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      Prevalence of Self-Reported Pain, Joint Complaints and Knee or Hip Complaints in Adults Aged ≥ 40 Years: A Cross-Sectional Survey in Herne, Germany

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          Abstract

          Background

          Pain and musculoskeletal complaints are among the most common symptoms in the general population. Despite their epidemiological, clinical and health economic importance, prevalence data on pain and musculoskeletal complaints for Germany are scarce.

          Methods

          A cross-sectional survey of a random sample of citizens of Herne, Germany, aged ≥ 40 years was performed. A detailed self-complete postal questionnaire was used, followed by a short reminder questionnaire and telephone contacts for those not responding. The questionnaire contained 66 items, mainly addressing pain of any site, musculoskeletal complaints of any site and of knee and hip, pain intensities, the Western Ontario MacMaster Universities (WOMAC) index, medication, health care utilization, comorbidities, and quality of life.

          Results

          The response rate was 57.8% (4,527 of 7,828 individuals). Survey participants were on average 1.3 years older, and the proportion of women among responders tended to be greater than in the population sample. There was no age difference between the population sample and 2,221 participants filling out the detailed questionnaire. The following standardized prevalences were assessed: current pain: 59.7%, pain within the past four weeks: 74.5%, current joint complaints: 49.3%, joint complaints within the past four weeks and twelve month: 62.8% and 67.4%, respectively, knee as the site predominantly affected: 30.9%, knee bilateral: 9.7%, hip: 15.2%, hip bilateral: 3.5%, knee and hip: 5.5%. Pain and musculoskeletal complaints were significantly more often reported by women. A typical relationship of pain and joint complaints to age could be found, i.e. increasing prevalences with increasing age categories, with a drop in the highest age groups. In general, pain and joint pain were associated with comorbidity and body mass index as well as quality of life.

          Conclusions

          Our data confirm findings of other recent national as well as European surveys. The high site specific prevalences of knee and hip complaints underline the necessity to further investigate characteristics and consequences of pain and symptomatic osteoarthritis of these joints in adults in Germany.

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          Most cited references28

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          Osteoarthritis.

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            Chronic musculoskeletal pain, prevalence rates, and sociodemographic associations in a Swedish population study.

            To estimate the prevalence of chronic regional and widespread musculoskeletal pain in a sample of the general adult population and study the association to age, sex, socioeconomic class, immigration, and housing area. A cross sectional survey with a postal questionnaire to 3928 inhabitants on the west coast of Sweden. The age and sex adjusted prevalence of chronic regional pain (CRP) was 23.9% and chronic widespread pain (CWP) 11.4% among 2425 subjects who responded to the complete questionnaire. Odds ratio (OR) for CWP showed a systematic increasing gradient with age and was highest in the age group 59-74 yrs (OR 6.36, 95% CI 3.85-10.50) vs age group 20-34 yrs. CWP was also associated with female sex (OR 1.91, 95% CI 1.41-2.61), being an immigrant (OR 1.83, 95% CI 1.22-2.77), living in a socially compromised housing area (OR 3.05, 95% CI 1.48-6.27), and being an assistant nonmanual lower level employee (OR 1.92, 95% CI 1.09-3.38) or manual worker (OR 2.72, 95% CI 1.65-4.49) vs being an intermediate/higher nonmanual employee. OR for CRP showed a systematic increasing gradient with age and was highest in the age group 59-74 yrs (OR 2.22, 95% CI 1.62-3.05) vs age group 20-34 yrs. CRP was also associated with being a manual worker (OR 1.63, 95% CI 1.19-2.23) vs being an intermediate/higher nonmanual employee. Chronic musculoskeletal pain is common in the general population. Sociodemographic variables were overall more frequently and strongly associated with CWP than with CRP, which indicates different pathophysiology in the development or preservation of pain in the 2 groups.
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              Prevalence of self reported musculoskeletal diseases is high.

