Musculoskeletal chronic pain in general practice. Studies of health care utilisation in comparison with pain prevalence.
OBJECTIVE
To study the relations between population prevalence of chronic pain and pain-related diagnoses (musculoskeletal and headaches) in primary health care (PHC) and to examine longitudinal variations in these diagnoses.


METHODS
A population-based mailed survey to catch prevalence data and continuous computerised diagnosis registration in PHC.


METHODS
General population in a well-defined Swedish PHC district.


METHODS
A random sample of 15% of the population aged 25-74, n = 1101. Annual visitors to district physicians at the health centre.


METHODS
Rates of pain-related diagnoses in PHC in relation to population prevalence of chronic pain. Comparisons of the number of individuals (annual visiting rates) with pain-related diagnoses 1987-1996.


RESULTS
Population pain prevalence and pain-related diagnoses in PHC corresponded as regards the magnitude and distribution of chronic pain by age and partly by pain location. Compared to low-back and widespread pain, neck-shoulder pain and headaches were less frequent in PHC in relation to reported prevalence. From 1987 to 1996 we found an increasing number of individuals seeking primary care with pain-related diagnoses. The increase was mainly assigned to the groups of fibrositis/myalgia and headache.


CONCLUSIONS
Pain-related diagnoses in PHC reflect partly the occurrence of self-reported chronic pain symptoms in the population. The observed increase in visits with pain-related diagnoses in the last 10 years is due to an increased number of individuals with soft-tissue rheumatism and headaches. Future studies will have to elucidate whether these findings are due to an increase in morbidity or changes in care-seeking and social conditions.
Andersson
H I
HI
Bromölla Health Centre, Sweden.
Ejlertsson
G
G
Leden
I
I
Scherstén
B
B
D000328:Adult; D000368:Aged; D001416:Back Pain / Q000453:epidemiology; D002908:Chronic Disease; D005194:Family Practice; D005260:Female; D006261:Headache / Q000453:epidemiology; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D019547:Neck Pain / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology*; D015995:Prevalence; D013548:Sweden