Prevalence of Self Reported Neck, Shoulder, Arm Pain and Concurrent Low Back Pain or Psychological Distress: Time-Trends in a General Population, 1990-2006
From: Spine: 2009 Aug 1;34(17): 1863-8
Nonspecific neck, shoulder, arm pain is a very common symptom in the general population. It causes suffering for individuals as well as high societal costs in form of sick leave, disability pensions, health care utilization, and loss of productivity. Reviews have reported that the 12-month prevalence of neck pain range from 14% up to 78% and that the 12-month prevalence of shoulder pain range from 5% to 47%. It is important to understand whether the magnitude of different pain conditions are changing in order to plan and provide appropriate health care as well as preventive measures. However, differences in case definitions and study methodologies are considerable, making it difficult to establish time trends for neck, shoulder and arm pain. The authors are not aware of any published studies that have attempted to investigate time trends by repeatedly following the prevalence in a given geographical area.
Neck, shoulder, arm pain is more common among females. A summary of data from epidemiological studies in the general population found a median ratio between females and males of 1.4 for neck pain and 1.3 for shoulder pain. Treaster and Burr concluded that females do have higher prevalence than males for many types of upper extremity musculoskeletal disorders, even after controlling for the type of data source self reporting, plant/worker compensation records or physical examinations and confounders such as age. The reasons behind the prevalence differences are poorly understood, and it is still unclear whether this gender gap has been constant over time, or is increasing or decreasing.
Several studies have reported that both comorbid low back pain and comorbid psychological distress are common. Both a national study and a cross national study have shown that about two-third of individuals with musculoskeletal pain reported pain in at least 2 regions. The link between symptoms in different bodily regions may involve shared pathology, common mechanical risk factors, or some aspects of psychological distress. To the authors knowledge, no studies have reported whether the prevalence of neck, shoulder, arm pain with concurrent low back pain or psychological distress has changed over time.
This article presents data on the prevalence of neck, shoulder, arm pain, neck, shoulder, arm pain with concurrent low back pain, and neck, shoulder, arm pain with concurrent psychological distress, from the Stockholm Public Health Surveys that have been carried out every 4 years since 1990.
It has been hypothesized that the prevalence of musculoskeletal pain is increasing, but the evidence has been both sparse and equivocal. In contrast to an earlier study that found a 2 to 4 fold increase of pain in 2 surveys conducted 40 years apart, the results in the present article indicated a slight rise in the prevalence of neck, shoulder, arm pain, which may indicate a similar but weaker time trend.
