Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Sep;154(9):1769-1777.
doi: 10.1016/j.pain.2013.05.039. Epub 2013 May 29.

Patterns of multisite pain and associations with risk factors

David Coggon  1 , Georgia Ntani, Keith T Palmer, Vanda E Felli, Raul Harari, Lope H Barrero, Sarah A Felknor, David Gimeno, Anna Cattrell, Sergio Vargas-Prada, Matteo Bonzini, Eleni Solidaki, Eda Merisalu, Rima R Habib, Farideh Sadeghian, M Masood Kadir, Sudath S P Warnakulasuriya, Ko Matsudaira, Busisiwe Nyantumbu, Malcolm R Sim, Helen Harcombe, Ken Cox, Maria H Marziale, Leila M Sarquis, Florencia Harari, Rocio Freire, Natalia Harari, Magda V Monroy, Leonardo A Quintana, Marianela Rojas, Eduardo J Salazar Vega, Clare E Harris, Consol Serra, Miguel J Martinez, George Delclos, Fernando G Benavides, Michele Carugno, Marco M Ferrario, Angela C Pesatori, Leda Chatzi, Panos Bitsios, Manolis Kogevinas, Kristel Oha, Tuuli Sirk, Ali Sadeghian, Roshini J Peiris-John, Nalini Sathiakumar, Rajitha A Wickremasinghe, Noriko Yoshimura, Helen L Kelsall, Victor C W Hoe, Donna M Urquhart, Sarah Derrett, David McBride, Peter Herbison, Andrew Gray
Affiliations

Patterns of multisite pain and associations with risk factors

David Coggon et al. Pain. 2013 Sep.

Abstract

To explore definitions for multisite pain, and compare associations with risk factors for different patterns of musculoskeletal pain, we analysed cross-sectional data from the Cultural and Psychosocial Influences on Disability (CUPID) study. The study sample comprised 12,410 adults aged 20-59 years from 47 occupational groups in 18 countries. A standardised questionnaire was used to collect information about pain in the past month at each of 10 anatomical sites, and about potential risk factors. Associations with pain outcomes were assessed by Poisson regression, and characterised by prevalence rate ratios (PRRs). Extensive pain, affecting 6-10 anatomical sites, was reported much more frequently than would be expected if the occurrence of pain at each site were independent (674 participants vs 41.9 expected). In comparison with pain involving only 1-3 sites, it showed much stronger associations (relative to no pain) with risk factors such as female sex (PRR 1.6 vs 1.1), older age (PRR 2.6 vs 1.1), somatising tendency (PRR 4.6 vs 1.3), and exposure to multiple physically stressing occupational activities (PRR 5.0 vs 1.4). After adjustment for number of sites with pain, these risk factors showed no additional association with a distribution of pain that was widespread according to the frequently used American College of Rheumatology criteria. Our analysis supports the classification of pain at multiple anatomical sites simply by the number of sites affected, and suggests that extensive pain differs importantly in its associations with risk factors from pain that is limited to only a small number of anatomical sites.

Keywords: Definition; Multisite; Pain; Risk factors; Widespread.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Risk of extensive and limited pain by occupational group.
See this image and copyright information in PMC

References

    1. Cho N.H., Kim I., Lim H.S., Kim H.A. Prevalence of widespread pain and its influence on quality of life: population study in Korea. J Korean Med Sci. 2012;27:16–21. - PMC - PubMed
    1. Coggon D., Martyn C., Palmer K.T., Evanoff B. Assessing case definitions in the absence of a diagnostic gold standard. Int J Epidemiol. 2005;34:949–952. - PubMed
    1. Coggon D, Ntani G, Palmer KT, Felli VE, Harari R, Barrero LH, Felknor SA, Gimeno D, Cattrell A, Serra C, Bonzini M, Solidaki E, Merisalu E, Habib RR, Sadeghian F, Kadir M, Warnakulasuriya SSP, Matsudaira K, Nyantumbu B, Sim MR, Harcombe H; and other members of the CUPID Collaboration. The CUPID (Cultural and Psycosocial Influences on Disability) study: methods of data collection and characteristics of study sample. PLos One 2012;7:e39820. - PMC - PubMed
    1. Coggon D., Ntani G., Palmer K.T., Felli V.E., Harari R., Barrero L.H., Felknor S.A., Gimeno D., Cattrell A., Serra C., Bonzini M., Solidaki E., Merisalu E., Habib R.R., Sadeghian F., Masood Kadir M., Warnakulasuriya S.S., Matsudaira K., Nyantumbu B., Sim M.R., Harcombe H., Cox K., Marziale M.H., Sarquis L.M., Harari F., Freire R., Harari N., Monroy M.V., Quintana L.A., Rojas M., Salazar Vega E.J., Harris E.C., Vargas-Prada S., Martinez J.M., Delclos G., Benavides F.G., Carugno M., Ferrario M.M., Pesatori A.C., Chatzi L., Bitsios P., Kogevinas M., Oha K., Sirk T., Sadeghian A., Peiris-John R.J., Sathiakumar N., Wickremasinghe A.R., Yoshimura N., Kelsall H.L., Hoe V.C., Urquhart D.M., Derrett S., McBride D., Herbison P., Gray A. Disabling musculoskeletal pain in working populations: is it the job, the person or the culture? PAIN®. 2013;154:856–863. - PMC - PubMed
    1. Coggon D, Ntani G, Vargas-Prada S, Martinez JM, Serra C, Benavides FG, Palmer KT; and other members of the CUPID collaboration. International variation in absence from work attributed to musculoskeletal illness: findings from the CUPID study. Occup Environ Med 2013 [Epub ahead of print]. - PMC - PubMed

Publication types