Predictors of change in pain and physical functioning among post-menopausal women with recurrent pain conditions in the women's health initiative observational cohort.
Pain complaints are commonly reported symptoms among postmenopausal women and can have significant effects on health-related quality of life. We sought to identify medical and psychosocial factors that predict changes in pain and overall physical functioning over a 3-year period among postmenopausal women with recurrent pain conditions. We examined data from postmenopausal women age 50 to 79 with recurrent pain conditions (low back pain, neck pain, headache or migraines, or joint pain or stiffness) over a 3-year period using the Women's Health Initiative Observational Study Cohort (N = 67,963). Multinomial logistic regression models controlling for demographic and clinical characteristics were used to identify baseline predictors of change in the SF-36 subscales for pain and physical functioning between baseline and 3-year follow-up. Body mass index (BMI) was associated with worsening of pain (OR [95% CI] 1.54 [1.45-1.63] for BMI ≥30) and physical functioning (1.83 [1.71-1.95] for BMI ≥30). A higher reported number of nonpain symptoms, higher medical comorbidity, and a positive screen for depression (1.13 [1.05-1.22] for worsened pain) were also associated with worsening of pain and physical functioning. Baseline prescription opioid use was also associated with lack of improvement in pain (OR .42, 95% CI .36-.49) and with worsened physical functioning (1.25 [1.04-1.51]).


CONCLUSIONS
This study presents prospective data on change in pain and physical functioning in postmenopausal women over a 3-year period. Our results suggest depression, nonpain physical symptoms, obesity, and possibly opioid treatment are associated with worse long-term pain outcomes in this population.
Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA. jkbrenn@uw.edu
Jennifer Brennan
JB
Braden
Alicia
A
Young
Mark D
MD
Sullivan
Brian
B
Walitt
Andrea Z
AZ
Lacroix
Lisa
L
Martin
D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D003863:Depression; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D019370:Observation; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology; D017698:Postmenopause; D011237:Predictive Value of Tests; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016387:Women's Health