shoulder pain: A cross-sectional case control study
2023, Musculoskeletal Science and PracticeWidespread Proprioceptive Acuity Impairment in Chronic Back Pain: A Cross-sectional Study
2023, Archives of Physical Medicine and RehabilitationSex, gender, and pain
2023, Principles of Gender-Specific Medicine: Sex and Gender-Specific Biology in the Postgenomic Era