Exploring the Pain Experience of Chinese Elderly Patients with Chronic Musculoskeletal Pain and Multimorbidity in Primary Care: A Qualitative Study using a Grounded Theory Approach

Background: Chronic musculoskeletal pain (CMSP) is common in older people with multimorbidity (MM). Given the complex etiology of CMSP, it is worthwhile to explore the meanings attached to an individual and its interaction with MM. The study aimed to explore the meanings underneath the experience of CMSP and MM, to generate new insight on the support of pain management in the elderly population. Methods: 20 eligible subjects aged between 65 and 80 were recruited through purposive sampling. Semi-structured in-depth interviews were conducted, with data transcript, coded and analyzed using grounded theory approach. Results: Quotes evolved on the interaction between CMSP and MM, with participants expressed worries of pain may affect disease control. Three themes emerged which included the impact of CMSP on the physical and psychosocial well-being among the elderly with MM, the barriers to pain care in the community, and the perception and strategies on pain management. Conclusions: Older people with CMSP and MM were suffering from a significant physical and psychological impact on their well-being. Self-care remains a preferred adjunct in pain management; support should be strengthened at individual (education) and community (urban development) level.

BackgroundThe belief that cannabis has analgesic and anti-inflammatory properties continues to attract patients with chronic musculoskeletal (MSK) pain towards its use. However, the role that cannabis will play in the management of chronic MSK pain remains to be determined. This study examined 1) the rate, patterns of use, and self-reported efficacy of cannabis use among patients with chronic MSK pain and 2) the interest and potential barriers to cannabis use among patients with chronic MSK pain not currently using cannabis.MethodsSelf-reported cannabis use and perceived efficacy were prospectively collected from chronic MSK pain patients presenting to the Orthopaedic Clinic at the University Health Network, Toronto, Canada. The primary dependent variable was current or past use of cannabis to manage chronic MSK pain; bivariate and multivariable logistic regression were used to identify patient characteristics independently associated with this outcome. Secondary outcomes were summarized descriptively, including self-perceived efficacy among cannabis users, and interest as well as barriers to cannabis use among cannabis non-users.ResultsThe sample included 629 patients presenting with chronic MSK pain (mean age: 56±15.7 years; 56% female). Overall, 144 (23%) reported past or present cannabis use to manage their MSK pain, with 63.7% perceiving cannabis as very or somewhat effective and 26.6% considering it as slightly effective. The strongest predictor of cannabis use in this study population was a history of recreational cannabis use (OR 12.7, p<0.001). Among cannabis non-users (N=489), 65% expressed interest in using cannabis to manage their chronic MSK pain, but common barriers to use included lack of knowledge regarding access, use and evidence, and stigma.ConclusionsOne in five patients presenting to an orthopaedic surgeon with chronic MSK pain are using or have used cannabis with the specific intent to manage their pain, and most report it to be effective. Among non-users, two-thirds reported an interest in using cannabis to manage their MSK pain, but common barriers to use existed. Future double-blind placebo-controlled trials are required to understand if this reported efficacy is accurate, and what role, if any, cannabis may play in the management of chronic MSK pain.

Chronic musculoskeletal pain (CMP) is the most common type of chronic pain, defined as persistent or recurrent pain condition deriving from musculoskeletal structures such as muscles, joints or bones that lasts for more than 3 months. CMP is multifactorial and severely affects people's quality of life. CMP may be influenced by a number of factors, including contextual factors, the presence of comorbidities, arthritis coping efficacy and access to CMP care. To deepen the comprehensive understanding of CMP, this narrative review provides the latest literature on disease classification, clinical diagnosis, treatment and basic research. In terms of the classification of the disease, here we introduce the 11th edition of the International Classification of Diseases (IDC-11), in which CMP is divided into chronic primary musculoskeletal pain and chronic secondary musculoskeletal pain. In the clinical diagnosis section, the progress of central sensitization in the diagnosis of CMP will also be summarized. In addition, we summarize some recent advances in clinical treatment and basic research.

