Musculoskeletal pain and quality of life in patients with noninflammatory joint pain compared to rheumatoid arthritis: a population survey

Abstract

Objective: To establish the prevalence of different types of noninflammatory musculoskeletal pain in the general population, to determine the sociodemographic characteristics of persons reporting such pain, and to compare the epidemiological features in a population setting between different types of noninflammatory musculoskeletal pain and patients with confirmed rheumatoid arthritis (RA).

Methods: A cross sectional postal survey of 20,000 (response rate 59%) randomly selected adults in 2 counties of Norway. Patients with RA were identified by a clinical and laboratory examination.

Results: The self-reported one month prevalence was 15.4% for noninflammatory neck pain, 21.6% for noninflammatory low back pain, and 17.0% for noninflammatory widespread pain. Neck pain was significantly associated to younger, lower educated, working, and married women; low back pain to higher educated and non-working men; and widespread pain to lower educated middle aged, divorced or widowed, and non-working women. Patients with RA and widespread pain experienced similar pain intensity, mental distress levels, problems with insomnia, and similar scores on global health satisfaction, whereas pain as well as reported health consequences were less pronounced in subjects with regional pain. Disability levels were highest in RA, followed by widespread pain, low back pain, and neck pain.

Conclusion: This population study supports the hypothesis of a continuum for most health related quality of life measures, starting with noninflammatory regional musculoskeletal pain and ending with multiple periarticular or inflammatory disease (widespread pain and RA). This study also shows that widespread pain and RA had similar health effect, except for levels of disability.