Summary: In this cross-sectional analysis of the UK Biobank cohort, a history of fracture was associated with increased risk of current widespread chronic pain. Purpose/Introduction: We aimed to test the hypothesis that a history of fracture is associated with reporting chronic widespread bodily pain (CWBP), using baseline data from the UK Biobank cohort, comprising 502,656 people aged 40 69 years.
Methods: The case definition of current chronic widespread bodily pain was based on a response of yes to the question do you have pain all over the body? and yes to and have you experienced pain all over the body for more than 3 months? Multivariable Poisson regression with robust standard errors was used to test the relationship between fracture (occurring within 5 years prior to the baseline interview, and recorded by self-report) at the spine, hip, upper limb or lower limb and CWBP, adjusting for confounders.
Results: Of 501,733 participants (mean age 56.5 years), 7130 individuals reported CWBP and 23,177 had a history of fracture affecting the upper limb, lower limb, spine and/or hip. Individuals with prior fracture were significantly more likely to report CWBP than those without. After adjustment for potential risk factors (age, gender, demographic, lifestyle and socioeconomic, and psychological), risk ratios were attenuated but remained statistically significant with a more than doubling of risk for CWBP with spine fractures in men (risk ratio (RR) 2.67, 95 % confidence interval (CI) 1.66 4.31; p?<?0.001) and women (RR 2.13, 95 % CI 1.35 3.37, p?=?0.001) and with hip fractures in women (RR 2.19, 95 % CI 1.33 3.59; p?=?0.002).
Conclusions: In this cross-sectional analysis, previous fracture is associated with an increased likelihood of chronic widespread bodily pain, particularly with hip fractures in women, and spine fractures in both sexes. If replicated, these findings may help inform the identification of those most at risk of chronic widespread pain post-fracture, allowing preventative measures to be targeted.
Walker-Bone, K., Harvey, N.C., Ntani, G. et al. Chronic widespread bodily pain is increased among individuals with history of fracture: findings from UK Biobank Arch Osteoporos (2016) 11: 1. doi:10.1007/s11657-015-0252-1
Epidemiology of chronic pain
The background to this project is to examine the descriptive epidemiology of chronic pain in the UK Biobank sample. To determine whether the prevalence of regional and widespread pain, which has been well documented across several large population studies, can be replicated in this more highly selected sample participating in UK Biobank.
This project will investigate the epidemiology of chronic pain. It will determine:
* how common pain is at individual sites throughout the body as well as "widespread body pain"
*the factors associated with the reporting of pain including demographic (age, sex, socioeconomic status), lifestyle factors (smoking , alcohol, physical activity)
*other health related factors reported with pain (e.g. fatigue and mood disorders)
*whether persons who report pain also report markers of poor cardiovascular (heart) and respiratory (lung) health and whether their lifestyle puts them at an increased risk of cancer.
*the relationship between reporting of pain and history of falls and fractures.
Walker-Bone, K., Harvey, N.C., Ntani, G. et al. Chronic widespread bodily pain is increased among individuals with history of fracture: findings from UK Biobank, Arch Osteoporos (2016) 11: 1. doi:10.1007/s11657-015-0252-1
Macfarlane TV, Beasley M, Macfarlane GJ. Self-Reported Facial Pain in UK Biobank Study: Prevalence and Associated Factors. J Oral Maxillofac Res. 2014 Oct 1;5(3):e2. doi:10.5037/jomr.2014.5302.
Beasley, Marcus J.; Macfarlane, Tatiana V.; Macfarlane, Gary J. Is alcohol consumption related to likelihood of reporting chronic widespread pain in people with stable consumption? Results from UK biobank, PAIN: November 2016 - Volume 157 - Issue 11 - p 2552-2560 doi: 10.1097/j.pain.0000000000000675
Macfarlane GJ, Barnish MS, Jones GT. Persons with chronic widespread pain experience excess mortality: longitudinal results from UK Biobank and meta-analysisAnnals of the Rheumatic Diseases 2017;76:1815-1822. doi:10.1136/annrheumdis-2017-211476
|Lead investigator:||Gary Macfarlane|
|Lead institution:||University of Aberdeen|