Local Pain Is Really Rather Rare

When patients report back pain, neck pain, shoulder pain, or other local sites of body pain, it’s rare that they don’t have pain in other parts of the body as well. But most studies focus on an individual (local) area of pain. So the idea that low back pain is really present as part of a widespread pain pattern gets lost.

And with that clinical picture comes a different understanding of how local versus widespread pain affects patients’ lives. Widespread pain (present in multiple places of the body) results in decreased function, increased disability, and greater absenteeism in the workplace.

In this study, researchers from Norway verify the idea that localized back pain is rare. Most people really have low back pain along with painful symptoms in multiple other sites. They proved this by mailing questionnaires to over 3,000 people. They asked questions of adults in seven age groups. The people were between 24 and 86 years old. The age groups were divided by two-year intervals.

Everyone was asked to report if they had any pain or discomfort in any one or more of 10 different body parts. The symptoms were limited to two time periods: the last seven days and the past 12 months. The questionnaire included a body drawing to show a picture of the areas in question (head, neck, shoulder, elbow, hand/wrist, upper back, lower back, hip, knee, ankle/foot).

Each person completed a separate questionnaire about functional ability. Questions were asked about physical fitness, feelings, daily activities, and social activities. After compiling all the data, the authors focused on the past seven day period and found the following:

  • The most common sites of pain were the neck, shoulder, and head (headache).
  • Women were more likely to report neck pain. Men had more low back pain.
  • In general, women had more areas of pain than men.
  • The majority of people (85 per cent) had pain in more than one area at one time.
  • People with local pain (one site only) did not report a decrease or change in function related to that pain.
  • Participants with multiple sites of pain had decreased function in all four areas measured. The more sites of pain, the more function was reduced. Daily activities were affected most often.

    This is the first study to clearly show a direct link between widespread pain and reduced function. The overall effect of these two factors is a decrease in quality of life. The authors point out the need to recognize pain and symptoms that coexist. When studying one area of the body, the big picture of widespread pain and dysfunction is overlooked. Future research and practice in medicine must take this information into account when studying a single site of pain.