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Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Breivik, Harald

4 Issues per year


CiteScore 2017: 0.84

SCImago Journal Rank (SJR) 2017: 0.401
Source Normalized Impact per Paper (SNIP) 2017: 0.452

Online
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1877-8879
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Volume 15, Issue 1

Diabetes mellitus and hyperlipidaemia as risk factors for frequent pain in the back, neck and/or shoulders/arms among adults in Stockholm 2006 to 2010 – Results from the Stockholm Public Health Cohort

Oscar Javier Pico-Espinosa
  • Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  • Other articles by this author:
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/ Eva Skillgate
  • Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  • Naprapathögskolan – Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
  • Other articles by this author:
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/ Giorgio Tettamanti
  • Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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/ Anton Lager
  • Department of Public Health Sciences, Karolinska Institutet, Centre for Epidemiology and Community Medicine, Stockholm, Sweden
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/ Lena W. Holm
  • Corresponding author
  • Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  • Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
  • Email
  • Other articles by this author:
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Published Online: 2017-04-01 | DOI: https://doi.org/10.1016/j.sjpain.2016.11.005

Abstract

Background and aims

Frequent back, neck and/or shoulder pain (BNSP) are common conditions which pose high burden for the society. Results from previous studies suggest that diabetes and hyperlipidaemia may be associated with a higher risk of getting such conditions, but there is in general, few studies based on longitudinal designs. The aim of this study was therefore to compare the risk of developing frequent BNSP in men and women with and without diabetes and/or hyperlipidaemia.

Methods

A longitudinal study based on the Stockholm Public Health Cohort was conducted based on subjects aged 45–84, who were free from pain at the mentioned sites in 2006 and followed up until 2010. The data in the current study is based on questionnaires, except socioeconomic status which was derived from Statistics Sweden. The exposure diabetes and hyperlipidaemia was self-reported and, a categorical variable was created; without any of the conditions, with hyperlipidaemia only, with diabetes only and with both conditions. The outcome frequent BNSP was defined using the following questions in the questionnaire in 2010: “During the past 6 months, have you had pain in the neck or upper part of the back?”, “During the past 6 months, have you had pain in the lower back?”, and “During the past 6 months, have you had pain in the shoulders/arms?”. All questions had three possible response options: no; yes, a couple of days per month or less often and; yes, a couple of days per week or more often. Those who reported weekly pain to at least one of these questions were considered to having frequent BNSP. Binomial regressions were run to calculate the crude and adjusted risk ratio (RR) in men and women separately. Additional analysis was performed in order to control for potential bias derived from individuals lost to follow-up.

Results

A total of 10,044 subjects fulfilled the criteria to be included in the study. The mean age of the sample was 60 years and evenly distributed by sex. After adjusting for age, body mass index, physical activity, high blood pressure and socioeconomic status, the RR for frequent BNSP among men with diabetes was 1.64 (95% CI: 1.23–2.18) and 1.19 (95% CI: 0.98–1.44) for hyperlipidaemia compared to men with neither diabetes nor hyperlipidaemia. Among women the corresponding RRs were 0.92 (95% CI: 0.60–1.14) and 1.23 (95% CI: 1.03–1.46). Having both diabetes and hyperlipidaemia at baseline was not associated with increased risk of frequent BNSP. Diabetes and hyperlipidaemia seems to be associated with an increased risk for frequent BNSP and the risk may differ between men and women. Behaviours and/or biological underlying mechanisms may explain the results.

Conclusions

This study suggests that metabolic diseases such as diabetes and hyperlipidaemia may have an impact on the pathophysiology of frequent BNSP and thus, contributes to the knowledge in musculoskeletal health. Furthermore, it confirms that men and women may differ in terms of risk factors for BNSP.

Implications

Health professionals should contemplate the results from this study when planning primary prevention strategies.

Keywords: Diabetes mellitus; Hyperlipidaemia; Back pain; Neck pain; Shoulder pain

References

About the article

Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, Box 210, SE-171 77 Stockholm, Sweden.Tel.: +46 8 524 870 23; mobile +46 704 82 74 79.


Received: 2016-08-26

Revised: 2016-10-28

Accepted: 2016-11-13

Published Online: 2017-04-01

Published in Print: 2017-04-01


Ethical issues: All the participants were informed of the purpose of the research and gave their informed consent to the preservation of their national registration number, future contacts and record linkages [37]. There is an ethical approval for this study (DNr: 2013/497-32) and the Stockholm Public Health Cohort Steering Committee reviewed the present proposal prior to the provision of the data. There is no conflict of interest declared by the authors.

Conflict of interest: The authors declare that they do not have any conflict of interest to this paper.


Citation Information: Scandinavian Journal of Pain, Volume 15, Issue 1, Pages 1–7, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2016.11.005.

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