Chronic musculoskeletal (MSK) pain has multiple causes and a high prevalence. Frequently, pharmacological options do not provide optimal pain relief, and treatment with opioids may lead to serious adverse effects. Although pharmacological effects of cannabis in pain management have been recognized, knowledge about a person’s motivations regarding this therapeutic strategy is limited. Such knowledge is important, given possible serious adverse effects of cannabis, and an increasing trend for self-medication. Our study aimed at exploring, understanding and quantifying pain patients’ motivations, concerns and needs regarding the use of medical cannabis for pain management. Thus, a questionnaire study, based on the Theory of Planned Behavior (TPB), was performed. The TPB’s contribution to the understanding of health-related behaviors has been widely recognized. In a prior, purely qualitative part of this research, semi-structured interviews were conducted with adults affected by chronic MSK pain in Canada. Using the results of these interviews, a questionnaire was developed and validated in a pilot step. This questionnaire aimed at quantifying which TPB elements relate to the intention to use medical cannabis for the management of chronic MSK pain. It also included questions on pain and personal characteristics, assessed through validated scales. Among 226 persons who completed this online questionnaire, 160 could be included in final analyses. The adjusted and reduced TPB based model explained 51% of the intention to use medical cannabis to manage chronic MSK pain. The explanatory exogenous factors of this model were current pain, prior experience of pain reduction and prior cannabis use. Normative, control and behavior beliefs were also included in the final model. These beliefs related to subjective norms, perceived ability, and attitudes, which in turn were associated with the behavioral intention. The study results are relevant for adults suffering from chronic MSK pain and their health professionals, when making decisions on the use of medical cannabis to manage this condition. Given possible serious adverse effects of cannabis and the growing trend for self-medication, these results should be tested for other indications and on other populations, to help patients’ and prescribers improve use of medical cannabis.

BackgroundUrbanization and population aging may affect prevalence of chronic pain from various causes. This cross-sectional study aimed to investigate the prevalence of chronic musculoskeletal pain, including some subtypes, in independent Japanese older people, and whether population density and population aging rate explained prevalence and differences in pain levels between municipalities.MethodsWe analyzed data from 12,883 independent older people living in 58 municipalities who completed mailed questionnaires and did not need support for daily living. We identified three types of pain: “chronic musculoskeletal pain” lasting ≥ 3 months (overall and in each part of the body), “chronic widespread-type pain” in the spinal and peripheral area, and “chronic multisite pain” in at least three sites. The latter two were measured using new definitions. These types of pain are correlated with depressive symptoms and we therefore examined the construct validity of the definitions by comparing the Geriatric Depression Scale score. We also used analysis of covariance to compare the prevalence of these three types of pain between municipalities. Odds ratios, median odds ratios, and the municipal variance in prevalence of chronic musculoskeletal pain were estimated by Bayesian multilevel logistic regression analysis using the Markov Chain Monte Carlo method.ResultsThe construct validity of the definitions of chronic widespread-type pain and chronic multisite pain was confirmed. The prevalence of the three types of pain (chronic musculoskeletal, widespread, and multisite pain) was 39.0%, 13.9%, and 10.3%, respectively. Chronic musculoskeletal pain showed a higher prevalence among older people and women. Individuals in underpopulated, suburban, or metropolitan areas tended to have more pain than those in urban areas, but this was not statistically significant (odds ratio [95% credible interval] 1.15 [0.86–1.51], 1.17 [0.93–1.43], 1.17 [0.94–1.46]). Population density and population aging rate did not explain the differences between municipalities.ConclusionsThe prevalence of chronic musculoskeletal pain was consistent with previous global reports. Areas with overpopulation and depopulation tended to have higher pain prevalence, but population density and population aging rate did not explain municipal variance. Further research is needed to identify other factors that contribute to regional variance.

The study evaluated if chronic musculoskeletal (MSK) pain predicts the severity of insomnia, and whether the effect is moderated by age, gender, and number of comorbid diseases in older people. An 18-month prospective study was performed within the framework of a community health program in Hong Kong. A total of 498 older people aged ≥ 60 with multimorbidity were recruited. The predictors included the presence of chronic MSK pain, pain measured by the Brief Pain Inventory (BPI), insomnia measured by baseline Insomnia Severity Index (ISI), and number of co-morbid diseases, age, and gender. The outcome was ISI repeated at 18 months. The moderators included age, gender, and number of comorbid diseases. Multivariate linear regression and moderation analysis were conducted. We found that the presence of chronic MSK pain (β = 1.725; 95% CI, 0.607–2.842; P < 0.01) predicted the severity of ISI, after controlling for age, gender, BMI, and the number of comorbid diseases. Participants with chronic MSK pain throughout the period had worse trend of improvement in ISI compared to those who were “pain-free” (β = 2.597; 95% CI, 1.311–3.882; P < 0.001). Age, gender, and number of comorbid diseases did not moderate the longitudinal relationship. We propose that pain management should prioritized in the prevention of insomnia.

