Prevalence of chronic spinal pain and identification of associated factors in a sample of the population of São Paulo, Brazil
cross-sectional study
Keywords:
Back pain, Chronic pain, Low back pain, Prevalence, Cross-sectional studiesAbstract
CONTEXT AND OBJECTIVE: Chronic spinal pain, especially low-back pain and neck pain, is a leading cause of years of life with disability. The aim of the present study was to estimate the prevalence of chronic spinal pain among individuals aged 15 years or older and to identify the factors associated with it. DESIGN AND SETTING: Cross-sectional epidemiological study on a sample of the population of the city of São Paulo. METHOD: Participants were selected using random probabilistic sampling and data were collected via face-to-face interviews. The Hospital Anxiety and Depression Scale (HADS), EuroQol-5D, Alcohol Use Disorders Identification Test (AUDIT), Fagerström test for nicotine dependence and Brazilian economic classification criteria were used. RESULTS: A total of 826 participants were interviewed. The estimated prevalence of chronic spinal pain was 22% (95% confidence interval, CI: 19.3-25.0%). The factors independently associated with chronic spinal pain were: female sex, age 30 years or older, schooling level of four years or less, symptoms compatible with anxiety and high physical exertion during the main occupation. Quality of life and self-rated health scores were significantly worse among individuals with chronic spinal pain. CONCLUSION: The prevalence of chronic spinal pain in this segment of the population of São Paulo was 22.0%. The factors independently associated with chronic pain were: female sex, age 30 years or older, low education, symptoms compatible with anxiety and physical exertion during the main occupation.
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Manchikanti L, Singh V, Datta S, et al. Comprehensive review of epidemiology, scope, and impact of spinal pain. Pain Physician. 2009;12(4):E35-70.
Cassidy JD, Carroll LJ, Côté P. The Saskatchewan health and back pain survey. The prevalence of low back pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976). 1998;23(17):1860-6; discussion 1867.
Côté P, Cassidy JD, Carroll L. The Saskatchewan Health and Back Pain Survey. The prevalence of neck pain and related disability in Saskatchewan adults. Spine (Phila Pa 1976). 1998;23(15):1689-98.
Von Korff M. Studying the natural history of back pain. Spine (Phila Pa 1976). 1994;19(18 Suppl):2041S-2046S.
Murray CJ, Lopez AD. Measuring the global burden of disease. N Engl J Med. 2013;369(5):448-57.
Merskey H, Bogduk N. Introduction. In: Merskey H, Bogduk N. Classification of chronic pain: descriptions of chronic pain syndromes and definition of pain terms. 2nd ed. Seattle: IASP press; 1994. p. ix-xv.
Cruz DALM, Pimenta CAM. Avaliação do doente com dor crônica em consulta de enfermagem: proposta de instrumento segundo diagnósticos de enfermagem [Evaluation of patients with chronic pain in nursing consultations: proposal of an instrument according to nursing diagnoses]. Rev Latino-Am Enfermagem. 1999;7(3):49-62.
Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 criteria for the Classification of Fibromyalgia. Report of Multicenter Criteria Committee. Arthritis Rheum. 1990;33(2):160-72.
Parsons S, Breen A, Foster NE, et al. Prevalence and comparative troublesomeness by age of musculoskeletal pain in different body locations. Fam Pract. 2007;24(4):308-16.
Eriksen J, Jensen MK, Sjøgren P, Ekholm O, Rasmussen NK. Epidemiology of chronic non-malignant pain in Denmark. Pain. 2003;106(3):221-8.
Bergman S, Herrström P, Högström K, et al. Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study. J Rheumatol. 2001;28(6):1369-77.
Azevedo LF, Costa-Pereira A, Mendonça L, Dias CC, Castro-Lopes JM. Epidemiology of chronic pain: a population-based nationwide study on its prevalence, characteristics and associated disability in Portugal. J Pain. 2012;13(8):773-83.
Huisstede BM, Wijnhoven HA, Bierma-Zeinstra SM, et al. Prevalence and characteristics of complaints of the arm, neck, and/or shoulder (CANS) in the open population. Clin J Pain. 2008;24(3):253-9.
Jiménez-Sánchez S, Fernández-de-Las-Peñas C, Carrasco-Garrido P, et al. Prevalence of chronic head, neck and low back pain and associated factors in women residing in the Autonomous Region of Madrid (Spain). Gac Sanit. 2012;26(6):534-40.
Guez M, Hildingsson C, Nilsson M, Toolanen G. The prevalence of neck pain: a population-based study from northern Sweden. Acta Orthop Scand. 2002;73(4):455-9.
Sá K, Baptista AF, Matos MA, Lessa I. Prevalência de dor crônica e fatores associados na população de Salvador, Bahia [Prevalencia de dolor crónico y factores asociados en la población de Salvador, Bahia]. Rev Saúde Pública. 2009;43(4):622-30.
