Prevalence of chronic pain in LTCs and multimorbidity: A cross-sectional study using UK Biobank, 2021, Nicholl et al

Abstract
Objectives:
Chronic pain is often experienced alongside other long-term conditions (LTCs), yet our understanding of this, particularly in relation to multimorbidity (≥2 LTCs) is poor. We aimed to examine associations between the presence/extent of chronic pain with type/number of LTCs experienced.

Methods:
We examined the relationship between number/type of LTCs (N = 45) in UK Biobank participants (n = 500,295) who self-reported chronic pain lasting ≥3 months in seven body sites or widespread. Relative risk ratios (RRR) for presence/extent of chronic pain sites were compared using logistic regression adjusted for sociodemographic (sex/age/socioeconomic status) and lifestyle factors (smoking/alcohol intake/BMI/physical activity).

Results:
218,648 participants self-reported chronic pain. Of these, 69.1% reported ≥1 LTC and 36.2% reported ≥2 LTCs. In 31/45 LTCs examined, >50% of participants experienced chronic pain. Chronic pain was common with migraine/headache and irritable bowel syndrome where pain is a primary symptom, but also with mental health conditions and diseases of the digestive system. Participants with >4 LTCs were over three times as likely to have chronic pain (RRR 3.56, 95% confidence intervals (CIs) 3.44–3.68) and 20 times as likely to have widespread chronic pain (RRR 20.13, 95% CI 18.26–22.19) as those with no LTCs.

Conclusions:
Chronic pain is extremely common across a wide range of LTCs. People with multimorbidity were at higher risk of having a greater extent of chronic pain. These results show that chronic pain is a key factor for consideration in the management of patients with LTCs or multimorbidity.

https://journals.sagepub.com/doi/10.1177/26335565211005870

 

From the paper.

"Participants reporting migraine/headaches had the largest frequency of chronic pain (74.8%, of which 91.6% reported chronic head pain), followed by chronic fatigue syndrome (68.1%, of which 91.1% reported chronic back pain), irritable bowel syndrome (67.4%, of which 90.0% reported chronic knee pain)."
....
"We next measured the relationship between the extent of chronic pain reported and type of LTC by examining the number of sites of chronic pain reported by participants with particular LTCs (Figure 2). Participants with chronic fatigue syndrome had the highest prevalence of widespread pain, with 17.6% reporting this. Widespread pain was also commonly reported by participants with connective tissue diseases (10.0%), multiple sclerosis (8.8%) and psychoactive substance misuse (7.2%). Reporting of four to seven sites of chronic pain were most prevalent in participants with psychoactive substance misuse (12.4%) and chronic fatigue syndrome (10.4%)."
....
"Previous research has highlighted the impact of chronic pain in conditions where fatigue is a major symptom, particularly in patients diagnosed with fibromyalgia25,26 or chronic fatigue syndrome."

 

"irritable bowel syndrome (67.4%, of which 90.0% reported chronic knee pain)."

???

 

Ah, the things we find when sifting through massive systemic misdiagnosis. We find all sorts of silly things when silly decisions are made for arbitrary reasons. This could be because GI pain is common in joint pain disorders, but without clear signs and findings so it just gets dumped in the IBS bin.

Kind of like when Peter White, "expert" on CFS, argued that he is not aware that GI pain is common in CFS. I doubt experts in other chronic conditions do much better on this front, I rarely see pain associated with MS, for example, and fatigue rarely gets acknowledged by the experts, even though MS patients usually cite it as the most disabling symptom.

There is basically no recognition of chronic pain in ME/CFS, for inexplicable reasons. Despite literally being in the name, it's just that obscure. I don't remember that there's much mention of it in any guidelines, other than vaguely as an afterthought. Maybe this could be used to change that. This has always been pretty ridiculous. And especially in the UK would avoid that dreadful guideline about "primary pain" where they are pushing the standard BPS formula.

Although it's good to confirm that one of the two most common symptoms in medicine are indeed common, it sure would be useful if those results were actually accepted as is, rather than heavily interpreted. Because using the standard formula, this can be expected to somehow argue about BPS this or that. I have a very strong feeling that "but also with mental health conditions" means us. You know, since CFS is categorized under mental health. For invalid reasons.

It's almost as if the human body is a whole organism, or something like that. Not just disparate organs working their own thing isolated from everything else. And when things start to go bad they usually have knock-on effects. You know, like literally everything else. But when the official definition of "holistic", of "whole organism", is basically "well some people answered some vague questionnaire in some way so we're applying some arbitrary interpretation to you and it's final", well, thinking about the whole organism is basically impossible, strawmen make for a very poor model of reality.