ABSTRACTBackground and AimVirtual reality (VR) has been proposed for the management of chronic musculoskeletal pain (MSKP). This umbrella review aimed to systematically search, critically appraise, summarize, and synthesize the current systematic reviews (SRs) on delivering VR interventions to rehabilitate patients with chronic primary MSKP and disability.MethodData were obtained from five databases. Only SRs were included. This umbrella review utilized the AMSTAR‐2 to assess the methodological quality of the included SRs and the GRADE to assess the certainty in the body of evidence.ResultsSeven SRs were included. The overall confidence in the SRs ranged from low to critically low, whereas the certainty in the body of evidence ranged from moderate to very low. Whilst the majority of the SRs suggested that VR, standalone or adjunctive to other interventions, had a significant short‐term positive effect on patient‐reported outcomes for pain in patients with chronic primary MSKP, results on patient‐reported outcomes for disability and kinesiophobia were inconsistent. Adverse events included motion sickness, nausea, and vertigo.ConclusionsAlthough the current evidence indicates that VR may hold promise in patients with chronic primary MSKP, the included studies suffered from critical weaknesses that precluded this review from drawing a conclusive conclusion. It remains uncertain which VR interventions, including dosage, mode of delivery, supervision, frequency, duration, level of immersion, VR platform, displayed content, and mechanism of action, are more effective than the others. Future SRs should sub‐group VR based on the treatment types. Further rigorously designed studies focusing on immersive VR, standalone or adjunctive to other interventions, with long‐term follow‐up, are warranted. It is worth repeating the call for an agreed consensus on a clear definition and classification of VR within the healthcare context.

Background Chronic musculoskeletal pain is a major health concern among older people. The experience of chronic musculoskeletal pain is influenced by psychosocial factors such as beliefs, coping strategies, and pain catastrophizing. It is believed that culture can influence pain related factors and psychosocial factors vary across different cultures. Objective To identify the common pain-related beliefs, coping strategies and pain catastrophizing in older people with chronic musculoskeletal pain. Method A descriptive cross-sectional study was conducted in Dhulikhel among 150 older people. Semi-structured questionnaire gathered information on pain beliefs and coping strategies, while, pain catastrophizing scale was used to identify catastrophization. A convenient sampling was used and data were analyzed using SPSS, version 26. Result The median age of the participants was 69 years (IQR 10). The median pain score on facial pain rating scale was 6 (IQR 2). Participants believed that musculoskeletal pain was associated with aging (81%), past workload (64%) and karma (49%). They predominantly believed in doctors (78%) and physiotherapists (43%) for treatment. Nearly half also believed in spiritual healers. Commonly utilized coping strategies were self-statements like "I can handle anything" (89%) and it is not so bad, it's normal" (81%), massage (88%), God (87%) and exercise (84%). The level of pain catastrophization was not statistically significant among the participants. Conclusion The findings of the study highlighted the significance of beliefs and coping strategies in influencing pain experiences, suggesting a strong need of implementation of biopsychosocial approach in assessment and management of pain among older people.

