Development Of Musculoskeletal Pain Research Articles

Preventive Effect of an Intervention Program with Increased Physical Activity on the Development of Musculoskeletal Pain in Community-Dwelling Older Adults: A Randomized Controlled Trial: A Critical Analysis.

Journal Article Accepted manuscript Preventive Effect of an Intervention Program with Increased Physical Activity on the Development of Musculoskeletal Pain in Community-Dwelling Older Adults: A Randomized Controlled Trial: A Critical Analysis Get access John Andre Socci, B.S. Fordham University John Andre Socci, B.S. Fordham University Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ Corresponding author: John Andre Socci, OMS-1, B.S. Fordham University, Department of Medicine, Rowan School of Osteopathic Medicine, Address: 1 Medical Center Dr, Stratford, NJ 08084, Phone: (908) 339 8025, Fax:(908) 339 8025, Email: soccij24@rowan.edu. https://orcid.org/0009-0001-0181-7157 Search for other works by this author on: Oxford Academic PubMed Google Scholar Pain Medicine, pnad084, https://doi.org/10.1093/pm/pnad084 Published: 22 June 2023 Article history Received: 29 May 2023 Accepted: 15 June 2023 Published: 22 June 2023

Reply to Letter to the Editor regarding "Preventive effect of an intervention program with increased physical activity on the development of musculoskeletal pain in community-dwelling older adults: a randomized controlled trial".

Journal Article Accepted manuscript Reply to Letter to the Editor regarding “Preventive effect of an intervention program with increased physical activity on the development of musculoskeletal pain in community-dwelling older adults: a randomized controlled trial” Get access Tatsuya Hirase, PhD, Tatsuya Hirase, PhD Division of Physical Therapy Science, Graduate Course of Health and Social Work, Kanagawa University of Human Services, Kanagawa, Japan Corresponding author: Tatsuya Hirase, PhD, Division of Physical Therapy Science, Graduate Course of Health and Social Work, Kanagawa University of Human Services, 1-10-1 Heisei-cho, Yokosuka, Kanagawa, Japan, Tel: +81 46 828 2730; Fax: +81 46 828 2731; Email: hirase-rx7@kuhs.ac.jp. Search for other works by this author on: Oxford Academic PubMed Google Scholar Shigeru Inokuchi, PhD, Shigeru Inokuchi, PhD Department of Physical Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Minoru Okita, PhD Minoru Okita, PhD Department of Physical Therapy Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar Pain Medicine, pnad082, https://doi.org/10.1093/pm/pnad082 Published: 20 June 2023 Article history Received: 12 June 2023 Accepted: 15 June 2023 Published: 20 June 2023

Development and Interrelation of Pain, Depression, and Anxiety in Music Students: Does Successful Treatment of Pain Have an Impact on Mental Health?

Musculoskeletal pain is a common problem among professional musicians as well as music students. Studies have emphasized the effectiveness of music-specific physiotherapy for affected musicians. This study was designed to evaluate if physiotherapy treatment of pain-affected music students had an impact on pain perception as well as psychological well-being. To explore the possible development of musculoskeletal pain, depression, and anxiety, a second sample of pain-free music students, matched for age and gender, was examined twice at identical time intervals. A convenience sample of 31 university music students with moderate to severe musculoskeletal pain and 31 pain-free music students, matched in age and gender, were included in the study. Both groups were examined physically and completed biographical, music-related, and psychological questionnaires. Perceived pain intensity was assessed with a visual-analogue scale (VAS), and depression and anxiety symptoms were assessed with the Beck Depression Inventory II (BDI-II) and the Hospital Anxiety and Depression Scale (HAD). Music students with pain received a series of 12 sessions of musician-specific physiotherapy, while controls waited for the same amount of time for retesting. On the 10-cm VAS, music students with pain reported an average improvement in pain intensity from a baseline of 6.25 (SD 1.95) to 2.7 (2.03) after the intervention, while the controls (music students without pain) did not change. Furthermore, music students with pain indicated higher depression and anxiety scores as compared to the control group before and after therapy. After intervention, music students with pain with higher BDI-II scores demonstrated clinical improvement concerning depression, but no significant improvement in mental health was found in the pain group taken as a whole. Physiotherapy was effective in reducing pain symptoms in music students affected by chronic musculoskeletal pain. However, physiotherapy did not improve mental health in pain-affected music students. Additional psychotherapeutic interventions may be needed to support music students with psychological comorbidities such as depression and anxiety.

