Tuesday, October 15, 2019

Trajectories of multisite musculoskeletal pain in midlife: Associations with common mental disorders

Abstract

Objectives

We examined developmental trajectories of multisite musculoskeletal pain in midlife, and their associations with mental well‐being.

Methods

Midlife municipal employees at baseline aged 40, 45, 50, 55 or 60 years (80% women) from the City of Helsinki, Finland, responded to a baseline questionnaire in 2000‐02 (N=8960; response rate 67%) and follow‐ups in 2007 (N=7332; 83%) and 2012 (N=6809; 78%). Trajectories of the number of pain sites (0‐4) were modeled using latent class growth analysis (n=6527). Common mental disorders were assessed by the General Health Questionnaire (GHQ) 12‐item version (trichotomized to low, intermediate or high). Information on health‐related behaviour, co‐morbidity and socioeconomic position was obtained from the questionnaire. Associations of baseline factors with pain trajectories were assessed by multinomial logistic regression.

Results

We identified four distinct pain trajectories: high (15%), increasing (24%), decreasing (20%) and low (41%). After an initial increase, the high and increasing trajectories stabilized at around 2.5 and 1.5 pain sites, respectively. In a multivariable model, high, increasing and decreasing trajectories of pain sites were associated with higher baseline GHQ scores. The association was strongest for the high trajectory (low GHQ: OR 3.7, 95% CI 2.8‐4.9; high GHQ: OR 5.4, 95% 4.4‐6.6). Trajectory membership also associated with unhealthy behaviours, musculoskeletal comorbidities and a low socioeconomic position at baseline. Average GHQ was consistently highest for the high pain trajectory and decreased in the decreasing trajectory over the follow‐up.

Conclusions

Multisite musculoskeletal pain shows variable developmental patterns among midlife employees. The trajectories are associated with the level of common mental disorders.



from Wiley: European Journal of Pain: Table of Contents https://ift.tt/2IWLczE
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