| dc.description.abstract | Background. The prevalence of musculoskeletal pain in the general
population is alarming. Studies on musculoskeletal pain in clinical
settings and in the community show that there exists a relationship
between widespread musculoskeletal pain and psychological symptoms.
Objective. The present study was designed to examine the hypothesis
that psychological distress precedes the development of widespread
musculoskeletal pain.
Methods. In late autumn 1990 all inhabitants of the municipality of
Ullensaker, Norway, belonging to six birth cohorts (20-22 years, 30-32
years, 40-42 years, 50-52 years, 60-62 years and 70-72 years) were sent
a questionnaire from which data on musculoskeletal pain and
psychological distress were collected. Demographic characteristics were
also gathered in the questionnaire. Of 1144 responders who were free of
musculoskeletal pain in 1990, 702 persons returned a second
questionnaire with complete data four years later (1994).
Results. Twenty-one (3.0%) of the responders at the follow-up, two
thirds of which were females, reported to have widespread
musculoskeletal pain. At the 95% confidence intervals, a multivariate
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analysis showed that psychological distress was associated with the
development of widespread musculoskeletal pain four years later even
after adjustment for gender, age and some demographic and work
characteristics.
Conclusion. Persons who are free from musculoskeletal pain, are
nevertheless at constant increased future risk of its development if they
experience psychological distress. Findings from this population-based
prospective study supported previous findings of a relationship between
musculoskeletal pain and psychological distress and provided evidence
that psychological distress precedes widespread musculoskeletal pain.
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Readers column in Drammens Tidende og Buskeruds Blad, April 29, 2002
...very few of us were getting an accurate diagnosis of our chronic pain
condition... Doctors also have to learn that many of our additional pains
influence our quality of life... Nobody needs to suffer from chronic pain
without getting an appropriate help and relief. The help is there, but the
will and knowledge about the complexity of pain are lacking. Since not
everything can be weighed and measured, mutual cooperation is
important. Everybody has the right to a good quality of life, and the
doctors are not there to judge the reliability of what the patients are
saying. When it is about pain, you have to trust what the patients are
telling you. There is no other way! [Original text is in Norwegian]
One of many patients in Drammen
1.1 Theoretical background
Pain is a complex concept, and an accurate definition of this
phenomenon should be able to encompass all variations of this concept
from the point of view of all the relevant disciplines, e.g. medicine,
psychology, sociology, philosophy and anthropology. Unfortunately, such
a precise definition does not exist. Furthermore, not only is the
phenomenon complex, but the mechanisms underlying pain are also complex, and the more they are investigated, the more complex they
appear (1).
The most accurate definition for pain to date is that given by the
International Association for the Study of Pain (IASP) Committee for
Taxonomy, which describes pain as an unpleasant sensory and
emotional experience associated with actual or potential tissue damage. | nor |