Repeated measurements of Adaptive Force: Maximal holding capacity differs from other maximal strength parameters and preliminary characteristics for non-professional strength vs. endurance athletes.

The Adaptive Force (AF) reflects the neuromuscular capacity to adapt to external loads during holding muscle actions and is similar to motions in real life and sports. The maximal isometric AF (AFisomax) was considered to be the most relevant parameter and was assumed to have major importance regarding injury mechanisms and the development of musculoskeletal pain. The aim of this study was to investigate the behavior of different torque parameters over the course of 30 repeated maximal AF trials. In addition, maximal holding vs. maximal pushing isometric muscle actions were compared. A side consideration was the behavior of torques in the course of repeated AF actions when comparing strength and endurance athletes. The elbow flexors of n = 12 males (six strength/six endurance athletes, non-professionals) were measured 30 times (120s rest) using a pneumatic device. Maximal voluntary isometric contraction (MVIC) was measured pre and post. MVIC, AFisomax, and AFmax (maximal torque of one AF measurement) were evaluated regarding different considerations and statistical tests. AFmax and AFisomax declined in the course of 30 trials [slope regression (mean ± standard deviation): AFmax = -0.323 ± 0.263; AFisomax = -0.45 ± 0.45]. The decline from start to end amounted to -12.8% ± 8.3% (p < 0.001) for AFmax and -25.41% ± 26.40% (p < 0.001) for AFisomax. AF parameters declined more in strength vs. endurance athletes. Thereby, strength athletes showed a rather stable decline for AFmax and a plateau formation for AFisomax after 15 trials. In contrast, endurance athletes reduced their AFmax, especially after the first five trials, and remained on a rather similar level for AFisomax. The maximum of AFisomax of all 30 trials amounted 67.67% ± 13.60% of MVIC (p < 0.001, n = 12), supporting the hypothesis of two types of isometric muscle action (holding vs. pushing). The findings provided the first data on the behavior of torque parameters after repeated isometric-eccentric actions and revealed further insights into neuromuscular control strategies. Additionally, they highlight the importance of investigating AF parameters in athletes based on the different behaviors compared to MVIC. This is assumed to be especially relevant regarding injury mechanisms.

Predictors of Musculoskeletal Pain among Primary School Students Using Smartphones in Nakhon Si Thammarat, Thailand.

School-age children increasingly use smartphones to conduct their learning activities; increasing reports of disorders related to smartphone use exist, including visual-related symptoms, stress, and musculoskeletal pain. This study aimed to examine risk factors for musculoskeletal pain among primary school students using smartphones. A cross-sectional study was conducted with 233 school-aged children in Nakhon Si Thammarat, Thailand. Data collection used a questionnaire for musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire with ISO 11,226:2000. Through Chi-square, t-test, and logistic regression analysis, factors independently associated with musculoskeletal pain were determined. An important factor in the development of musculoskeletal pain was the prolonged use of smartphones for longer than 60 min, particularly among children aged 6–9 years old. In regards to musculoskeletal pain, almost 53% of the students used their smartphones while lying down. Posing in a prone position while using a smartphone was 7.37 times more dangerous than sitting. The laying position tilts numerous organs at varying angles, especially the upper arm. The risk of musculoskeletal complaints must be reduced by educating parents, children, and the relevant government organizations about safe smartphone usage. The mentioned factors may be used to anticipate the onset of musculoskeletal pain caused by smartphone use in young children.

