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Open Access Research article

Prevalence and long-term predictors of persistent chronic widespread pain in the general population in an 11-year prospective study: the HUNT study

Ingunn Mundal12*, Rolf W Gråwe3, Johan H Bjørngaard45, Olav M Linaker16 and Egil A Fors47

Author Affiliations

1 Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, 7491 Trondheim, Norway

2 Outpatient Department of Psychiatry, Kristiansund Hospital, Møre and Romsdal Hospital Trust, Kristiansund, Norway

3 Department of Research and Development, Addiction Medicine, St. Olav’s University Hospital, Trondheim, Norway

4 Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway

5 Forensic Department and Research Centre Bröset, St Olav’s University Hospital, Trondheim, Norway

6 Department of Psychiatry, Department of Research and Development, St Olavs University Hospital, Trondheim, Norway

7 Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway

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BMC Musculoskeletal Disorders 2014, 15:213  doi:10.1186/1471-2474-15-213

Published: 20 June 2014

Abstract

Background

Chronic widespread pain (CWP) is common and associated with prominent negative consequences. The aim of this study was to assess the prevalence of persistent CWP in an 11-year prospective cohort study in the general population, and to examine anxiety, depression, alcohol use, poor sleep, body mass index (BMI) and chronic disease, along with demographic, lifestyle and other health-related variables as possible predictors for the assumed CWP persistence.

Methods

CWP was defined as having pain at three or more predefined sites (involving the trunk and upper and lower limbs) for at least three months in the last year. We used a Norwegian general population cohort of 28,367 individuals who responded to both the second (1995–1997) and the third (2006–2008) waves of the Nord-Trøndelag Health Study (HUNT2 and HUNT3, respectively). Data were analysed with logistic regression models.

Results

CWP prevalence in HUNT2 was 17%. Of those reporting CWP in HUNT2, 53% still reported CWP at follow-up in HUNT3. Adjusted analyses revealed that depression and alcohol consumption were not substantially associated with the 11-year prospective CWP outcome. Poor sleep, obesity and chronic disease predicted persistent CWP, and being male and/or 60 years or older was protective.

Conclusions

This cohort study revealed that nearly half of the participants with baseline CWP resolved from CWP 11 years later. Among those whose CWP did not resolve, obesity, sleeping problems and chronic disease predicted CWP persistence, while aging and male sex was protective. Anxiety, mixed anxiety and depression, former smoking, and overweight were weakly associated, while depression, moderate exercise, and alcohol use were not associated with persistent CWP.

Keywords:
Chronic widespread pain; Anxiety; Depression; Alcohol; Prospective cohort study; General population