MedicalResearch.com: What are the main findings of the study?
Dr. McBeth: In this study, reporting musculoskeletal pain was common with just under half of participants reporting some pain and one quarter reporting widespread pain. Of those who were free of WP at baseline, 19% reported new onset widespread pain at three year follow up.
In addition to osteoarthritis, sleep, cognitive impairment, anxiety and physical health independently predicted the onset of widespread pain and are important treatment targets. In this study non-restorative sleep was the strongest predictor of new onset widespread pain. Sleep is a modifiable target that could improve outcome in this patient group.
MedicalResearch.com: Were any of the findings unexpected?
Dr. McBeth: We did expect osteoarthritis to improve the prediction of onset of widespread pain but this was not found. This highlights the need to look at combined treatment targets to osteoarthritis for managing widespread pain.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. McBeth: Currently the management and treatment of musculoskeletal pain in older adults is suboptimal. Clinical approaches that target multiple sites of osteoarthritis may be useful. However the clinical approach to managing widespread pain in older adults may need to move beyond focusing on treatment of osteoarthritis and consider combined interventions. This study suggests that in addition to osteoarthritis, sleep, cognitive impairment, anxiety and physical health are important treatment targets. In this study non-restorative sleep was the strongest predictor of new onset widespread pain. Sleep is a modifiable target that could improve outcome in this patient group.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. McBeth: The clinical effectiveness of pharmacological and non-pharmacological approaches to sleep should be tested in randomized controlled trials. Future studies should seek to identify other factors that increase the risk of developing new onset widespread pain in older people and that may offer targets for pain reduction. Such mechanisms are likely to be multi-factorial including common factors known to be associated with reporting widespread pain, age-specific social factors that influence pain reporting, and changes in pain processing mechanisms. The role of these psychosocial factors and new onset WP in older people may be a useful line of future inquiry.
Predictors of New Onset Widespread Pain in Older Adults- Results from the Prospective Population-based NorStOP Study.” John McBeth, Rosie J Lacey and Ross Wilkie. Arthritis & Rheumatology; Published Online: February 13, 2014 (DOI: 10.1002/art.38284).