Impact of pain severity and location on health-related quality of life.

Despite evidence that persistent pain affects well-being, little is known about the relationship of the location of pain to psychological and functional well-being. To determine whether patients with musculoskeletal disorders (MSD) are more likely to be depressed and functionally disabled compared to patients with pain at other sites, we conducted a secondary data analysis of the Medical Outcome Study--an observational study of adult outpatients with chronic medical conditions. Of the 3,360 patients who completed the baseline assessment, 1,237 (36.8%) had MSD and 2,123 (63.2%) had no MSD. Among patients in the MSD group, 84.5% reported > or = mild pain as compared to 70% in the no MSD. In multivariate analyses, MSD patients were more likely than non-MSD patients to be depressed (beta coefficient=-1.9, p=0.008) and functionally disabled (beta coefficient=-4.4, p<0.0001). However, the impact of MSD was eliminated after controlling for pain severity. Regardless of the location of pain, pain severity appears to be an important correlate of functional status, both mental and physical.