Many people with chronic disease have more than one chronic condition, which is referred to as multimorbidity. The term comorbidity is also used but this is now taken to mean that there is a defined index condition with other linked conditions, for example diabetes and cardiovascular disease. It is also used when there are combinations of defined conditions that commonly co-exist, for example diabetes and depression. While this is not a new phenomenon, there is greater recognition of its impact and the importance of improving outcomes for individuals affected. Research in the area to date has focused mainly on descriptive epidemiology and impact assessment. There has been limited exploration of the effectiveness of interventions to improve outcomes for people with multimorbidity. To determine the effectiveness of health-service or patient-oriented interventions designed to improve outcomes in people with multimorbidity in primary care and community settings. Multimorbidity was defined as two or more chronic conditions in the same individual. We searched MEDLINE, EMBASE, CINAHL and seven other databases to 28 September 2015. We also searched grey literature and consulted experts in the field for completed or ongoing studies. Two review authors independently screened and selected studies for inclusion. We considered randomised controlled trials (RCTs), non-randomised clinical trials (NRCTs), controlled before-after studies (CBAs), and interrupted time series analyses (ITS) evaluating interventions to improve outcomes for people with multimorbidity in primary care and community settings. Multimorbidity was defined as two or more chronic conditions in the same individual. This includes studies where participants can have combinations of any condition or have combinations of pre-specified common conditions (comorbidity), for example, hypertension and cardiovascular disease. The comparison was usual care as delivered in that setting. Two review authors independently extracted data from the included studies, evaluated study quality, and judged the certainty of the evidence using the GRADE approach. We conducted a meta-analysis of the results where possible and carried out a narrative synthesis for the remainder of the results. We present the results in a 'Summary of findings' table and tabular format to show effect sizes across all outcome types. We identified 18 RCTs examining a range of complex interventions for people with multimorbidity. Nine studies focused on defined comorbid conditions with an emphasis on depression, diabetes and cardiovascular disease. The remaining studies focused on multimorbidity, generally in older people. In 12 studies, the predominant intervention element was a change to the organisation of care delivery, usually through case management or enhanced multidisciplinary team work. In six studies, the interventions were predominantly patient-oriented, for example, educational or self-management support-type interventions delivered directly to participants. Overall our confidence in the results regarding the effectiveness of interventions ranged from low to high certainty. There was little or no difference in clinical outcomes (based on moderate certainty evidence). Mental health outcomes improved (based on high certainty evidence) and there were modest reductions in mean depression scores for the comorbidity studies that targeted participants with depression (standardized mean difference (SMD) -2.23, 95% confidence interval (CI) -2.52 to -1.95). There was probably a small improvement in patient-reported outcomes (moderate certainty evidence) although two studies that specifically targeted functional difficulties in participants had positive effects on functional outcomes with one of these studies also reporting a reduction in mortality at four year follow-up (Int 6%, Con 13%, absolute difference 7%). The intervention may make little or no difference to health service use (low certainty evidence), may slightly improve medication adherence (low certainty evidence), probably slightly improves patient-related health behaviours (moderate certainty evidence), and probably improves provider behaviour in terms of prescribing behaviour and quality of care (moderate certainty evidence). Cost data were limited. This review identifies the emerging evidence to support policy for the management of people with multimorbidity and common comorbidities in primary care and community settings. There are remaining uncertainties about the effectiveness of interventions for people with multimorbidity in general due to the relatively small number of RCTs conducted in this area to date, with mixed findings overall. It is possible that the findings may change with the inclusion of large ongoing well-organised trials in future updates. The results suggest an improvement in health outcomes if interventions can be targeted at risk factors such as depression, or specific functional difficulties in people with multimorbidity.

Many people with chronic disease have more than one chronic condition, which is referred to as multimorbidity. The term comorbidity is also used but this is now taken to mean that there is a defined index condition with other linked conditions, for example diabetes and cardiovascular disease. It is also used when there are combinations of defined conditions that commonly co-exist, for example diabetes and depression. While this is not a new phenomenon, there is greater recognition of its impact and the importance of improving outcomes for individuals affected. Research in the area to date has focused mainly on descriptive epidemiology and impact assessment. There has been limited exploration of the effectiveness of interventions to improve outcomes for people with multimorbidity. To determine the effectiveness of health-service or patient-oriented interventions designed to improve outcomes in people with multimorbidity in primary care and community settings. Multimorbidity was defined as two or more chronic conditions in the same individual. We searched MEDLINE, EMBASE, CINAHL and seven other databases to 28 September 2015. We also searched grey literature and consulted experts in the field for completed or ongoing studies. Two review authors independently screened and selected studies for inclusion. We considered randomised controlled trials (RCTs), non-randomised clinical trials (NRCTs), controlled before-after studies (CBAs), and interrupted time series analyses (ITS) evaluating interventions to improve outcomes for people with multimorbidity in primary care and community settings. Multimorbidity was defined as two or more chronic conditions in the same individual. This includes studies where participants can have combinations of any condition or have combinations of pre-specified common conditions (comorbidity), for example, hypertension and cardiovascular disease. The comparison was usual care as delivered in that setting. Two review authors independently extracted data from the included studies, evaluated study quality, and judged the certainty of the evidence using the GRADE approach. We conducted a meta-analysis of the results where possible and carried out a narrative synthesis for the remainder of the results. We present the results in a 'Summary of findings' table and tabular format to show effect sizes across all outcome types. We identified 17 RCTs examining a range of complex interventions for people with multimorbidity. Nine studies focused on defined comorbid conditions with an emphasis on depression, diabetes and cardiovascular disease. The remaining studies focused on multimorbidity, generally in older people. In 11 studies, the predominant intervention element was a change to the organisation of care delivery, usually through case management or enhanced multidisciplinary team work. In six studies, the interventions were predominantly patient-oriented, for example, educational or self-management support-type interventions delivered directly to participants. Overall our confidence in the results regarding the effectiveness of interventions ranged from low to high certainty. There was little or no difference in clinical outcomes (based on moderate certainty evidence). Mental health outcomes improved (based on high certainty evidence) and there were modest reductions in mean depression scores for the comorbidity studies that targeted participants with depression (standardized mean difference (SMD) -0.41, 95% confidence interval (CI) -0.63 to -0.2). There was probably a small improvement in patient-reported outcomes (moderate certainty evidence). The intervention may make little or no difference to health service use (low certainty evidence), may slightly improve medication adherence (low certainty evidence), probably slightly improves patient-related health behaviours (moderate certainty evidence), and probably improves provider behaviour in terms of prescribing behaviour and quality of care (moderate certainty evidence). Cost data were limited. This review identifies the emerging evidence to support policy for the management of people with multimorbidity and common comorbidities in primary care and community settings. There are remaining uncertainties about the effectiveness of interventions for people with multimorbidity in general due to the relatively small number of RCTs conducted in this area to date, with mixed findings overall. It is possible that the findings may change with the inclusion of large ongoing well-organised trials in future updates. The results suggest an improvement in health outcomes if interventions can be targeted at risk factors such as depression in people with co-morbidity.

To estimate the prevalence of musculoskeletal pain (MSP) across age groups in a Dutch population sample of middle-aged and older adults. Cross-sectional data of 8618 participants aged 40–75 years from The Maastricht Study was used. Participants reported any (≥ 1 day in the past month) and chronic (≥ 3 months) MSP. Additionally, the latter group reported pain locations (grouped in six pain regions) and intensity (visual analogue scale 1–10). Prevalence of any and (patterns of) chronic MSP were described across seven age groups. Logistic and multinominal regression analyses assessed associations of age groups with MSP, adjusted for sex or type 2 diabetes mellitus (T2DM). Interactions between age and sex or T2DM were tested. Prevalence of any and chronic MSP was 53% and 29%, respectively. Any MSP was less common in participants aged 70–75 years compared to those aged 40–44 years (OR = 0.80, 95% CI: 0.65–0.99). Chronic MSP plateaued after age 60 (range ORs 55–69 years 1.27–1.38). Neck/chest/shoulder (65%) and lower back (55%) were the most common chronic pain regions. Pain in four or more locations was reported by 43%, with no age-group differences. Sex and T2DM did not modify the relation between age group and chronic MSP. Mean pain intensity in those with chronic MSP (5.6, SD 1.7) was stable across age groups. The prevalence of chronic MSP seems not to increase further after the age of 60, possibly reflecting decreased work demands, altered pain perception, effective pain management, or selection bias of healthier older individuals.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00296-025-05961-w.

Purpose: Exercise is a core component of chronic musculoskeletal (CMS) pain management and is widely supported by clinical guidelines. Despite this, many individuals with CMS pain struggle to maintain physical activity (PA) in daily life. This study explored the feasibility and preliminary effects of a supervised, individualised, patient-centred multicomponent exercise programme on disability, physical capacity, and engagement in PA. Methods: A 16-session exercise programme was delivered, consisting of warm-up, functional exercises, and breath-centred yoga with relaxation. Exercises were graded throughout the sessions. Assessments were conducted at the first and last session using the Oswestry Disability Index (ODI), the ATEMPT questionnaire (to assess exercise adherence), and the Senior Fitness Test (SFT) battery. Given the small sample size and lack of control group, findings are reported descriptively, with focus on clinical relevance. Results: Forty-nine participants (mean age: 53.4 ± 8.6 years) attended an average of 12.5 sessions, reflecting a high adherence rate (78%). The mean ODI score decreased from 39.4 ± 17.5 to 34.8 ± 17.6 (mean change: 4.6 points). While statistically significant (p = .002), the change did not reach the commonly accepted threshold for clinical relevance (6–10 points). The 30-second chair-stand test showed improvement (mean increase: 1.6 repetitions; p &lt; .001), suggesting a gain in lower limb strength. ATEMPT scores also improved (mean change: 5.6 points; p &lt; .001), though without a control group, these changes should be interpreted cautiously. Importantly, over 80% of participants completed at least 75% of the sessions, indicating strong engagement. Conclusion: Although the functional and self-reported outcomes showed modest improvements, the results fall short of demonstrating clinically meaningful change in disability and must be interpreted within the limitations of the study design. Nonetheless, the high adherence and acceptability of the programme suggest its potential as a feasible intervention to support active living in people with CMS pain. Future research should include a control group, longer follow-up, and larger sample size to assess efficacy and sustainability more robustly. Support/Funding Source: This study was funded by the European Union (NextGenerationEU) and the Republic of Slovenia, Ministry of Health, under the Recovery and Resilience Plan

