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Musculoskeletal chronic pain in general practice: studies of health care utilisation in comparison with pain prevalence
Department of Community Medicine, Lund University.ORCID iD: 0000-0001-9283-5096
Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Människa - Hälsa - Samhälle (MHS).
Department of Medicine, Rheumatology section, Central Hospital, Kristianstad.
Department of Community Medicine, Lund University.
1999 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 17, no 2, p. 87-92Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To study the relations between population prevalence of chronic pain and pain-related diagnoses (musculoskeletal and headaches) in primary health care (PHC) and to examine longitudinal variations in these diagnoses. DESIGN: A population-based mailed survey to catch prevalence data and continuous computerised diagnosis registration in PHC. SETTING: General population in a well-defined Swedish PHC district. SUBJECTS: A random sample of 15% of the population aged 25-74, n = 1101. Annual visitors to district physicians at the health centre. MAIN OUTCOME MEASURES: Rates of pain-related diagnoses in PHC in relation to population prevalence of chronic pain. Comparisons of the number of individuals (annual visiting rates) with pain-related diagnoses 1987-1996. RESULTS: Population pain prevalence and pain-related diagnoses in PHC corresponded as regards the magnitude and distribution of chronic pain by age and partly by pain location. Compared to low-back and widespread pain, neck-shoulder pain and headaches were less frequent in PHC in relation to reported prevalence. From 1987 to 1996 we found an increasing number of individuals seeking primary care with pain-related diagnoses. The increase was mainly assigned to the groups of fibrositis/myalgia and headache. CONCLUSION: Pain-related diagnoses in PHC reflect partly the occurrence of self-reported chronic pain symptoms in the population. The observed increase in visits with pain-related diagnoses in the last 10 years is due to an increased number of individuals with soft-tissue rheumatism and headaches. Future studies will have to elucidate whether these findings are due to an increase in morbidity or changes in care-seeking and social conditions.

Place, publisher, year, edition, pages
1999. Vol. 17, no 2, p. 87-92
Keywords [en]
chronic pain, primary care, visits
National Category
General Practice Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hkr:diva-966DOI: 10.1080/028134399750002700ISI: 000081708600007PubMedID: 10439491OAI: oai:DiVA.org:hkr-966DiVA, id: diva2:224974
Available from: 2009-06-23 Created: 2009-06-23 Last updated: 2018-01-13Bibliographically approved
In thesis
1. Chronic pain: epidemiological studies in a general population
Open this publication in new window or tab >>Chronic pain: epidemiological studies in a general population
1998 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim was to study the epidemiology of chronic pain (> 3 months duration) and factors associated to pain prevalence, prognosis, health care and medication in a general population. A cross-sectional mailed survey to a random population sample (n = 1806) was followed by a clinical examination and a prospective study of three selected groups. Pain related diagnoses from primary health care was monitored and compared with pain prevalence. The most important findings were: - a high total prevalence of chronic pain, 55.2%, without gender difference but varying by age and socioeconomic level. About one fourth (12.8%) reported high pain intensity and functional impairments. Women experienced pain at more locations and with higher intensity. - in a multivariate analysis increasing age, female gender, low education, high work strain, depression and insomnia were associated with chronic pain. - widespread pain showed a worse 2- year prognosis compared with neck shoulder pain. - musculoskeletal location of pain dominated, myalgia and myofascial pain being the most common symptom descriptions. - co-morbidity with chronic pain was common. More hypertensives and an increased level of serum uric acid associated to widepread pain indicated possible metabolic connections to pain. - smoking (current and previous) was associated with low-back and widespread pain. - chronic pain had a substantial influence of primary health care-seeking and medication; high pain intensity being the most important predictor of care and medication. - pain related diagnoses in primary health care increased between 1987 and 1996. Chronic pain, mainly with musculoskeletal location, is a community health problem. A multi-factorial approach in prevention and treatment on the basis of present knowledge is necessary.

Place, publisher, year, edition, pages
Lund: Univ., 1998. p. 142
Keywords
chronic pain, epidemiology, health care
National Category
Public Health, Global Health, Social Medicine and Epidemiology Medical and Health Sciences
Identifiers
urn:nbn:se:hkr:diva-968 (URN)91-628-2935-1 (ISBN)
Public defence
1998-04-29, Segerfalksalen, Wallenberg Neuro Centre, Lunds Universitet, Lund, 09:00 (Swedish)
Opponent
Supervisors
Note

ISRN LUMEDW/MECH-1025-SE

Available from: 2009-06-24 Created: 2009-06-23 Last updated: 2014-01-15Bibliographically approved

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Andersson, H. IngemarEjlertsson, Göran

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