Ektor-Andersen John, Isacsson Sven-Olof, Lindgren Anna, Ørbæk Palle
Department of Community medicine, Lund University, Malmö University Hospital, S-205 02 Malmö, Sweden Multidisciplinary Pain Clinic, Malmö University Hospital, S-205 02 Malmö, Sweden Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden National Institute for Working Life, Stockholm, Sweden.
Pain. 1999 Sep;82(3):289-295. doi: 10.1016/S0304-3959(99)00053-6.
The present paper presents the relationship between the total body-pain (TBP) score, defined as the total number of areas shaded on a pain drawing, and the pain from one area, the Shoulder-Neck (SN), among subjects in or out of full-time gainful work respectively. Furthermore, relationships between pain-score, self-experienced health (SEH) and level of mental distress, measured with the General Health Questionnaire (GHQ) were investigated. The analyses is based on a general population sample of 8,116 men and women, 45-60 years of age, completing a questionnaire in the Malmö Shoulder Neck Study. The TBP-score was higher with increasing pain from the SN area, being out of full-time work and among women. Independently of working status, the SEH decreased with increasing pain in the SN area, which was enhanced, by increasing TBP-score. The proportion of women out of full-time gainful work was twice as high as for men. Women showed the same SEH levels with regard to their pain status, independently of their working status while men working full-time scored higher than women did. Oppositely, men out of full-time work had the lowest SEH in relation to their pain status. The GHQ scores of mental distress varied essentially in the same way as the SEH did. The results emphasize the need for an assessment of the number of pain locations and which one that first gave symptoms when studying possible causal relationships between low force musculoskeletal load and development of localized pain. If such data are not collected in epidemiological studies on causes for musculoskeletal pain it will at best lead to unnoticed effect modifications. At worst a potential confounding situation may occur. The relationship between the self-experienced health, mental distress and chronic pain identifies chronic pain as a major public-health problem and suggests a multidisciplinary approach in the treatment and rehabilitation already before work capacity is lost.
本文呈现了全身疼痛（TBP）评分（定义为疼痛图上阴影区域的总数）与分别处于全职有酬工作和非全职有酬工作的受试者中一个区域（肩颈，SN）的疼痛之间的关系。此外，还研究了疼痛评分、自我感知健康（SEH）与用一般健康问卷（GHQ）测量的心理困扰水平之间的关系。分析基于马尔默肩颈研究中8116名45至60岁的男性和女性的一般人群样本，这些人完成了一份问卷。随着SN区域疼痛加剧、处于非全职工作状态以及女性群体，TBP评分更高。与工作状态无关，SN区域疼痛加剧时SEH降低，且随着TBP评分增加这种降低更明显。非全职有酬工作的女性比例是男性的两倍。女性在疼痛状况方面表现出相同的SEH水平，与工作状态无关，而全职工作的男性得分高于女性。相反，非全职工作的男性在疼痛状况方面的SEH最低。心理困扰的GHQ评分变化方式与SEH基本相同。结果强调，在研究低强度肌肉骨骼负荷与局部疼痛发展之间可能的因果关系时，需要评估疼痛部位的数量以及首先出现症状的部位。如果在肌肉骨骼疼痛原因的流行病学研究中未收集此类数据，充其量会导致未被注意到的效应修正。最坏的情况可能会出现潜在的混杂情况。自我感知健康、心理困扰和慢性疼痛之间的关系将慢性疼痛确定为一个主要的公共卫生问题，并建议在工作能力丧失之前就采取多学科方法进行治疗和康复。
