title: Prevalence and characteristics of widespread pain in female primary health care patients with chronic low back pain.
abstract: OBJECTIVE
  To estimate the prevalence of widespread pain (WP) according to the American College of Rheumatology, 1990, in women with chronic low back pain (CLBP) consulting primary health care and to evaluate the differences in body function, activity, participation, environmental factors, health-related quality of life, and other health-related aspects between patients having CLBP with or without WP.
  
  
  METHODS
  A cross-sectional study of women with CLBP including clinical assessment and questionnaires was conducted. Patients were categorized as having CLBP with or without WP and differences between these groups were evaluated.
  
  
  RESULTS
  One hundred thirty patients were assessed. Twenty-eight percent (n=37) had WP. Patients with CLBP+WP showed more impaired physical performance (6-min walk test, handgrip strength), higher numbers of tender points, more severe pain, fatigue, and depression compared with CLBP (P<0.05). The CLBP+WP showed greater activity limitation (P=0.00047). Work disability was 35% (n=13/37) in CLBP+WP compared with 16% (n=15/93) in CLBP (P=0.032). Private social support was negatively impacted in CLBP+WP (P=0.010). The CLBP+WP showed lower health-related quality of life (SF-36) in the physical function, bodily pain, and vitality dimension (P<0.05). More severe clinical stress symptoms and risk for future disability were registered for the CLBP+WP (P<0.001).
  
  
  CONCLUSIONS
  Twenty-eight percent fulfilled the American College of Rheumatology 1990 criteria for WP. When WP was present, patients reported significantly more impaired body functions, more severe activity limitations, and participation restrictions. Environmental factors, health-related quality of life, and other health-related aspects were also negatively impacted. It is suggested that the presence of WP should be evaluated in female patients with CLBP.
authors.affiliation: Sahlgrenska School of Public Health and Community Medicine, University of Gothenburg (UGOT), Sweden. lena.nordeman@vgregion.se
authors.forename: Lena
authors.initials: L
authors.lastname: Nordeman
authors.forename: Ronny
authors.initials: R
authors.lastname: Gunnarsson
authors.forename: Kaisa
authors.initials: K
authors.lastname: Mannerkorpi
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D015992:Body Mass Index; D059350:Chronic Pain / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D004777:Environment; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology; D008875:Middle Aged; D009043:Motor Activity; D010147:Pain Measurement; D015995:Prevalence; D011320:Primary Health Care; D011788:Quality of Life; D012189:Retrospective Studies; D012944:Social Support; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires