Prevalence, incidence, and re-occurrence risk of musculoskeletal pain in older adults in the United Kingdom: a population-based study

Abstract

Background: Throughout the literature, pain burden has been assessed by asking different questions, often cross-sectionally, different populations of interest. We know little about pain re-occurrence and how to translate knowledge between pain questions within the population of interest. We aimed to estimate the burden of musculoskeletal pain by estimating prevalence, incidence rates, and re-occurrence risk of back, hand, hip, knee, and foot pain using different questions from UK population-based samples and predict the number of affected individuals in the UK in 2030.

Methods: We used two UK population-representative studies, with two eight-year-apart follow-ups and two pain questions assessing recent pain episodes and often troubled pain when walking. We estimated prevalence, 8-year incidence rates, and 8-year pain re-occurrence risk for women and men aged 50 years and older and the relation between the two pain questions.

Results: Among UK individuals older than 50 years, the prevalence of musculoskeletal pain episode was 20%-50%, and the incidence was 20-40/1,000 person-years, while the prevalence of pain when walking was 10%-25%, and the incidence was 6-12/1,000 person-years. The most prevalent musculoskeletal pain types were back and knee pain; of five women experiencing back or knee pain episodes, three are expected to be often troubled by pain. Hip and foot pain had similar estimates in both questions. Hand pain peaked in women aged 50-65 years. Women had higher prevalence and incidence rates, but men had higher 8-year re-occurrence risk of all types of musculoskeletal pain. Reporting a pain episode was associated with two times higher risk, but often troubled by pain when walking was associated with four to seven times times higher risk of the same pain in 8 years. Women and men with a body mass index (BMI) of ≥27 kg/m² were twice as likely to experience musculoskeletal pain than those with BMI<27 kg/m². In 2030, we expect 2-7 million people older than 50 years in the United Kingdom to seek site-specific musculoskeletal pain-focused healthcare.

Conclusions: In individuals older than 50 years, the experience of musculoskeletal pain at least doubles the chance of experiencing it again. Women report musculoskeletal pain more often, but men report more persistent pain. Musculoskeletal pain presents a significant burden to public health.

Keywords: body mass index; incidence rate; musculoskeletal pain; prevalence; re-occurrence; relative risk.

Figure 1

The study flowchart.

Figure 2

The prevalence of musculoskeletal pain per age and body mass index groups. (A–C) The prevalence of musculoskeletal pain episodes in women (the Chingford study) and often troubled by pain when walking in women and men (the ELSA study) per age groups (<50, 50–65, 65–80, ≥80 years) in 1989, 1996, 2004, and 2012; (D−F) The prevalence of musculoskeletal pain episode in women (the Chingford study) and often troubled by pain when walking in women and men (the ELSA study) per body mass index groups (normal weight: 18.5–25 kg/m², overweight: 25–30 kg/m², and obese: ≥30 kg/m²) in 1989, 1996, 2004, and 2012; the percentages of underweight (<18.5 kg/m²) participants were <1%, and the estimates were not shown in this group.