Ferreira GD, Silva MC, Rombaldi AJ, et al. Prevalência de dor nas costas e fatores associados em adultos do sul do Brasil: estudo de base populacional [Prevalence and associated factors of back pain in adults from southern Brazil: a population-based study]. Rev Bras Fisioter. 2011;15(1):31-6.
Silva MC, Fassa AG, Valle NCJ. Dor lombar crônica em uma população adulta no Sul do Brasil: prevalência e fatores associados [Chronic low back pain in a Southern Brazilian adult population: prevalence and associated factors]. Cad Saúde Pública. 2004;20(2):377-85.
Meucci RD, Fassa AG, Paniz VMV, Silva MC, Wegman DH. Increase of chronic low back pain prevalence in a medium-sized city of southern Brazil. BMC Musculoskeletal Disord. 2013;14:155.
Almeida ICGB, Sá KN, Silva M, et al. Prevalência de dor lombar crônica na população da cidade de Salvador [Chronic low back pain prevalence in the population of the city of Salvador]. Rev Bras Ortop. 2008;43(3):96-102.
Farrar JT, Portenoy RK, Berlin JA, Kinman JL, Strom BL. Defining the clinically important difference in pain outcome measures. Pain. 2000;88(3):287-94.
Burgoyne DS. Prevalence and economic implications of chronic pain. Manag Care. 2007;16(2 Suppl 3):2-4.
Smith BH, Elliott AM, Hannaford PC; Royal College of General Practitioners’ Oral Contraception Study. Is chronic pain a distinct diagnosis in primary care? Evidence arising from the Royal College of the General Practitioners’ Oral Contraception study. Fam Pract. 2004;21(1):66-74.
Picavet HS, Schouten JS. Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC(3)-study. Pain. 2003;102(1-2):167-78.
Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287-333.
Blyth FM, March LM, Brnabic AJ, et al. Chronic pain in Australia: a prevalence study. Pain. 2001;89(2-3):127-34.
Raspe A, Matthis C, Héon-Klin V, Raspe H. [Chronic back pain: more than pain in the back. Findings of a regional survey among insurees of a workers pension insurance fund]. Rehabilitation (Stuttg). 2003;42(4):195-203.
Carroll LJ, Cassidy JD, Côté P. Depression as a risk factor for onset of an episode of troublesome neck and low back pain. Pain. 2004;107(1-2):134-9.
Currie SR, Wang J. Chronic back pain and major depression in the general Canadian population. Pain. 2004;107(1-2):54-60.
Deyo RA, Dworkin SF, Amtmann D, et al. Report of the NIH Task Force on research standards for chronic low back pain. J Pain. 2014;15(6):569-85.
Bracher ES, Pietrobon R, Eluf-Neto J. Cross-cultural adaptation and validation of a Brazilian Portuguese version of the chronic pain grade. Qual Life Res. 2010;19(6):847-52.
Cabral DM, Bracher ES, Depintor JD, Eluf-Neto J. Chronic pain prevalence and associated factors in a segment of the population of São Paulo city. J Pain. 2014;15(11):1081-91.
Kish L. Survey sampling. New York: Wiley; 1965.
Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore. 1994;23(2):129-38.
UK BEAM Trial Team. United Kingdom back pain exercise and manipulation (UK BEAM) randomised trial: cost effectiveness of physical treatments for back pain in primary care. BMJ. 2004;329(7479):1381.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361-70.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002;52(2):69-77.
Castro MMC, Quarantini L, Batista-Neves S, et al. Validade da escala hospitalar de ansiedade e depressão em pacientes com dor crônica [Validity of the hospital anxiety and depression scale in patients with chronic pain]. Rev Bras Anestesiol. 2006;56(5):470-7.
Reenen MV, Janssen B. EQ-5D-5L User Guide. Basic information on how to use the EQ-5D-5L instrument. Available from: http://www. euroqol.org/fileadmin/user_upload/Documenten/PDF/Folders_ Flyers/EQ-5D-5L_UserGuide_2015.pdf. Accessed in 2016 (Sep 12).
Carmo JT, Pueyo AA. A adaptação ao português do Fagerström test for nicotine dependence (FTND) para avaliar a dependência e tolerância à nicotina em fumantes brasileiros [Adaptation into portuguese for the Fagerström test for nicotine dependence (FTND) to evaluate the dependence and tolerance for nicotine in brazilian smokers]. RBM Rev Bras Med. 2002;59(1/2):73-80.
Meneses-Gaya IZ, Zuardi AW, Loureiro SR, Crippa JAS. As propriedades psicométricas do Teste de Fagerström para Dependência de Nicotina [Psychometric properties of the Fagerström Test for Nicotine Dependence]. J Bras Pneumol. 2009;35(1):73-82.
Méndez EB. Uma versão Brasileira do AUDIT (Alcohol use Disorders Identification Test) [dissertation]. Pelotas: Universidade Federal de Pelotas; 1999.
Associação Brasileira de Empresas de Pesquisa (ABEP). Critério de classificação econômica Brasil; 2008. Available from: http://www. abep.org/criterio-brasil. Accessed in 2016 (Jul 5).
Barros AJ, Hirakata VN. Alternatives for logistic regression in cross- sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003.3:21.
Lin DY, Wei LJ. The robust inference for the Cox Proportional Hazards Model. Journal of the American Statistical Association. 1989;84(408):1074-8.
Leboeuf-Yde C, Nielsen J, Kyvik KO, Fejer R, Hartvigsen J. Pain in the lumbar, thoracic or cervical regions: do age and gender matter? A population-based study of 34,902 Danish twins 20-71 years of age. BMC Musculoskeletal Disord. 2009;10:39.
Manchikanti L, Singh V, Kloth D, et al. Interventional techniques in the management of chronic pain: Part 2.0. Pain Physician. 2001;4(1):24-96.
Goode AP, Freburger J, Carey T. Prevalence, practice patterns, and evidence for chronic neck pain. Arthritis Care Res (Hoboken). 2010;62(11):1594-601.
Guez, M. Chronic neck pain. An epidemiological, psychological and SPECT study with emphasis on whiplash-associated disorders. Acta Orthop Suppl. 2006;77(320):preceding 1, 3-33.
Croft P, Rigby AS, Boswell R, Schollum J, Silman A. The prevalence of chronic widespread pain in the general population. J Rheumatol. 1993;20(4):710-3.
Portenoy RK, Ugarte C, Fuller I, Haas G. Population-based survey of pain in the United States: differences among white, African American, and Hispanic subjects. J Pain. 2004;5(6):317-28.
Nordeman L, Gunnarsson R, Mannerkorpi K. Prevalence and characteristics of widespread pain in female primary health care patients with chronic low back pain. Clin J Pain. 2012;28(1):65-72.
Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL 3rd. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009;10(5):447-85.
DePalma MJ, Ketchum JM, Saullo TR. Multivariable analyses of the relationships between age, gender, and body mass index and the source of chronic low back pain. Pain Med. 2012;13(4):498-506.
Skillgate E, Magnusson C, Lundberg M, Hallgvist J. The age- and sex-specific occurrence of bothersome neck pain in the general population--results from the Stockholm public health cohort. BMC Musculoskelet Disord. 2012;13:185.
Racine M, Tousignant-Laflamme Y, Kloda LA, et al. A systematic literature review of 10 years of research on sex/gender and experimental pain perception - part 1: are there really differences between women and men? Pain. 2012;153(3):602-18.
Mitchell C. Assessment and management of chronic pain in elderly people. Br J Nurs. 2001;10(5):296-304.
Sofaer-Bennett B, Schofield P, Cameron PA. Chronic pain in older people. Midlife and Beyond. 2012;42:13-21. Available from: http:// www.cpaqv.org/afai/bennett.pdf. Accessed in 2016 (Jul 5).
Skovron ML. Epidemiology of low back pain. Baillieres Clin Rheumatol. 1992:6(3):559-73.
Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low-back pain and its related medical care in the United States. Spine (Phila Pa 1976). 1987;12(3):264-8.
de Moraes Vieira EB, Garcia JB, da Silva AA, Mualem Araújo RL, Jansen RC. Prevalence, characteristics, and factors associated with chronic pain with and without neuropathic characteristics in São Luís, Brazil. J Pain Symptom Manage. 2012;44(2):239-51.
Dionne CE, Von Korff M, Koepsell TD, et al. Formal education and back pain: a review. J Epidemiol Community Health. 2001;55(7):455-68.
Frymoyer JW, Cats-Baril W. Predictors of low back pain disability. Clin Orthop Relat Res. 1987;(221):89-98.
Demyttenaere K, Bruffaerts R, Lee S, et al. Mental disorders among persons with chronic back or neck pain: results from the World Mental Health Surveys. Pain. 2007;129(3):332-42.
Lefevre-Colau MM, Fayad F, Rannou F, et al. Frequency and interrelations of risk factors for chronic low back pain in a primary care setting. PLos One. 2009;4(3):e4874.
Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. Lancet. 2012;379(9814):482-91.
Wong WS, Fielding R. Prevalence and characteristics of chronic pain in the general population of Hong Kong. J Pain. 2011;12(2):236-45.
Johannes CB, Le TK, Zhou X, Johnston JA, Dworkin RH. The prevalence of chronic pain in United States adults: results of an Internet-based survey. J Pain. 2010;11(11):1230-9.
