Undiagnosed mood disorders and sleep disturbances in primary care patients with chronic musculoskeletal pain.

Objective. The study aims to determine the prevalence of undiagnosed comorbid mood disorders in patients suffering chronic musculoskeletal pain in a primary care setting and to identify sleep disturbances and other associated factors in these patients, and to compare the use of health services by chronic musculoskeletal pain patients with and without comorbid mood disorders. Design. Cross-sectional study. Subjects. A total of 1,006 patients with chronic musculoskeletal pain from a representative sample of primary care centers were evaluated. Outcome Measures. Pain was measured using a visual analog scale and the Primary Care Evaluation of Mental Disorders questionnaire was used to measure mood disorders. Results. We observed a high prevalence of undiagnosed mood disorders in chronic musculoskeletal pain patients (74.7%, 95% confidence interval [CI] 71.9–77.4%), with greater comorbidity in women (adjusted odds ratio [OR] = 1.91, 95% CI 1.37–2.66%) and widow(er)s (adjusted OR = 1.87, 95% CI 1.19–2.91%). Both sleep disturbances (adjusted OR = 1.60, 95% CI 1.17–2.19%) and pain intensity (adjusted OR = 1.02, 95% CI 1.01–1.02%) displayed a direct relationship with mood disorders. Moreover, we found that chronic musculoskeletal pain patients with comorbid mood disorders availed of health care services more frequently than those without (P < 0.001). Conclusions. The prevalence of undiagnosed mood disorders in patients with chronic musculoskeletal pain is very high in primary care settings. Our findings suggest that greater attention should be paid to this condition in general practice and that sleep disorders should be evaluated in greater detail to achieve accurate diagnoses and select the most appropriate treatment

Common exercise prescription for management of weight and osteoarthritis : a systematic review : a thesis presented in partial fulfilment of the requirements for the degree of Master of Sport and Exercise at Massey University, Wellington, New Zealand

Background: Obesity and osteoarthritis are two debilitating conditions that are increasing in prevalence. Obese populations are at an increased risk for developing osteoarthritis in later life. Exercise has been shown to be successful in improving both weight status and musculoskeletal pain, yet it remains unclear if there is an exercise intervention that results in improved weight status while preventing the development of osteoarthritis. Objective: The purpose of this systematic review is to investigate the existence of a natural overlap in exercise prescription for obese and osteoarthritic populations and recommend an evidence-based exercise intervention for the management of weight and prevention of musculoskeletal pain. Methods: A structured electronic review was conducted using the following electronic databases: MEDLINE, PubMed, and SPORTDiscus. Two searches were performed using the search strings “obes*” AND “exercise” AND “interven*” AND “musculoskeletal pain OR knee pain OR hip pain” and “osteoarth*” AND “exercise” AND “interven*” AND “musculoskeletal pain OR knee pain OR hip pain”. Studies were then reviewed using inclusion/exclusion criteria (exclusion criteria: menopausal, cancer, review, obesity related co-morbidities, animal studies; inclusion criteria: studies had to be randomised controlled trials, participants aged 18-50, include non-exercise control, and outcomes must include physical function or musculoskeletal pain). Included studies were ranked by change in measured outcome variables (descending order); a summary of recommended exercise prescription was based on common prescription used in the interventions with greatest change. A Downs and Black checklist was completed for all studies included in this review to assess methodological quality. Results: Twenty-one studies met inclusion criteria and were included in this review (obesity n = 11; OA n = 7; obesity & OA n= 3). Exercise significantly improved weight status and/or musculoskeletal pain. Similarities in exercise intensity (40-80% VO2max), frequency (3 times per week), duration (30-60 minutes), and exercise mode (treadmill, cross-trainer, stationary bike, aquatic exercise) were observed between studies. Conclusion: Substantial overlap in exercise prescription for obese and OA populations exist. These findings suggest that moderate intensity exercise for 30-60 minutes, 3 times per weeks can achieve effective improvements in weight and musculoskeletal pain. Exercise and weight loss are effective treatments for obesity and musculoskeletal symptoms and should be recommended to all at-risk individuals

Rationale, design and methods of the Study of Work and Pain (SWAP): a cluster randomised controlled trial testing the addition of a vocational advice service to best current primary care for patients with musculoskeletal pain (ISRCTN 52269669)

Background Musculoskeletal pain is a major contributor to short and long term work absence. Patients seek care from their general practitioner (GP) and yet GPs often feel ill-equipped to deal with work issues. Providing a vocational case management service in primary care, to support patients with musculoskeletal problems to remain at or return to work, is one potential solution but requires robust evaluation to test clinical and cost-effectiveness. Methods/Design This protocol describes a cluster randomised controlled trial, with linked qualitative interviews, to investigate the effect of introducing a vocational advice service into general practice, to provide a structured approach to managing work related issues in primary care patients with musculoskeletal pain who are absent from work or struggling to remain in work. General practices (n = 6) will be randomised to offer best current care or best current care plus a vocational advice service. Adults of working age who are absent from or struggling to remain in work due to a musculoskeletal pain problem will be invited to participate and 330 participants will be recruited. Data collection will be through patient completed questionnaires at baseline, 4 and 12 months. The primary outcome is self-reported work absence at 4 months. Incremental cost-utility analysis will be undertaken to calculate the cost per additional QALY gained and incremental net benefits. A linked interview study will explore the experiences of the vocational advice service from the perspectives of GPs, nurse practitioners (NPs), patients and vocational advisors. Discussion This paper presents the rationale, design, and methods of the Study of Work And Pain (SWAP) trial. The results of this trial will provide evidence to inform primary care practice and guide the development of services to provide support for musculoskeletal pain patients with work-related issues. Trial registration Current Controlled Trials ISRCTN52269669

