Butera Katie A, Roff Shannon R, Buford Thomas W, Cruz-Almeida Yenisel
Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA.
Charles River Laboratories Inc., Frederick, MD 21701, USA.
J Pain Res. 2019 Mar 29;12:1115-1125. doi: 10.2147/JPR.S192755. eCollection 2019.
Multisite pain, or pain that occurs simultaneously at >1 anatomical site, is more prevalent than single-site pain. While multisite pain affects over half of older adults, it remains an understudied pain entity that may have important functional implications in an aging population. Greater understanding of this complex pain entity from a biopsychosocial perspective is critical for optimizing clinical and functional outcomes in older adults with pain. Therefore, the primary purpose of this review is to summarize the relationship between multisite pain and functional outcomes in older adults to further elucidate the impact of multisite pain as a distinct entity within this population. A comprehensive literature search revealed 17 peer-reviewed articles. Multisite pain in older individuals is associated with reductions in several physical function domains: 1) lower-extremity mobility; 2) upper-extremity impairments; 3) balance and increased fall risk; and 4) general disability and poor physical function. Further, multisite pain in older individuals is associated with psychological dysfunction (eg, anxiety and depressive symptoms) and social factors (eg, income and education). Overall, this review highlights the scant literature investigating the functional implications of multisite pain in an aging population. Further, while multisite pain appears to have functional consequences, the neurobiological mechanisms contributing to this relationship are unknown. Thus, how this pain characteristic may contribute to the variability in pain-related functional outcomes among older adults is not clear. Future investigations are strongly warranted to advance the understanding of multisite pain and its broad impact on physical and psychosocial function in older adults.
多部位疼痛，即同时在一个以上解剖部位出现的疼痛，比单部位疼痛更为普遍。虽然多部位疼痛影响超过半数的老年人，但它仍是一个研究不足的疼痛实体，可能对老年人群体具有重要的功能影响。从生物心理社会角度更好地理解这一复杂的疼痛实体，对于优化老年疼痛患者的临床和功能结局至关重要。因此，本综述的主要目的是总结老年人多部位疼痛与功能结局之间的关系，以进一步阐明多部位疼痛作为该人群中一个独特实体的影响。全面的文献检索发现了17篇经同行评审的文章。老年人的多部位疼痛与几个身体功能领域的下降有关：1）下肢活动能力；2）上肢功能障碍；3）平衡能力及跌倒风险增加；4）总体残疾和身体功能不佳。此外，老年人的多部位疼痛与心理功能障碍（如焦虑和抑郁症状）以及社会因素（如收入和教育）有关。总体而言，本综述凸显了在老年人群体中研究多部位疼痛功能影响的文献稀缺。此外，虽然多部位疼痛似乎会产生功能后果，但其背后的神经生物学机制尚不清楚。因此，这种疼痛特征如何导致老年人疼痛相关功能结局的差异尚不清楚。强烈需要未来的研究来增进对多部位疼痛及其对老年人身体和心理社会功能广泛影响的理解。
