de Luca Katie, Wong Arnold, Eklund Andreas, Fernandez Matthew, Byles Julie Ellen, Parkinson Lynne, Ferreira Manuela Loureiro, Hartvigsen Jan
1Research Centre for Generational Health and Ageing, University of Newcastle, Callaghan, NSW Australia.
2Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, NSW 2109 Australia.
Chiropr Man Therap. 2019 Feb 12;27:8. doi: 10.1186/s12998-018-0224-9. eCollection 2019.
Musculoskeletal pain frequently occurs in more than one body region, with up to 80% of adults reporting more than one joint pain site in the last 12 months. Older people and females are known to be more susceptible to multiple joint pain sites, however the association of multisite joint pain with physical and psychosocial functions in this population are unknown.
Cross-sectional data from 579 women were analyzed. Women were asked "Which of your joints have been troublesome on most days of the past month?" Pain qualities were measured using the McGill Pain Questionnaire (Short Form) and PainDETECT, and health was assessed using the SF-36 and sociodemographic variables. Statistical analysis using generalized ordinal logistic regression included comparison of three joint pain groups: no joint pain, 1-4 sites of joint pain and ≥ 5 sites of joint pain.
Two thirds of respondents had multisite pain (>1 site), and one third had ≥5 joint pain sites. Compared to women with fewer joint pain sites, women with >5 joint pain sites (multisite joint pain) had significantly poorer physical and emotional health-related quality of life, more severe pain, a higher probability of neuropathic pain, and a longer duration of pain. More than half of women in the multisite joint pain group were still employed, statistically significantly more than women with no joint pain. In the final model, pain duration, the number of medications, pain intensity (discomforting and distressing) and the physical component of health-related quality of life were significantly associated with increased number of joint pain sites.
Over one-third of older women in our sample had >5 painful joints in the last month. These women demonstrated significantly poorer psychosocial health, and increased medication use, than women with no or fewer sites of joint pain. Many women with multisite joint pain were still in the workforce, even when nearing retirement age. This study has important implications for future research into musculoskeletal pain, particularly in regards to womens health and wellbeing, and for clinical practice where there should be increased awareness of the implications of concurrent, multisite joint pain.
肌肉骨骼疼痛经常在多个身体部位出现，在过去12个月中，多达80%的成年人报告有不止一个关节疼痛部位。已知老年人和女性更容易出现多个关节疼痛部位，然而，该人群中多部位关节疼痛与身体和心理社会功能之间的关联尚不清楚。
分析了579名女性的横断面数据。询问女性“在过去一个月的大多数日子里，你的哪些关节出现过问题？”使用麦吉尔疼痛问卷（简表）和疼痛检测量表测量疼痛性质，并使用SF-36和社会人口统计学变量评估健康状况。使用广义有序逻辑回归进行统计分析，包括比较三个关节疼痛组：无关节疼痛、1 - 4个关节疼痛部位和≥5个关节疼痛部位。
三分之二的受访者有多部位疼痛（>1个部位），三分之一的受访者有≥5个关节疼痛部位。与关节疼痛部位较少的女性相比，有>5个关节疼痛部位（多部位关节疼痛）的女性在与身心健康相关的生活质量方面明显较差，疼痛更严重，神经性疼痛的可能性更高，疼痛持续时间更长。多部位关节疼痛组中超过一半的女性仍在工作，在统计学上显著多于无关节疼痛的女性。在最终模型中，疼痛持续时间、药物数量、疼痛强度（令人不适和痛苦）以及与健康相关生活质量的身体成分与关节疼痛部位数量的增加显著相关。
在我们的样本中，超过三分之一的老年女性在上个月有>5个疼痛关节。与无关节疼痛或关节疼痛部位较少的女性相比，这些女性的心理社会健康状况明显较差，药物使用增加。许多有多部位关节疼痛的女性即使接近退休年龄仍在工作。这项研究对未来肌肉骨骼疼痛的研究具有重要意义，特别是在女性健康和福祉方面，并且对于临床实践也有重要意义，临床实践中应提高对同时存在的多部位关节疼痛影响的认识。
