Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20220034-en
Brazilian Journal of Pain
Original Article

Musculoskeletal pain, multimorbidity and associated factors in individuals followed at a physiotherapy service: cross-sectional observational study

Dor musculoesquelética, multimorbidade e fatores associados em indivíduos acompanhados por serviço de fisioterapia: estudo observacional de corte transversal

Ana Francisca Ferreira; Jesús Enrique Patiño Escarcina; Dryele Teles C. Luz; Ruan Barbosa Souza; Eduardo Martins Netto

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Abstract

BACKGROUND AND OBJECTIVES: Musculoskeletal pain is among the most disabling conditions, aggravating multimorbidity scenarios. Difficulties in the treatment of pain and multimorbidity highlight the importance of the study of these populations. The objective of this study was to determine the frequency of musculoskeletal pain and multimorbidity, the main complaints in patients admitted to physiotherapy services.

METHODS: This is a cross-sectional observational study. Patients 50 years or older were evaluated using the Brief Pain Inventory, Roland Morris Disability Questionnaire for general pain, sociodemographic and clinical data form, and timed-up-and-go test. Descriptive analyses were performed through the distribution of absolute numbers and proportions for categorical variables.

RESULTS: The sample consisted of 62 patients with 2 or more painful regions, 88.7% women with a median age of 67 years [IQR 62-72], 81% with body mass index above normal, 71% hypertensive and 97% with multimorbidity. The median of painful regions was 7 [IQR 4-8], the most prevalent being low back and knees (87%); 66% of patients describe severe pain, and median pain duration of 7.5 years [IQR 3-15]. The high number of painful regions had greater interference (p<0.05) in the lives of individuals and was associated with females (p=0.04) and the occurrence of a fall in the last year (p<0.003).

CONCLUSION: The described population is mostly composed of hypertensive, overweight women with multimorbidity, chronic pain and a high number of painful regions, interfering in activities and in the affective components of life. A continuous study of chronic, diffuse musculoskeletal pain and multimorbidity is necessary, seeking better interventions for these patients.

HIGHLIGHTS

  • Almost all patients had multimorbidity and described a median of 7 painful regions
  • The high number of painful regions had high interference in the lives of individuals
  • Two-thirds of the patients described severe pain, and median duration of 7.5 years.

Keywords

Chronic pain, Multimorbidity, Musculoskeletal pain.

Resumo

JUSTIFICATIVA E OBJETIVOS: Dores musculoesqueléticas estão entre as condições mais incapacitantes, agravando quadros de multimorbidade. Dificuldades no tratamento da dor e multimorbidade ressaltam a importância do estudo dessas populações. O objetivo deste estudo foi determinar a frequência de dor musculoesquelética e multimorbidade, principais queixas em pacientes admitidos em serviço de fisioterapia.

MÉTODOS: Este é um estudo observacional de corte transversal. Pacientes com 50 anos ou mais foram avaliados através do Inventário Breve de Dor, Questionário de Incapacidade de Roland Morris para dor em geral, formulário de dados sociodemográficos e clínicos e teste timed-up-and-go. Foram realizadas análises descritivas através da distribuição de números absolutos e proporções para as variáveis categóricas.

RESULTADOS: A amostra foi composta por 62 pacientes com 2 ou mais regiões dolorosas, 88,7% mulheres com mediana de idade de 67 anos [IQR 62-72], 81% com índice de massa corpórea acima da normalidade, 71% hipertensos e 97% com multimorbidade. A mediana de regiões dolorosas foi de 7 [IQR 4-8], sendo as mais prevalentes lombar e joelhos (87%); 66% dos pacientes descrevem dor intensa e mediana da duração da dor de 7,5 anos [IQR 3-15]. O alto número de regiões dolorosas teve maior interferência (p<0,05) na vida dos indivíduos e foi associado ao sexo feminino (p=0,04) e a ocorrência de queda no último ano (p<0,003).

CONCLUSÃO: A população descrita é majoritariamente composta por mulheres hipertensas, com sobrepeso, multimorbidade, dor crônica e alto número de regiões dolorosas, interferindo nos componentes de afetividade e atividades da vida. Faz-se necessário contínuo estudo da dor musculoesquelética crônica, difusa e multimorbidade, buscando melhores intervenções para estes pacientes.

DESTAQUES

  • Quase todos os pacientes apresentaram multimorbidade e relataram uma mediana de 7 regiões dolorosas
  • O alto número de regiões dolorosas teve alta interferência na vida das pessoas
  • Dois terços dos pacientes relataram dor intensa e duração mediana de 7,5 anos.

