title: Spreading of chronic pain between body regions: prospective cohort study among health care workers.
abstract: OBJECTIVE
  To estimate the prognostic value of pain in one body region on the risk for developing chronic pain in other body regions.
  
  
  METHODS
  Prospective cohort study among 5052 Danish female health care workers responding to a baseline and follow-up questionnaire in 2005 and 2006, respectively. Using adjusted logistic regression analysis, the risk for developing chronic pain (>30 days last year) at follow-up in the low back (among those without low back pain during the last year at baseline) when experiencing sub-chronic (1-30 days last year) or chronic pain in other body regions (i.e., the neck/shoulders and/or the knees at baseline) was modelled. Similar risks were modelled for developing chronic pain in the neck/shoulders and knees.
  
  
  RESULTS
  Chronic pain in the neck/shoulders (OR 3.14; 95% CI 1.74-5.70) or knees (OR 2.57; 95% CI 1.28-5.16) at baseline increased the risk for developing chronic pain in the low back at follow-up. Likewise, chronic pain in the neck/shoulders (OR 2.39; 95% CI 1.36-4.17) or low back (OR 1.82 95%; CI 1.07-3.09) at baseline increased the risk for developing chronic pain in the knees at follow-up. The risk for developing chronic neck/shoulder pain was not significantly increased when having pain in the low back or knees at baseline.
  
  
  CONCLUSIONS
  Among health care workers, chronic musculoskeletal pain in one body region increases the risk for developing chronic pain in other pain-free body regions. Prevention of musculoskeletal disorders among health care workers should focus holistically on the musculoskeletal system.
authors.affiliation: National Research Centre for the Working Environment, Copenhagen, Denmark. lla@nrcwe.dk
authors.forename: L L
authors.initials: LL
authors.lastname: Andersen
authors.forename: T
authors.initials: T
authors.lastname: Clausen
authors.forename: I G
authors.initials: IG
authors.lastname: Carneiro
authors.forename: A
authors.initials: A
authors.lastname: Holtermann
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000453:epidemiology / Q000503:physiopathology; D059350:Chronic Pain / Q000453:epidemiology* / Q000503:physiopathology; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D016015:Logistic Models; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000453:epidemiology* / Q000503:physiopathology; D019547:Neck Pain / Q000453:epidemiology / Q000503:physiopathology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D020069:Shoulder Pain / Q000453:epidemiology / Q000503:physiopathology; D011795:Surveys and Questionnaires