Work Facilities Improvement Using Systematic Layout Planning to Reduce the Risk of Manual Handling

Manual material handling (MMH) activity is considered a major ergonomic risk factor in Indonesian Small and Medium Enterprises (SMEs) that leads to the onset or development of musculoskeletal pain, particularly in the low back. It may exaggerate the risk of injury or disorders. This study evaluates the recommended weight limit (RWL) at UD Fatikh Sport, a SMES sports shoe manufacturer. In addition, we also propose a facility layout redesign to reduce the ergonomic risks of manual material handling activities. The NIOSH lifting equation was used to determine the RWL at four departments and during MMH activities. The Lifting Index (LI) of the MMH activity exceeded the recommended value, which might raise the ergonomic risks. The risks worsened because the operator carried the load manually to several departments, which were located separately on the second floor, without any aid tools. Two designs of facility layout improvement were developed using a systematic layout planning (SLP) approach. The first design was focused on minimizing the transportation distance, while the space requirement of each department or MMH activities was emphasized in the second design. It aims to improve working conditions and reduce workers' fatigue. Further research should calculate the productivity and estimate its cost-efficiency before and after implementing the proposed layout.

Muscular factor in the development of musculoskeletal pain. Treatment options

The importance of the muscular factor, which is traditionally considered in myofascial pain syndrome (MFPS), in the development and maintenance of musculoskeletal pain (MSP) is actively discussed. The hypothesis of the leading role of myofascial trigger points (MTPs) in muscle pain remains debatable. Probably, muscle pain is secondary to the underlying disease. The MTP phenomenon is considered as an area of secondary hyperalgesia resulting from neurogenic inflammation in muscles that were not initially structurally and physiologically damaged. According to these ideas, MFPS is a complex form of neuromuscular dysfunction, which is represented by soft tissue damage with the development of peripheral and central sensitization as a result of neurogenic inflammation, changes in the functioning of limbic system structures. MFPS is a clinical diagnosis, based on the presence of painful spasmodic muscles, painful muscle indurations, active trigger points with zones of reflected pain. The sensitivity and specificity of clinical tests for MFPS have not been determined. Currently, there are no proven universally accepted criteria (such as biomarkers, electrophysiological evaluation, imaging, diagnostic blocks, etc.) for objectifying or quantifying MTPs. Nonpharmacological interventions with the most proven effectiveness include therapeutic exercises and psychotherapeutic techniques, other methods are of secondary importance. The effectiveness of aceclofenac (Aertal®) and the muscle relaxant tolperisone (Mydocalm®) in the of MSP treatment is discussed. It is noted that a new form of tolperisone – Mydocalm®-Long 450 mg - can reduce the frequency of drug administration, provide a proven and predictable therapeutic effect, and increase treatment adherence.

Musculoskeletal pain and its association with health status, maturity, and sports performance in adolescent sport school students: a 2-year follow-up

BackgroundMusculoskeletal pain and its risk factors are rarely assessed in studies on adolescent athletes. The aim was to identify risk factors at baseline that were associated with the persistence or development of musculoskeletal pain at a two-year follow-up in adolescent sport school students, and to study cross-sectional associations at follow-up between musculoskeletal pain and sports performance.MethodsSport school students (79 boys and 52 girls, aged 14 years at baseline) were divided into infrequent (never–monthly) or frequent (weekly–almost daily) pain groups, based on frequency of pain using a pain mannequin. Logistic regression analyses were performed to study longitudinal associations between frequent pain at follow-up and baseline variables: pain group, number of regions with frequent pain, health status by EQ-5D, maturity offset (pre, average, or post peak height velocity), and sports (contact or non-contact). Linear regression analyses were used to study cross-sectional associations between pain groups and 20-m sprint, agility T-test, counter-movement jump, and grip strength at follow-up. Results were stratified by sex.ResultsA higher percentage of girls than boys reported frequent pain at follow-up (62% vs. 37%; p = 0.005). In boys, frequent pain at follow-up was associated with being pre peak height velocity at baseline (OR 3.884, CI 1.146–13.171; p = 0.029) and participating in non-contact sports (OR 3.429, CI 1.001–11.748; p = 0.050). In girls, frequent pain at follow-up was associated with having frequent pain in two or more body regions at baseline (OR 3.600, CI 1.033–12.542; p = 0.044), having a worse health status at baseline (OR 3.571, CI 1.026–12.434; p = 0.045), and participating in non-contact sports (OR 8.282, CI 2.011–34.116; p = 0.003). In boys, frequent pain was associated with worse performances in 20-m sprint and counter-movement jump, but not in agility T-test and grip strength.ConclusionsBaseline risk factors for having frequent pain at follow-up were late maturation in boys, frequent pain and worse health status in girls, and participation in non-contact sports in both sexes. Boys with pain performed worse in sports tests. Coaches and school health-care services should pay attention to the risk factors and work towards preventing pain from becoming persistent.

Combined ergonomic exposures and development of musculoskeletal pain in the general working population: A prospective cohort study.

Objective:This study aimed to investigate the importance of combined ergonomic exposures at work for the development of musculoskeletal pain.Methods:Through four rounds (2012–2018) of the Work Environment and Health in Denmark Study, 18 905 employees of the general working population replied to a baseline and 2-year follow-up questionnaire. First, a k-means cluster analysis of seven ergonomic factors (back bending, arm above shoulders, lifting etc., from ‘never’ to ‘almost all the time’) identified nine naturally occurring clusters. Second, using a weighted survey regression model controlling for age, gender, survey year, education, lifestyle, influence at work, and pain intensity at baseline, we estimated development of pain intensity (0–10) in the neck-shoulder and low-back in these clusters. The largest cluster served as reference to the other clusters and was characterized by low ergonomic exposures.Results:Clusters characterized by multiple combined ergonomic exposures for a relatively high percentage of the working time showed the largest increase in neck-shoulder as well as low-back pain intensity from baseline to follow-up. However, clusters characterized by high exposure to a few specific ergonomic factors also increased pain significantly, eg, standing/walking combined with lifting/carrying or twisted/bent back for the majority of the working time increased low-back pain, whereas repetitive arm movements for the majority of the working time with or without standing/walking increased neck-shoulder pain.Conclusion:Combined occupational ergonomic exposures play an important role in the development of musculoskeletal pain. Workplace preventive approaches should consider this in risk assessments and organization of the work.

The importance of weak physical performance in older adults for the development of musculoskeletal pain that interferes with normal life. A prospective cohort study.

There are associations between pain, comorbidity and risk of falling, and falling increases the risk of mortality in older persons, but few studies have investigated the development of pain as a result of impaired physical function. The aim of this study was to examine possible associations between weak physical performance and the development of musculoskeletal pain that interferes with normal life in a sample of older adults. The sample derived from a national, longitudinal multicenter study; the Swedish National Study on Ageing and Care; SNAC-B. The participants (n = 490) were between 60 and 78 years at the baseline examinations. Three variables were chosen for the exposure physical function, from the baseline examinations; One Leg Stand, Grip strength and Sit-to-Stand. The outcome musculoskeletal pain that interferes with normal life was measured using EQ5D and SF-12 6 years later, and logistic regression was used to investigate possible associations between the exposures and the outcome. Maximum grip strength (Grippit) was inversely associated with musculoskeletal pain that interferes with normal life (OR 2.31; 95% CI 1.15-4.61), and One-Leg Stand and Sit-to-Stand were not associated with the development of pain (OR 1.30; 95% CI 0.64-2.64) and (OR 0.91; 95% CI 0.45-1.86), respectively. Weak grip strength was inversely associated with the development of musculoskeletal pain that interferes with normal life in older adults. Impaired proprioceptive function, strength and mobility in elderly with pain have been found in earlier research. Since pain increases the risk of falling, it is important to investigate if it may develop as a function of an impaired physical function. The results of the present study could be of importance for future prevention programs aiming to protect elderly from falling.

Are perinatal factors associated with musculoskeletal pain across the lifespan? A systematic review with meta-analysis