Palavras-chave

Dor crônica, Dor musculoesquelética, Multimorbidade.

References

2009-2010 Global Year Against Musculoskeletal Pain. .

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211-59.

Koch P, Schablon A, Latza U, Nienhaus A. Musculoskeletal pain and effort-reward imbalance--a systematic review. BMC Public Health. 2014;15:14-37.

Cimmino MA, Ferrone C, Cutolo M. Epidemiology of chronic musculoskeletal pain. Best Pract Res Clin Rheumatol. 2011;25(2):173-83.

de Souza JB, Grossmann E, Perissinotti DMN, de Oliveira Junior JO, da Fonseca PRB, Posso IP. Prevalence of chronic pain, treatments, perception, and interference on life activities: Brazilian population-based survey. Pain Res Manag. 2017;2017:4643830.

Aguiar DP, Souza CP, Barbosa WJ, Santos-Junior FF, Oliveira AS. Prevalence of chronic pain in Brazil: systematic review. BrJP. 2021;4(3):257-67.

van Hecke O, Torrance N, Smith BH. Chronic pain epidemiology and its clinical relevance. Br J Anaesth. 2013;111(1):13-8.

Teixeira MJ, Teixeira WGJ, Santos FPS, Andrade DCA, Bezerra SL, Figueiro JB. Clinical epidemiology of muscleskeletal pain. Rev Med. 2001;80(ed.esp.pt.1):1-21.

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789-858.

Blyth FM, Briggs AM, Schneider CH, Hoy DG, March LM. The Global Burden of Musculoskeletal Pain-Where to From Here?. Am J Public Health. 2019;109(1):35-40.

Blyth FM, Noguchi N. Chronic musculoskeletal pain and its impact on older people. Best Pract Res Clin Rheumatol. 2017;31(2):160-8.

van den Akker M, Buntinx F, Knottnerus JA. Comorbidity or multimorbidity what’s in a name? A review of literature. Eur J Gen Pract. 1996;2(2):65-70.

Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380(9836):37-43.

Boeckxstaens P, Peersman W, Goubin G, Ghali S, De Maeseneer J, Brusselle G, De Sutter A. A practice-based analysis of combinations of diseases in patients aged 65 or older in primary care. BMC Fam Pract. 2014;15:159.

Scherer M, Hansen H, Gensichen J, Mergenthal K, Riedel-Heller S, Weyerer S, Maier W, Fuchs A, Bickel H, Schön G, Wiese B, König HH, van den Bussche H, Schäfer I. Association between multimorbidity patterns and chronic pain in elderly primary care patients: a cross-sectional observational study. BMC Fam Pract. 2016;17:68.

Roland M, Morris R. A. study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain. Spine. 1983;8(2):141-4.

Sardá Júnior JJ, Nicholas MK, Pimenta CA, Asghari A, Thieme AL. Validation of the Roland Morris disability questionnaire for general pain. Rev Dor. 2010;11(1):28-36.

Stanhope J. Brief Pain Inventory review. Occup Med (Lond). 2016;66(6):496-7.

Ferreira KA, Teixeira MJ, Mendonza TR, Cleeland CS. Validation of brief pain inventory to Brazilian patients with pain. Support Care Cancer. 2011;19(4):505-11.

Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singap. 1994;23(2):129-38.

Stienen MN, Ho AL, Staartjes VE, Maldaner N, Veeravagu A, Desai A, Gautschi OP, Bellut D, Regli L, Ratliff JK, Park J. Objective measures of functional impairment for degenerative diseases of the lumbar spine: a systematic review of the literature. Spine J. 2019;19(7):1276-93.

Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903.

Rose DJ, Jones CJ, Lucchese N. Predicting the probability of falls in community-residing older adults using the 8-foot up-and-go: a new measure of functional mobility. J Aging Phys Activity. 2002;10(4):466-75.

Alexandre TS, Meira DM, Rico NC, Mizuta SK. Accuracy of timed up and go test for screening risk of falls among community-dwelling elderly. Rev Bras Fisioter. 2012;16(5):381-8.

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):e296.

Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthritis Cartilage. 2013;21(9):1145-53.

Pereira E, Teixeira C, Daronco L, Acosta MA. Estilo de vida, prática de exercício físico e dores musculoesqueléticas em idosas fisicamente ativas. RBCEH (Passo Fundo). 2009;6(3):343-52.

