The experience of pain from the shoulder-neck area related to the total body pain, self-experienced health and mental distress

The present paper presents the relationship between the total body-pain (TBP) score, defined as the total number of areas shaded on a pain drawing, and the pain from one area, the Shoulder-Neck (SN), among subjects in or out of full-time gainful work respectively. Furthermore, relationships between pain-score, self-experienced health (SEH) and level of mental distress, measured with the General Health Questionnaire (GHQ) were investigated. The analyses is based on a general population sample of 8,116 men and women, 45-50 years of age, completing a questionnaire in the Malmo Shoulder Neck Study. The TBP-score was higher with increasing pain from the SN area, being out of full-time work and among women. Independently of working status, the SEH decreased with increasing pain in the SN area, which was enhanced, by increasing TBP-score. The proportion of women out of full-time gainful work was twice as high as for men. Women showed the same SEH levels with regard to their pain status, independently of their working status while men working full-time scored higher than women did. Oppositely, men out of full-time work had the lowest SEH in relation to their pain status. The GHQ scores of mental distress varied essentially in the same way as the SEH did. The results emphasize the need for an assessment of the number of pain locations and which one that first gave symptoms when studying possible causal relationships between low force musculoskeletal load and development of localized pain. If such data are not collected in epidemiological studies on causes for musculoskeletal pain it will at best lead to unnoticed effect modifications. At worst a potential confounding situation may occur. The relationship between the self-experienced health, mental distress and chronic pain identifies chronic pain as a major public-health problem and suggests a multidisciplinary approach in the treatment and rehabilitation already before work capacity is lost. (C) 1999 International Association for the Study of Pain. Published by Elsevier Science B.V.