Prevalence and Correlates of Musculoskeletal Pain in Adults with Type 2 Diabetes in Populations with Low-Risk of Obesity: A Cross- Sectional Study

BACKGROUND፡ There are few data concerning the prevalence and predictors of musculoskeletal pain among adults with type 2 diabetes in population with low-risk of obesity. Our objective was to describe the point prevalence and factors associated with increased risk of musculoskeletal pain in this population.METHODS: A cross-sectional data of 200 adults with type 2 diabetes, aged ≥ 18 years who were attending two tertiary hospitals were examined. Musculoskeletal pain and physical activity were collected with Nordic Musculoskeletal Questionnaire (NMQ) and International Physical Activity Questionnaire (IPAQSF) respectively. We used logistic regression to examine the risks associated with musculoskeletal pain.RESULTS: The point prevalence of musculoskeletal pain was 72.7% and similar between men (72.3%) and women (73.1%). In the last 7days, advancing age (odds ratio=1.09;95%CI:1.02-1.16) and comorbidity (odds ratio=3.0;95%CI:1.07-8.39) were risk factors associated with musculoskeletal pain. In the last 12 months, only comorbidity (odds ratio=5.57;95%CI:1.62-19.17) was a risk factor for increasing musculoskeletal pain. However, a unit increase in physical activity level (odds ratio=0.06;95%CI:0.008-0.51) was associated with decreased odds of musculoskeletal pain.CONCLUSIONS: The prevalence of musculoskeletal pain was high and physical activity was associated with a decreased risk thereof. A further research should be evaluated on the influence of physical activity on musculoskeletal pain

Perbedaan Angka Kejadian Nyeri Muskuloskeletal Antara Pria Dan Wanita Pada Kelompok Tani Nira Di Dusun Ngudi Mulyo Pajangan Bantul

Background : Pain disorders resulted by any damage such as muscle spasm, inflammation, degenaration, and bone fractures acommpanied by pain sensation so that reduces the ability of motion. The prevalence of musculoskeletal pain in workers ranged between 6-76% for a year. The prevalence of musculoskeletal pain is higher in female than in male. Objective : The objective of this research is to determine whether there is a difference in the incidence of Musculoskeletal Pain between male and female in Nira’s Farmer Group at Ngudi Mulyo, Pajangan, Bantul. Methods : This research has been used an analytic observational study by cross sectional approach. The sampling method was purposive sampling found 84 people. The data analysis was Mann-Whitney test. Result : Male Nira’s farmer mostly had a mild pain 64,3%, while female Nira’s farmer was 66,7 %. The results of this research showed a statistically significant difference in the incidence of musculoskeletal pain between male and female value p of < 0,0001. Conclusion : This research shows there is a difference in the incidence of musculoskeletal pain between male and female

Musculoskeletal pain and backpack usage among school children in Nairobi County, Kenya

Background: School children travel to and from school on daily basis. Active transportation such as walking, running and cycling contribute significantly to the increase in physical activity, health, and wellbeing in children. However, there has been a growing concern on the effect of carrying heavy backpack on the health of school going children who are at an important developmental stage of their lives.Objective: To determine the prevalence of musculoskeletal pain linked to backpack use and associated ergonomic factors among pupils in Nairobi City County in Kenya.Design: Descriptive cross-sectional study.Setting: Primary schools in Nairobi CountySubjects: 379 school-going childrenResults: The study results indicate that a significant number of pupils (73.6%) complain of musculoskeletal pain. Low back pain (25.1%) was the most prevalent musculoskeletal pain followed by neck pain (16.9%). There was a significant association (p=0.001) between backpack weight-to-schoolchild body weight (BTSW %) and the presence of musculoskeletal pain. The proportion of pupils carrying school bag weighing more than 15% of their body weight was 28%.Conclusion: Prevalence of musculoskeletal pain related to backpack usage among Kenyan school going children is high. School children who carry backpacks that weigh more than 15% of their body weight (BTSW %) are at risk of experiencing musculoskeletal pain

Are sleep problems a risk factor for the onset of musculoskeletal pain in children and adolescents? A systematic review

Study Objectives: Musculoskeletal pain is a major burden on the society. Adults with sleep problems are at higher risk of musculoskeletal pain onset, but there is no evidence for this relationship in children and adolescents. This study aimed to systematically review prospective studies on the risk of musculoskeletal pain onset in children and adolescents with sleep problems. Methods: Five databases (MEDLINE, PsycINFO, AMED, EMBASE, and HMIC) were systematically searched to identify prospective studies that investigated if children and adolescents (aged 6–19 years) with sleep problems are at higher risk of musculoskeletal pain onset. Included studies were assessed for study quality and a best evidence synthesis was carried out on extracted data. Results: Thirteen prospective studies were identified. Overall, evidence indicates that sleep problems (quality, quantity, and day time tiredness) are not risk factors for musculoskeletal pain onset. Further analysis on specific body regions shows strong evidence that sleep problems are a risk factor for neck pain onset (only in girls) and that sleep problems are not a risk factor for the onset of widespread pain. Conclusions: Overall, sleep problems are not a risk factor for musculoskeletal pain onset in children and adolescents. Increased risk was found for some specific body regions and subgroups, but the evidence base was less strong and generally inconsistent. This review found a lack of quality in research methodology compared to research in adults, and further research with improved methodology is required