Chronic musculoskeletal (MSK) pain can be characterized by its temporal variability and evolution, affecting both pain management and treatment outcomes. While pain variability is traditionally studied over long timescales (e.g. days or weeks), few studies have explored short-term fluctuations (e.g. minutes to seconds) and their clinical relevance. This study investigated the short-term variability of chronic musculoskeletal pain across consecutive days, examining whether these fluctuations are stable, exhibit consistent temporal patterns, and relate to clinical severity. We also explored whether individuals with chronic MSK pain could predict their pain intensity on the following day, suggesting an ability to learn about their pain’s levels. Eighty-one participants with chronic MSK pain to the back, neck, leg or arm (22–65 years, 72% females, 28% males) rated their pain continuously over two days, using a smartphone-based app. Results indicated that pain ratings were stable and exhibited consistent temporal patterns across days, with a temporally correlated structure. High mean pain levels were associated with lower variability, possibly reflecting a stabilized pain state. Short-term pain variability negatively correlated with clinical severity, indicating that greater variability is linked to milder pain. These findings highlight the importance of short-term variability as a distinct and clinically relevant feature of chronic MSK pain, with implications for personalized pain management strategies.

Background: Musculoskeletal disorders are leading cause of ill-health globally and workers are disproportionately affected due to repetitive tasks and postures. Little is known about these disorders among hotel employees in India. Objective: The study aims to find prevalence of musculoskeletal disorders among workers in luxury hotels and identify their determinants. Materials and Methods: A cross-sectional study design was employed. The study sites included eight hotels across other four cities. A pre-designed, pilot tested semi-structured questionnaire was self-administered by study respondents. Main outcome variable was self-reported musculoskeletal pain/discomfort. Data on predictor variables including socio-demographic, physical and psychosocial environment was collected. Prevalence of musculoskeletal pain/discomfort was estimated. Chi-square test was used for bi-variate analysis. Binary multiple logistic regression method was used to identify factors associated with the outcome variable 'Any chronic musculoskeletal pain' and site-specific subtypes. Results: Out of 1183 respondents, 526 (45%) reported having musculoskeletal pain/discomfort which chiefly included backache 320 (27%), pain in legs 206 (17%), joint pain 157 (13%) and neck pain 88 (7%). 'Chronic musculoskeletal pain' was associated withfour variables; namely, years of service (OR = 1.018; 1.002–1.034), heavy stress of lifting objects (OR = 1.908; 1.289–2.825), psychological wellbeing (GHQ–12 item) (OR = 1.214; 1.135–1.299) and type of work (desk workers had lower odds (OR = 0.355; 0.178–0.709) than housekeepers). Conclusion: Prevalence of musculoskeletal pain/discomfort is high among hotel workers. Stress of lifting objects, psychosocial well-being, duration of service and type of work are key determinants.

The opioid epidemic claims tens of thousands of lives annually in the United States (US) where opioids are prescribed more per capita than in any other country. Primary care providers contribute to nearly half of these prescriptions, often for chronic non-cancer pain conditions such as back, hip, and knee pain. Despite widespread use, evidence suggests that opioids do not improve pain control for chronic non-cancer musculoskeletal pain. This study aimed to assess whether an opioid prescription in the three months preceding internal medicine primary care appointments was associated with lower pain levels, as reported on a 1 to 10 scale during medical assistant check-ins, among patients with chronic non-cancer musculoskeletal pain. Using a cross-sectional design, we analyzed pain scores for adult patients who had been prescribed opioids versus those who had not. Our findings revealed no statistically significant difference in pain levels between the two groups, with both opioid and non-opioid users reporting similar median pain scores. These results align with existing evidence, reinforcing the notion that opioids offer no substantial advantage in pain management for chronic musculoskeletal pain.