Rossettini G, Carlino E, Testa M. Clinical relevance of contextual factors as triggers of placebo and nocebo effects in musculoskeletal pain. BMC Musculoskelet Disord. 2018;19(1):27.

Murphy KR, Han JL, Yang S, Hussaini SM, Elsamadicy AA, Parente B, Xie J, Pagadala P, Lad SP. Prevalence of specific types of pain diagnoses in a sample of the United States adults. Pain Physician. 2017;20(2):E257-68.

Xu X, Mishra GD, Jones M. Evidence on multimorbidity from definition to intervention: an overview of systematic reviews. Ageing Res Rev. 2017;37:53-68.

de Souza IMB, Sakaguchi TF, Yuan SLK, Matsutani LA, do Espírito-Santo AS, Pereira CAB, Marques AP. Prevalence of low back pain in the elderly population: a systematic review. Clinics (Sao Paulo). 2019;28:74:e789.

Ferreira G, Costa LM, Stein A, Hartvigsen J, Buchbinder R, Maher CG. Tackling low back pain in Brazil: a wake-up call. Braz J Phys Ther. 2019;23(3):189-95.

Edwards J, Hayden J, Asbridge M, Gregoire B, Magee K. Prevalence of low back pain in emergency settings: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2017;18(1):143.

Fatoye F, Gebrye T, Odeyemi I. Real-world incidence and prevalence of low back pain using routinely collected data. Rheumatol Int. 2019;39(4):619-26.

Ikeda T, Sugiyama K, Aida J, Tsuboya T, Watabiki N, Kondo K, Osaka K. Socioeconomic inequalities in low back pain among older people: the JAGES cross-sectional study. Int J Equity Health. 2019;18(1):15.

Hafsi K, McKay J, Li J, Lana JF, Macedo A, Santos GS, Murrell WD. Nutritional, metabolic and genetic considerations to optimize regenerative medicine outcome for knee osteoarthritis. J Clin Orthop Trauma. 2019;10(1):2-8.

Yucesoy B, Charles LE, Baker B, Burchfiel CM. Occupational and genetic risk factors for osteoarthritis: a review. Work. 2015;50(2):261-73.

Gallagher RM, Verma S, Mossey J. Chronic pain. Sources of late-life pain and risk factors for disability. Geriatrics. 2000;55(9):40-4.

Welsh VK, Clarson LE, Mallen CD, McBeth J. Multisite pain and self-reported falls in older people: systematic review and meta-analysis. Arthritis Res Ther. 2019;21(1):67.

Nur H, Sertkaya BS, Tuncer T. Determinants of physical functioning in women with knee osteoarthritis. Aging Clin Exp Res. 2018;30(4):299-306.

Dekker J, Buurman BM, van der Leeden M. Exercise in people with comorbidity or multimorbidity. Health Psychol. 2019;38(9):822-30.

Teixeira L, Araújo L, Duarte N, Ribeiro O. Falls and fear of falling in a sample of centenarians: the role of multimorbidity, pain and anxiety. Psychogeriatrics. 2019;19(5):457-64.

Doos L, Roberts EO, Corp N, Kadam UT. Multi-drug therapy in chronic condition multimorbidity: a systematic review. Fam Pract. 2014;31(6):654-63.

Montero-Odasso M, Sarquis-Adamson Y, Song HY, Bray NW, Pieruccini-Faria F, Speechley M. Polypharmacy, gait performance, and falls in community-dwelling older adults. results from the gait and brain study. J Am Geriatr Soc. 2019;67(6):1182-8.

Bierman AS. Preventing and managing multimorbidity by integrating behavioral health and primary care. Health Psychol. 2019;38(9):851-4.

Smith SM, Soubhi H, Fortin M, Hudon C, O’Dowd T. Managing patients with multimorbidity: systematic review of interventions in primary care and community settings. BMJ. 2012;345:e5205.

Cáceres-Matos R, Gil-García E, Cabrera-León A, Porcel-Gálvez AM, Barrientos-Trigo S. Factors that influence coping with chronic noncancer pain in European Countries: a systematic review of measuring instruments. Pain Manag Nurs. 2020;21(2):123-33.

Bratzke LC, Muehrer RJ, Kehl KA, Lee KS, Ward EC, Kwekkeboom KL. Self-management priority setting and decision-making in adults with multimorbidity: a narrative review of literature. Int J Nurs Stud. 2015;52(3):744-55.


Submitted date:
12/31/2021

Accepted date:
08/02/2022

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