Chronic Musculoskeletal Pain: Prevalence, impact and multidisciplinary treatment in Iceland

• Main Author: Björnsdóttir, Sigrún Vala
• Other Authors: Unnur Anna Valdimarsdóttir, Læknadeild (HÍ), Faculty of Medicine (UI), Heilbrigðisvísindasvið (HÍ), School of Health Sciences (UI), Háskóli Íslands, University of Iceland
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: University of Iceland, School of Health Sciences, Faculty of Medicine 2017
• Subjects: Chronic musculoskeletal pain; Prevalence; Multidisciplinary rehabilitation; Health-related quality of life; Evidence-based practice; Stoðkerfi (líffærafræði); Verkir; Endurhæfing; Algengi sjúkdóma; Lífsgæði; Gagnreynd heilbrigðisvísindi; Doktorsritgerðir; Iceland
• Online Access: https://hdl.handle.net/20.500.11815/316

Background and aims: Worldwide chronic musculoskeletal (MSK) pain is a prevalent problem constituting a considerable societal burden. The aim was to investigate the prevalence of chronic MSK pain conditions in Iceland and the potential impact on physical and mental health, and further, to assess the potential influence of a 4-week traditional multidisciplinary pain management program (TMP) and a similar program adding neuroscience patient education and mindfulness based cognitive therapy (NEM) on health-related quality of life (HRQL) and pain intensity among women experiencing chronic MSK pain. Methods: Using a population-based randomly selected sample of 5,906 Icelanders, aged 18-79 years (response rate of 60.3%), the prevalence of chronic MSK pain conditions in Iceland, in December 2007, was assessed. The prevalence estimations were weighted by gender, age and residential area to properly represent the underlying population. Multivariate logistic regression models were used to assess associations between chronic MSK pain conditions and functional limitations as well as symptoms. To assess the effectiveness of the two programs we used data from an Icelandic rehabilitation center (Heilsustofnun NLFÍ) including 122 women who received TMP, 90 receiving NEM, and 57 waiting list controls. The HRQL (Icelandic Quality of Life Scale) and pain intensity (100 mm Visual Analogue Scale) had been measured before, as well as after the interventions and 6-months after the completion of the interventions. Analysis of variance and linear regression were used for comparisons. Results: The point prevalence of chronic MSK pain conditions was 19.9% with distinct gender differences (men=15.2%; women=24.7%) and varied considerably with sociodemographic factors. Compared with individuals without chronic MSK pain, those with the condition reported considerably higher odds ratios (OR) of poor physical (OR men=4.0 [95%CI=3.0-5.2]; OR women=6.8 [95%CI=5.4-8.5]) and mental health (OR men=1.7 [95%CI=1.3-2.3]; OR women=2.4 [95%CI=1.9-3.0]) ...