Traffic accidents linked to increased risk of chronic widespread pain

March 21, 2011, Wiley

Individuals with poorer health or psychological issues may be prone to developing chronic widespread pain following a traumatic event. This new research, published today in Arthritis Care & Research, a peer-reviewed journal of the American College of Rheumatology (ACR), found that the onset of chronic pain was more often reported following a traffic accident than from other physically traumatic triggers.

The ACR defines chronic widespread pain as the presence of pain above and below the waist, or on both the left and right sides of the body, for three months or longer. Prior studies have reported chronic widespread pain prevalence rates between 11% and 13% in Germany, Sweden, the U.K. and the U.S. Medical literature suggests that this type of pain increases with age, is more common in women than men, and is a primary characteristic of fibromyalgia—one of the most common reasons for rheumatology consultations worldwide.

"We believe there are persons—defined by prior physical and psychological health—who in the event of a traumatic trigger are vulnerable to developing chronic widespread pain," explained Gareth Jones, PhD, of the University of Aberdeen School of Medicine and Dentistry, U.K., and lead author of the current study. "Under this hypothesis, the precise nature of the traumatic event may even be immaterial."

To examine the relationship between different physically and the onset of chronic widespread pain, researchers followed 2069 participants from the Epidemiology of Functional Disorders (EPIFUND) study. Participants in the EPIFUND study, a population-based prospective cohort, provided data on musculoskeletal pain and associated psychological distress at three time points over a four-year period. Patients were also asked about their recent experience with six physically traumatic events—traffic accident, workplace injury, surgery, fracture, hospitalization and childbirth.

Of those who participated in the study through follow-up, 241 (12%) reported new onset of chronic widespread pain, with more than one-third of these subjects more likely to report at least one traumatic event during the study period than other individuals. After researchers adjusted for age, sex, general practice and baseline pain status, those who reported a traffic accident experienced an 84% increase in the likelihood of new onset chronic widespread pain. No association was observed with hospitalization, surgery or in women who gave birth. "Further research should focus on the unique aspects of an auto accident and the individual's reaction to this particular trauma that causes the increased risk of chronic widespread pain onset," concluded Dr. Jones.

More information: Road Traffic Accidents, but Not other Physically Traumatic Events, Predict the Onset of Chronic Widespread Pain: Results from the EpiFunD Study." Gareth T. Jones, Barbara I. Nicholl, John McBeth, Kelly A. Davies, Richard K. Morriss, Chris Dickens and Gary J. Macfarlane. Arthritis Care and Research; Published Online: March 21, 2011. DOI:10.1002/acr.20417

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