Musculoskeletal pain in Malaysia: a COPCORD survey.
OBJECTIVE
To assess the nature and extent of rheumatic complaints in a semirural area in a multiracial (Malay, Indian, Chinese) community in Malaysia using the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) protocol initiated by ILAR and the WHO.


METHODS
All members of a community of 2700 persons over the age of 15 years were offered a questionnaire based interview in Phase 1 of the study. Those with rheumatic complaints (pain in the last 1 week) were invited for a physical examination by a rheumatologist in Phase 2.


RESULTS
In total, 2594 (96%) persons agreed to a questionnaire based interview. Of those interviewed, 21.1% had a current rheumatic complaint. The pain rate was higher in women (23.8%) than in men (17.8%). Chinese men had the lowest age-standardized pain rate (9.9%), while Indian women had the highest rate (28.4%). In the study population, 14.4% complained of pain in the joints and/or musculoskeletal pain and 11.6% had low back pain. The knee was responsible for 64.8% of all complaints pertaining to the joints, and more than half those examined with knee pain had clinical evidence of osteoarthritis (OA). The complaint rate increased with age, up to 53.4% in the group age > 65 years. The major disability encountered was the inability to squat (3.1%). Fibromyalgia, soft tissue lesions, and localized OA of the knees were the main clinical diagnoses. Inflammatory arthritis was uncommon. Both Western and traditional sources of healthcare were used, often together. Self-medication was common (58.8%).


CONCLUSIONS
Knee and back pain are the main rheumatic complaints in Malaysia, with complaint rates differing according to race and gender.
Veerapen
Kiran
K
University of Malaya Medical Centre, Kuala Lumpur, Malaysia. kveerapen@shaw.ca
Wigley
Richard D
RD
Valkenburg
Hans
H
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000453:epidemiology* / Q000208:ethnology*; D001416:Back Pain / Q000453:epidemiology* / Q000208:ethnology*; D002681:China / Q000208:ethnology; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology / Q000208:ethnology; D006306:Health Surveys; D006801:Humans; D007194:India / Q000208:ethnology; D007719:Knee Joint; D008296:Malaysia / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009790:Occupations; D020370:Osteoarthritis, Knee / Q000453:epidemiology / Q000208:ethnology; D044469:Racial Groups; D012737:Sex Factors