BackgroundMusculoskeletal conditions are common health issues with great impact on individuals. Although many factors have been associated with the development of musculoskeletal pain, such as perinatal factors, its aetiology is still poorly understood. ObjectiveTo systematically investigate whether perinatal factors can increase the risk of having musculoskeletal pain across the lifespan. MethodsMEDLINE, CINAHL, Scopus, Web of Science and EMBASE databases were searched from their inception to December 2017. Descriptors used in our search strategy were related to “perinatal factors” and “musculoskeletal pain”. There were no language, age, sex or date restrictions. Meta-analysis was used to pool the estimates of association between perinatal factors and musculoskeletal pain. ResultsAmong the six articles included in this systematic review, three were extracted for the meta-analysis. The pooled of three and two studies showed no association between chronic musculoskeletal pain and low birth weight (OR 1.8, 95% CI 0.9–3.8, I2 = 0; n = 157) or pre-term birth (OR 0.5, 95% CI 0.0–4.5; I2 = 78%; n = 374) in adults, respectively. Overall, the quality of evidence after applying the GRADE approach was very low across all the studies. ConclusionIn adults, our meta-analysis showed no association between birth weight or pre-term birth and musculoskeletal pain, and the quality of the evidence was very low. Thus, the very low quality of evidence and limited number of studies do not suggest a direct clear association. Further high-quality longitudinal studies accounting for more relevant confounders are needed to better understand the complex mechanism that may operate between perinatal factors and musculoskeletal pain.

Profile of musculoskeletal pain in patients with inflammatory bowel disease: a study protocol for assessing the multidimensional experience of self-reported pain

Background: Pain is known to affect over 70% of individuals with inflammatory bowel disease (IBD), with abdominal and musculoskeletal (MSK) pain representing the most common complaints in this population. Although possible mediating and overlapping pathways have been proposed in the development of MSK pain in IBD, the multifactorial nature of painful conditions is not well understood nor fully captured.Aims: Primary aims are to characterize MSK pain in individuals with IBD through a national survey, in order to identify patient subgroups based on self-reported features of pain and assess how these subgroups differ with regards to demographics, comorbidity, and IBD characteristics.Methods: The present study is a cross-sectional online survey of adults with IBD and self-reported pain, living in New Zealand. The survey includes a range of measures examining demographics and comorbidity, IBD status (type, activity, and severity of IBD course), and pain status (intensity, location, interference, and quality). Latent class analysis will be used to generate mechanism-based subgroups of pain in this populationDiscussion: The present study will gather data on the multidimensional experience of self-reported MSK pain in IBD, and describe subgroups of pain in this population. Subgrouping has been shown to generate distinct profiles of patients with similar attributes, while permitting comparison of features between subgroups. Use of mechanism-based classification provides the opportunity to understand differing and potentially overlapping contributions of pathophysiological pain mechanisms. Results from the present study will be used to develop a clinical framework for assessing and describing MSK pain in IBD.

Sociodemographic and organizational factors associated with musculoskeletal symptoms among intensive care unit professionals.

The heavy and complex work routine in the intensive care unit (ICU) involves high workload, long working hours, high levels of tension, exposure to extreme situations and to hazards of different nature. To investigate the influence of sociodemographic and organizational factors on the development of musculoskeletal pain, tension and fatigue among ICU professionals. We interviewed 128 professionals from seven public hospitals in João Pessoa, Paraiba, Brazil.The data were analyzed using a logistic regression model, and differences between professional categories by means of the likelihood ratio, the Wald and χ2 tests, with significance level set to <0.05. The risk to develop musculoskeletal symptoms differed as a function of the participants' professional category.The odds of nursing technicians to simultaneously develop musculoskeletal pain, fatigue and tension were 4.968 times higher (p=0.023) compared to physicians, nurses and physical therapists.This difference was mediated by factors such as sex, body mass index and number of ICU jobs.Nursing technicians were the most exposed group, and thus they require more attention as concerns workplace health interventions. The participants had long working hours, and differed in regard to the most frequent musculoskeletal complaints as a function of the specificities inherent to the activities of each professional category.

Association of psychological distress and work psychosocial factors with self-reported musculoskeletal pain among secondary school teachers in Malaysia.

