Hagen K B, Kvien T K, Bjørndal A
Health Services Research Unit, National Institute of Public Health, Oslo, Norway.
J Rheumatol. 1997 Sep;24(9):1703-9.
To establish the prevalence of different types of noninflammatory musculoskeletal pain in the general population, to determine the sociodemographic characteristics of persons reporting such pain, and to compare the epidemiological features in a population setting between different types of noninflammatory musculoskeletal pain and patients with confirmed rheumatoid arthritis (RA).
A cross sectional postal survey of 20,000 (response rate 59%) randomly selected adults in 2 counties of Norway. Patients with RA were identified by a clinical and laboratory examination.
The self-reported one month prevalence was 15.4% for noninflammatory neck pain, 21.6% for noninflammatory low back pain, and 17.0% for noninflammatory widespread pain. Neck pain was significantly associated to younger, lower educated, working, and married women; low back pain to higher educated and non-working men; and widespread pain to lower educated middle aged, divorced or widowed, and non-working women. Patients with RA and widespread pain experienced similar pain intensity, mental distress levels, problems with insomnia, and similar scores on global health satisfaction, whereas pain as well as reported health consequences were less pronounced in subjects with regional pain. Disability levels were highest in RA, followed by widespread pain, low back pain, and neck pain.
This population study supports the hypothesis of a continuum for most health related quality of life measures, starting with noninflammatory regional musculoskeletal pain and ending with multiple periarticular or inflammatory disease (widespread pain and RA). This study also shows that widespread pain and RA had similar health effect, except for levels of disability.
确定普通人群中不同类型非炎性肌肉骨骼疼痛的患病率，确定报告此类疼痛者的社会人口学特征，并比较不同类型非炎性肌肉骨骼疼痛与确诊类风湿关节炎（RA）患者在人群中的流行病学特征。
对挪威两个县随机抽取的20000名成年人进行横断面邮寄调查（回复率59%）。通过临床和实验室检查确定RA患者。
自我报告的非炎性颈部疼痛1个月患病率为15.4%，非炎性下背部疼痛为21.6%，非炎性广泛性疼痛为17.0%。颈部疼痛与年轻、低学历、在职和已婚女性显著相关；下背部疼痛与高学历和非在职男性相关；广泛性疼痛与低学历中年、离婚或丧偶及非在职女性相关。RA患者和广泛性疼痛患者经历相似的疼痛强度、精神痛苦水平、失眠问题，以及在总体健康满意度方面得分相似，而局部疼痛患者的疼痛及报告的健康后果则不那么明显。残疾水平在RA患者中最高，其次是广泛性疼痛、下背部疼痛和颈部疼痛。
这项人群研究支持这样一种假设，即对于大多数与健康相关的生活质量衡量指标存在一个连续谱，从非炎性局部肌肉骨骼疼痛开始，到多关节周围或炎性疾病（广泛性疼痛和RA）结束。这项研究还表明，除了残疾水平外，广泛性疼痛和RA具有相似的健康影响。
