Are determinants for new and persistent upper limb pain different? An analysis based on anatomical sites

Abstract

BACKGROUND: Only few longitudinal studies have explored separately predictors of pain incidence and persistence. OBJECTIVE: To investigate whether biological, lifestyle, occupational and psychological risk factors for the development of new episodes of upper limb pain (ULP) differ from those for its persistence. METHODS: Spanish nurses and office workers (1105) were asked at baseline about biological, lifestyle, occupational and psychological risk factors and pain in the past month at six anatomical sites in the upper limb (left and right shoulder, elbow and wrist/hand). At follow up, 12 months later, pain in the past month was again ascertained. Analysis was based on anatomical sites clustered by person. Associations were assessed by multilevel logistic regression models. RESULTS: Nine hundred and seventy-one participants (87.9%) completed follow-up. Job dissatisfaction and older age carried higher risk of new ULP. Somatising tendency (OR 2.2, 95%CI 1.6-3.1) was the strongest predictor of new ULP, with a risk estimate which differed significantly from that for the same exposure and persistence of ULP. Having adverse beliefs about the work-relatedness of ULP carried a significantly reduced risk for persistence of ULP. CONCLUSION: Our study provides only limited evidence that risk factors predicting new ULP differ from those predicting its persistence.