BackgroundMusculoskeletal pain is common among teachers. Work-related psychosocial factors are found to be associated with the development of musculoskeletal pain, however psychological distress may also play an important role.ObjectivesTo assess the prevalence of self-reported low back pain (LBP), and neck and/or shoulder pain (NSP) among secondary school teachers; and to evaluate the association of LBP and NSP with psychological distress and work-related psychosocial factors.MethodsThis was a cross-sectional study conducted among teachers in the state of Penang, Malaysia. The participants were recruited via a two stage sampling method. Information on demographic, psychological distress, work-related psychosocial factors, and musculoskeletal pain (LBP and NSP) in the past 12 months was collected using a self-administered questionnaire. Poisson regression was used to estimate the prevalence ratio (PR) for the associations between psychological distress and work-related psychosocial factors with LBP and NSP.ResultsThe prevalence of self-reported LBP and NSP among 1482 teachers in the past 12 months was 48.0% (95% Confidence Interval (CI) 45.2%, 50.9%) and 60.1% (95% CI 57.4%, 62.9%) respectively. From the multivariate analysis, self-reported LBP was associated with teachers who reported severe to extremely severe depression (PR: 1.71, 95% CI 1.25, 2.32), severe to extremely severe anxiety (1.46, 95% CI 1.22, 1.75), high psychological job demand (1.29, 95% CI 1.06, 1.57), low skill discretion (1.28, 95% CI 1.13, 1.47) and poorer mental health (0.98, 95% CI 0.97, 0.99). Self-reported NSP was associated with mild to moderate anxiety (1.18, 95% CI 1.06, 1.33), severe to extremely severe anxiety (1.25, 95% CI 1.09, 1.43), low supervisory support (1.13, 95% CI 1.03, 1.25) and poorer mental health (0.98, 95% CI 0.97, 0.99).ConclusionsSelf-reported LBP and NSP were common among secondary school teachers. Interventions targeting psychological distress and work-related psychosocial characteristics may reduce musculoskeletal pain among school teachers.

Predictive risk factors for chronic regional and multisite musculoskeletal pain: A 5-year prospective study in a working population

The role of psychosocial and physical factors in the development of musculoskeletal pain (MSP) has now been clearly demonstrated. However, it is unclear whether these factors contribute to specific regional MSP or to multisite pain. The main goal of this study was to assess the impact of work-related factors according to gender on the development of regional and multisite MSP. A total of 12,591 subjects (65% men and 35% women) who were born in 1938, 1943, 1948, and 1953 and were participating in a French longitudinal prospective epidemiological survey (ESTEV) in 1990 to 1995 were eligible. Personal factors and work exposure were assessed by self-administered questionnaires. Statistical associations between chronic MSP (regional body site or multisite), personal factors, and occupational factors were analyzed using logistic regression modeling. The incidence of regional MSP and multisite pain in 1995 were, respectively, 17% and 25.6%. For women, highly repetitive movements predicted neck/shoulder pain; posture and vibrations predicted arm and low back pain; and effort with tools predicted arm pain. For men, forceful effort and vibrations predicted neck/shoulder pain; posture and forceful effort predicted lower limb and low back pain; and forceful effort and effort with tools predicted arm pain. Physical constraints (ie, forceful effort or vibrations) were associated with multisite pain in both genders. Only for women, psychological factors were risk factors predictive of upper limb pain and in 3 or 4 painful anatomical sites. These results support the hypothesis that some physical and psychological work-related factors are predictive of regional or multisite MSP but differ according to gender. Gender differences and risk factors for work-related musculoskeletal pain should be also taken into account to more effectively target preventive measures.

Perceived occupational exposures of home care workers and the association to general tension, shoulder-neck and low back pain

Home care workers are at risk of various harmful occupational exposures, health complaints and sick leave. Identifying occupational exposures related to shoulder-neck and low back pain, and assessing the comparative importance of such exposures, for home care workers. One hundred and thirty-eight home care workers in a large municipality in Norway participated in the study (response rate 76.2%). Questionnaire comprised a combination of standardized items and context-specific VAS scales on mental, social, emotional and physical work demands, perceived general tension and pain in shoulder-neck and low back. Severe pain scores for both shoulder-neck and low back regions were common, with individual variations. All VAS measures on occupational exposures were significantly correlated with shoulder-neck pain and all except social demands were significantly correlated with low back pain. However, stronger associations were found with perceived general tension, which proved to be the strongest predictor of shoulder-neck and low back pain, indicating a mediating effect in the relationship between occupational exposures and musculoskeletal pain. Identifying and alleviating occupational exposures is important to ensure a healthy and sustainable work environment. Special attention should be drawn to early signs of symptoms, such as general tension, preventing further development of musculoskeletal pain.

Exploring the associations between sleep problems and chronic musculoskeletal pain in adolescents: a prospective cohort study.

