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The anatomical pattern and determinants of pain in the neck and upper limbs: an epidemiologic study

The anatomical pattern and determinants of pain in the neck and upper limbs: an epidemiologic study
The anatomical pattern and determinants of pain in the neck and upper limbs: an epidemiologic study
Little is known about the distribution and determinants of pain at multiple sites in the neck and upper limb. To investigate the prevalence, pattern, and clustering of such pains and the association of extensive involvement with putative risk factors, we mailed a questionnaire to a community sample of 9696 working-aged adults. Age–sex specific prevalence rates for pain were estimated and the frequency of bilateral involvement, pairwise overlap at different sites, and extent to which reports clustered within individuals were explored. Associations of multi-site involvement with age, gender, psychological health, smoking, and employment status were assessed by logistic regression. Among 6038 responders, 2657 reported at least a day of neck or upper limb pain in the past 7 days, including 1843 whose symptoms rendered normal activities difficult or impossible. Pain was frequently bilateral or in the dominant arm. Significant associations were seen for pain at anatomically adjacent sites. Pain affecting every site considered (neck, shoulders, elbows, wrists/hands) was far more common than might be expected if each site were statistically independent (observed/expected ratio 8750). Being female, unemployed, a blue-collar worker, or a smoker were independent risk factors for such extensive pain, but the strongest association was with psychological ill-health (odds ratio for worst vs. best third of the SF-36 low vitality score, 30.3, 95% CI 7.1–129.0). Neck and upper limb pain commonly cluster, and frequently display symmetry and adjacent patterns of involvement. Extensive neck and upper limb pain is far more strongly associated with poor mental vitality than localised pain.

neck and upper limb pain, epidemiology, risk factors
0304-3959
45-51
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Reading, Isabel
6f832276-87b7-4a76-a9ed-b4b3df0a3f66
Coggon, David
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Palmer, Keith T.
0cfe63f0-1d33-40ff-ae8c-6c33601df850
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
Reading, Isabel
6f832276-87b7-4a76-a9ed-b4b3df0a3f66
Coggon, David
2b43ce0a-cc61-4d86-b15d-794208ffa5d3
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Palmer, Keith T.
0cfe63f0-1d33-40ff-ae8c-6c33601df850

Walker-Bone, Karen, Reading, Isabel, Coggon, David, Cooper, Cyrus and Palmer, Keith T. (2004) The anatomical pattern and determinants of pain in the neck and upper limbs: an epidemiologic study. Pain, 109 (1-2), 45-51. (doi:10.1016/j.pain.2004.01.008).

Record type: Article

Abstract

Little is known about the distribution and determinants of pain at multiple sites in the neck and upper limb. To investigate the prevalence, pattern, and clustering of such pains and the association of extensive involvement with putative risk factors, we mailed a questionnaire to a community sample of 9696 working-aged adults. Age–sex specific prevalence rates for pain were estimated and the frequency of bilateral involvement, pairwise overlap at different sites, and extent to which reports clustered within individuals were explored. Associations of multi-site involvement with age, gender, psychological health, smoking, and employment status were assessed by logistic regression. Among 6038 responders, 2657 reported at least a day of neck or upper limb pain in the past 7 days, including 1843 whose symptoms rendered normal activities difficult or impossible. Pain was frequently bilateral or in the dominant arm. Significant associations were seen for pain at anatomically adjacent sites. Pain affecting every site considered (neck, shoulders, elbows, wrists/hands) was far more common than might be expected if each site were statistically independent (observed/expected ratio 8750). Being female, unemployed, a blue-collar worker, or a smoker were independent risk factors for such extensive pain, but the strongest association was with psychological ill-health (odds ratio for worst vs. best third of the SF-36 low vitality score, 30.3, 95% CI 7.1–129.0). Neck and upper limb pain commonly cluster, and frequently display symmetry and adjacent patterns of involvement. Extensive neck and upper limb pain is far more strongly associated with poor mental vitality than localised pain.

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More information

Published date: May 2004
Keywords: neck and upper limb pain, epidemiology, risk factors

Identifiers

Local EPrints ID: 24544
URI: http://eprints.soton.ac.uk/id/eprint/24544
ISSN: 0304-3959
PURE UUID: 22a954ca-860f-4cf3-b074-5edfdb653516
ORCID for Karen Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459
ORCID for Isabel Reading: ORCID iD orcid.org/0000-0002-1457-6532
ORCID for David Coggon: ORCID iD orcid.org/0000-0003-1930-3987
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 30 Mar 2006
Last modified: 18 Mar 2024 02:51

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Contributors

Author: Isabel Reading ORCID iD
Author: David Coggon ORCID iD
Author: Cyrus Cooper ORCID iD
Author: Keith T. Palmer

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