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
. 2019 Jun 29;9(6):e031971.
doi: 10.1136/bmjopen-2019-031971.

Comorbid insomnia, psychological symptoms and widespread pain among patients suffering from musculoskeletal pain in general practice: a cross-sectional study

Louise Sørensen  1 , Morten Sig Ager Jensen  1 , Michael Skovdal Rathleff  1   2 , Sinead Holden  1   2
Affiliations

Comorbid insomnia, psychological symptoms and widespread pain among patients suffering from musculoskeletal pain in general practice: a cross-sectional study

Louise Sørensen et al. BMJ Open. .

Abstract

Objective: The aim of this study was to examine the association between musculoskeletal (MSK) pain, insomnia, anxiety and depressive symptoms in patients from general practice.

Design: This is a cross-sectional study.

Setting: This study was conducted in general practice in Denmark.

Participants: A consecutive sample of 390 general practice patients (aged 12 years or older) were included; 183 patients with MSK pain and 207 patients without MSK pain. To be included in the MSK pain group, participants with MSK pain were required to report MSK pain at least weekly during the preceding month, which had a negative impact on daily activities.

Primary and secondary outcomes measures: The primary outcome was insomnia evaluated by the Athens Insomnia Scale. The secondary outcomes were psychological symptoms assessed by the Hospital Anxiety and Depression Scale.

Results: Patients with MSK pain had a significantly higher prevalence of insomnia (difference 25.5%, p<0.0001), anxiety (difference 24.3%, p<0.0001) and depressive symptoms (difference 11%, p<0.0001) compared with patients without MSK pain. Furthermore, patients with MSK pain and comorbid insomnia had significantly higher levels of anxiety and symptoms of depression compared with patients with MSK pain without insomnia (p<0.0001). These relationships remained robust when controlling for age, sex and body mass index in linear regression.

Conclusion: One in two patients in general practice report MSK pain. Comorbid MSK pain and insomnia are common and are associated with a higher prevalence of anxiety and depression. This highlights the importance of establishing the presence of insomnia and affective disorders as potentially modifiable factors during treatment of MSK pain in general practice.

Keywords: family practice; musculoskeletal disorders; pain; sleep medicine.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

References

    1. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1211–59. 10.1016/S0140-6736(17)32154-2 - DOI - PMC - PubMed
    1. Flaschs EM, Eriksen L, Koch MB, et al. . Sygdomsbyrden i Danmark - sygdomme. København: Sundhedsstyrelsen, 2015:384.
    1. Jordan KP, Kadam UT, Hayward R, et al. . Annual consultation prevalence of regional musculoskeletal problems in primary care: an observational study. BMC Musculoskelet Disord 2010;11:144 10.1186/1471-2474-11-144 - DOI - PMC - PubMed
    1. Breivik H, Collett B, Ventafridda V, et al. . Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 2006;10:287–333. 10.1016/j.ejpain.2005.06.009 - DOI - PubMed
    1. Simon GE, VonKorff M. Prevalence, burden, and treatment of insomnia in primary care. Am J Psychiatry 1997;154:1417–23. 10.1176/ajp.154.10.1417 - DOI - PubMed

Publication types

LinkOut - more resources