The prevalence of musculoskeletal chronic pain in adolescents is estimated to be approximately 4% to 40%. The development of musculoskeletal pain during teenage years could have a marked impact on physical, psychological and social well-being. To examine whether sleep problems during adolescence are associated with musculoskeletal pain, particularly chronic regional pain and chronic widespread pain. Using data from the Avon Longitudinal Study of Children, the relationship between sleep problems at 15 years of age and the presence of chronic regional and widespread pain at 17 years of age was explored. Pain data were not available at 15 years of age. A total of 2493 participants with complete data were identified. Relationships among sleep problems and musculoskeletal pain were examined using logistic regression. ORs were calculated after adjusting for sex, ethnicity, socioeconomic position and depression (15 years of age). Sleep disturbance (usually wakes up more than two or three times), difficulties with hypersomnolence and poor subjective sleep perception were associated with the presence of both musculoskeletal regional and widespread pain. Finally, using ordered logistic regression, poor subjective sleep perception was also found to be associated with greater pain severity in participants with chronic musculoskeletal regional and widespread pain. The results of the present study suggest an association between sleep problems during adolescence and the presence of musculoskeletal pain at a later stage. These findings are consistent with adult literature suggesting a link between sleep problems and musculoskeletal pain. Given these associations, sleep problems in adolescence may be an important risk factor for musculoskeletal pain.

The importance of physical performance in younger elderly for the development of musculoskeletal pain interfering with normal life: A prospective cohort study

The importance of physical performance in younger elderly for the development of musculoskeletal pain interfering with normal life: A prospective cohort study

Muscle strength in adolescent men and future musculoskeletal pain: a cohort study with 17 years of follow-up

ObjectivesMusculoskeletal pain is highly prevalent throughout adulthood with a major impact on health, function and participation in the society. Still, the association between muscle strength and development of musculoskeletal pain...

Abstract P3-15-06: No Correlation between Endocrine Symptoms and Musculoskeletal Symptoms in Women Receiving Adjuvant Aromatase Inhibitor Therapy

Abstract Background: The etiology of Aromatase Inhibitor (AI) associated musculoskeletal symptoms remains unclear. It has been proposed that musculoskeletal side effects are related to the estrogen depletion achieved on AI therapy. Estrogen depletion with AI therapy is known to result in endocrine side effects. The 18-item Functional Assessment of Cancer Therapy Breast Cancer-Endocrine Subscale (FACTB-ES) is a reliable and well validated quality of life questionnaire shown to be sensitive to changes in endocrine symptoms in breast cancer patients. The objective of this study was to determine whether among women with breast cancer treated with adjuvant AI therapy, self reported musculoskeletal side effects correlate with increased hormonal side effects as measured by the FACTB-ES. Methods: In this 6 month, single center, prospective cohort study, post-menopausal women with hormone-sensitive, non-metastatic breast cancer prescribed AIs by their treating oncologist were evaluated by a rheumatologist at baseline (before starting the AI) and at 6 months. Women who reported new or worsening musculoskeletal symptoms since starting the AI were classified as symptomatic. The FACTB-ES was administered at each visit. Changes in scores between baseline and 6 months were compared between the symptomatic and asymptomatic groups Results: Thirty-five subjects completed the 6 month follow up period. Nineteen (54%) were symptomatic and n=2 (5.7%) discontinued the AI due to these musculoskeletal symptoms. Mean time to onset of symptoms was 6 weeks (range 2 to 18 weeks). Baseline characteristics including age, ethnicity and body mass index did not differ between the groups. There was no significant difference in hormonal symptoms between groups. Both groups had equivalent worsening of their endocrine symptoms as seen by the reduction in their FACTB-score. The mean change in FACTB-ES score was -2.52 (range: -31.00, 23.00) in the symptomatic women versus -2.06 (range: -19.00, 22.21) in the asymptomatic women (Wilcoxon rank sum p=0.95). Conclusions: These data suggest that endocrine symptoms as measured by the FACTB-ES do not correlate with the development of musculoskeletal pain in women treated with adjuvant AI therapy for breast cancer. Though larger studies are necessary to confirm these results, the musculoskeletal symptoms associated with AI use may not be estrogen-dependent. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-15-06.