              To present the prevalence of self reported musculoskeletal diseases, the coexistence of these diseases, the test-retest reliability with six months in between, and the association with musculoskeletal pain symptoms. Twelve layman descriptions of common musculoskeletal diseases were part of the questionnaires of a prospective cohort study of a random sample in the general Dutch population aged 25 years or more (baseline: n=3664, follow up after six months: n=2338). Data collection also included information about pain relating to five different anatomical areas. Osteoarthritis of the knee (men 10.1%, women 13.6%) was amongst the most reported musculoskeletal diseases, whereas the figures for self reported rheumatoid arthritis (RA) were 1.6% and 4.6% for men and women, respectively. The coexistence of these diseases is high: 47 of the 66 combinations were reported more often than would be expected if they were independent of each other (p<0.05). For most diseases the test-retest reliability was good (kappa between 0.6 and 0.8), but for repetitive strain injury (kappa=0.37) and chronic arthritis other than RA (kappa=0.44) the agreement was fair to moderate. All complaints of pain were more often reported by those with musculoskeletal diseases than those without those diseases, and the pain pattern was disease-specific. Self reported musculoskeletal diseases are highly prevalent, with a fair to good reliability and a disease-specific pain pattern. Health surveys are a limited but valuable source of information for this group of health problems, which is not available from most other sources of information.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2013
                30 April 2013
                : 8
                : 4
                : e60753
                Affiliations
                [1 ]Department of Geriatrics, University of Bochum, Marienhospital Herne, Herne, Germany
                [2 ]Department of Medical Informatics, Biometry and Epidemiology, University of Bochum, Bochum, Germany
                [3 ]Department of Internal Medicine, Alfried Krupp Krankenhaus Steele, University of Duisburg-Essen, Essen, Germany
                [4 ]Department of Orthopedics, HELIOS Klinikum Berlin-Buch, Berlin, Germany
                [5 ]Department of Rheumatology and Clinical Immunology, Charite Berlin, University of Berlin, Berlin, Germany
                Tehran University of Medical Sciences, Iran (Islamic Republic of)
                Author notes

                Competing Interests: The study was supported by an unrestricted research grant of MSD Sharp & Dohme, Haar, Germany. L. Pientka has received fees from MSD Sharp & Dohme, Haar, Germany, as a consultant and for lectures, and also funding for other research projects. J Zacher is employed by HELIOS Klinikum Berlin-Buch. There are no patents, products in development or marketed products to declare. This does not alter the authors′ adherence to all the PLOS ONE policies on sharing data and materials.

                Interpreted the results: UT RL SG CB HGE LP. Revised the manuscript for important intellectual content: HGE RL SG JS CB JZ GRB LP. Conceived and designed the experiments: UT JS LP. Performed the experiments: UT RL SG JS. Analyzed the data: UT RL HGE. Wrote the paper: UT.

                Article
                PONE-D-12-04124
                10.1371/journal.pone.0060753
                3640012
                23646102
                4fb05d39-85ec-4541-b172-ef6aa07fc5ca
                Copyright @ 2013

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 9 February 2012
                : 5 March 2013
                Page count
                Pages: 10
                Funding
                In 2005 and 2006, U. Thiem and J. Schumacher were supported by a "Forschungskolleg Geriatrie" grant from the Robert Bosch Foundation, Stuttgart, Germany. The study was supported by an unrestricted research grant of MSD Sharp & Dohme, Haar, Germany, and the initiative "Stark gegen der Schmerz e.V.". The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine
                Anatomy and Physiology
                Musculoskeletal System
                Bone
                Cartilage
                Anesthesiology
                Pain Management
                Clinical Research Design
                Cross-Sectional Studies
                Epidemiology
                Epidemiology
                Epidemiological Methods
                Survey Methods
                Public Health
                Health Screening
                Rheumatology
                Bone and Mineral Metabolism
                Cartilage
                Osteoarthritis

                Uncategorized
                Uncategorized

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