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Chronic widespread bodily pain is increased among individuals with history of fracture: findings from UK Biobank

Chronic widespread bodily pain is increased among individuals with history of fracture: findings from UK Biobank
Chronic widespread bodily pain is increased among individuals with history of fracture: findings from UK Biobank
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 questions: “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), 7,130 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% 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.
epidemiology, chronic widespread pain, fracture, uk biobank, stressors
1862-3522
1-21
Walker-Bone, K.
ad7d1336-ed2c-4f39-ade5-da84eb412109
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Ntani, G.
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Tinati, T.
cd5da855-0c1a-4831-bd3d-6baeafa3ae07
Jones, G.T.
38fb956f-a1fc-4ae5-a589-75927f458a7d
Smith, B.H.
b79cbf7a-bf48-4d40-8d4f-630c78771458
Macfarlane, G.J.
332acabb-a9cf-4434-b375-c8dd3a659e9f
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Walker-Bone, K.
ad7d1336-ed2c-4f39-ade5-da84eb412109
Harvey, N.C.
ce487fb4-d360-4aac-9d17-9466d6cba145
Ntani, G.
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Tinati, T.
cd5da855-0c1a-4831-bd3d-6baeafa3ae07
Jones, G.T.
38fb956f-a1fc-4ae5-a589-75927f458a7d
Smith, B.H.
b79cbf7a-bf48-4d40-8d4f-630c78771458
Macfarlane, G.J.
332acabb-a9cf-4434-b375-c8dd3a659e9f
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6

Walker-Bone, K., Harvey, N.C., Ntani, G., Tinati, T., Jones, G.T., Smith, B.H., Macfarlane, G.J. and Cooper, C. (2016) Chronic widespread bodily pain is increased among individuals with history of fracture: findings from UK Biobank. Archives of Osteoporosis, 11 (1), 1-21. (doi:10.1007/s11657-015-0252-1).

Record type: Article

Abstract

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 questions: “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), 7,130 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% 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.

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CWP and fracture manuscript 14112015 R1.docx - Accepted Manuscript
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Walker-Bone 2015 Article Chronic Widespread Bodily Pain - Version of Record
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UKB pain fracture Figure 1 - Other
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More information

Accepted/In Press date: 1 December 2015
e-pub ahead of print date: 17 December 2015
Published date: December 2016
Keywords: epidemiology, chronic widespread pain, fracture, uk biobank, stressors
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 384760
URI: http://eprints.soton.ac.uk/id/eprint/384760
ISSN: 1862-3522
PURE UUID: 9cfa2ead-d546-4712-882d-18a992619337
ORCID for K. Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459
ORCID for N.C. Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

Catalogue record

Date deposited: 14 Dec 2015 16:20
Last modified: 17 Dec 2019 01:57

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