title: Factors Associated with Higher Reported Pain Levels in Patients with Chronic Musculoskeletal Pain: A Cross-Sectional, Correlational Analysis.
abstract: BACKGROUND
  Chronic musculoskeletal pain is highly prevalent, disabling, and costly, and has many negative effects on quality of life. The aim of this study was to investigate factors associated with higher reported pain levels in patients with chronic musculoskeletal pain among demographic, clinical, and psychological factors, and to evaluate whether insomnia is independently associated with pain intensity in this population.
  
  
  METHODS
  A total of 357 patients with chronic musculoskeletal pain (pain duration ≥ six months) satisfied the study inclusion criteria and were included in the analyses. Patient demographics, clinical, and psychological factors were evaluated with hierarchical multivariate logistic analysis to identify factors associated with severe pain (NRS [numeric rating scale] ≥ 7). Hierarchical linear regression analysis also performed to identify factors associated with pain intensity (0 to 10 NRS).
  
  
  RESULTS
  Multivariate logistic analyses revealed older age (OR [odds ratio] = 1.017, 95% CI [confidence interval] 1.001-1.032, P = 0.034), high anxiety level (OR = 1.162, 95% CI 1.020-1.324, P = 0.024), high pain catastrophizing (OR = 1.043, 95% CI 1.007-1.081, P = 0.018), and severe insomnia (OR = 1.112, 95% CI 1.057-1.170, P<0.001) were significantly associated with severe pain. Hierarchical linear regression analysis showed age (β = 0.106, P = 0.041), pain catastrophizing (β = 0.249, P<0.001), and insomnia (β = 0.286, P<0.001) were significantly associated with pain intensity. The variance in pain intensity explained by the final model was 32.2%.
  
  
  CONCLUSIONS
  Older age, severe insomnia, and high pain catastrophizing were significantly associated with higher reported pain levels. Insomnia was independently associated with pain intensity, even after controlling for various demographic and clinical factors. These factors should be considered when devising pain management strategies for this population.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Jun
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Duck Mi
authors.initials: DM
authors.lastname: Yoon
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyung Bong
authors.initials: KB
authors.lastname: Yoon
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Ae
authors.initials: JA
authors.lastname: Moon
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Shin Hyung
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D059350:Chronic Pain / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D010147:Pain Measurement; D012189:Retrospective Studies; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications