Some studies have shown that persons with chronic widespread pain experience premature mortality, although data is equivocal. Attempts to investigate the mediators of such a relationship have focused on low levels of physical activity, and other lifestyle factors such as smoking and poor diet. Here, we used data from UK Biobank to determine whether such a relationship exists, estimate its magnitude and establish what factors mediate any relationship.
Approximately 0.5 million people ages 40-69yrs were followed from study recruitment (2006-2010) by linking to national death records up to mid-2015. Mortality among persons reporting pain all over the body for at least three months was compared with persons without chronic pain. 7130 participants reported chronic widespread pain at recruitment, and these individuals were more than twice as likely to die during followup, compared to persons with no chronic pain, in particular due to cancer, cardiovascular disease, respiratory disease, or from other disease-related causes. However, the excess risk was considerably reduced when adjusting for low levels of physical activity, high body mass index, poor quality diet and smoking.
Evidence is now clear that persons with chronic widespread pain experience excess mortality. Data from UK Biobank considerably reduces the uncertainty around the magnitude of excess risk and are consistent with the excess being explained by adverse lifestyle factors. These factors should be targeted in the management of such patients.
Epidemiology of chronic pain
The background to this project is to examine the descriptive epidemiology of chronic pain in the UK Biobank sample. To determine whether the prevalence of regional and widespread pain, which has been well documented across several large population studies, can be replicated in this more highly selected sample participating in UK Biobank.
This project will investigate the epidemiology of chronic pain. It will determine:
* how common pain is at individual sites throughout the body as well as "widespread body pain"
*the factors associated with the reporting of pain including demographic (age, sex, socioeconomic status), lifestyle factors (smoking , alcohol, physical activity)
*other health related factors reported with pain (e.g. fatigue and mood disorders)
*whether persons who report pain also report markers of poor cardiovascular (heart) and respiratory (lung) health and whether their lifestyle puts them at an increased risk of cancer.
*the relationship between reporting of pain and history of falls and fractures.
Walker-Bone, K., Harvey, N.C., Ntani, G. et al. Chronic widespread bodily pain is increased among individuals with history of fracture: findings from UK Biobank, Arch Osteoporos (2016) 11: 1. doi:10.1007/s11657-015-0252-1
Macfarlane TV, Beasley M, Macfarlane GJ. Self-Reported Facial Pain in UK Biobank Study: Prevalence and Associated Factors. J Oral Maxillofac Res. 2014 Oct 1;5(3):e2. doi:10.5037/jomr.2014.5302.
Beasley, Marcus J.; Macfarlane, Tatiana V.; Macfarlane, Gary J. Is alcohol consumption related to likelihood of reporting chronic widespread pain in people with stable consumption? Results from UK biobank, PAIN: November 2016 - Volume 157 - Issue 11 - p 2552-2560 doi: 10.1097/j.pain.0000000000000675
Macfarlane GJ, Barnish MS, Jones GT. Persons with chronic widespread pain experience excess mortality: longitudinal results from UK Biobank and meta-analysisAnnals of the Rheumatic Diseases 2017;76:1815-1822. doi:10.1136/annrheumdis-2017-211476
|Lead investigator:||Gary Macfarlane|
|Lead institution:||University of Aberdeen|