Gender Differences in Demographic and Clinical Correlates among Veterans with Musculoskeletal Disorders.
Studies suggest that women may be at greater risk for developing chronic pain and pain-related disability.



Because musculoskeletal disorders (MSD) are the most frequently endorsed painful conditions among veterans, we sought to characterize gender differences in sociodemographic and clinical correlates among veterans upon entry into Veterans Health Administration's Musculoskeletal Disorders Cohort (n = 4,128,008).



Women were more likely to be younger, Black, unmarried, and veterans of recent conflicts. In analyses adjusted for gender differences in sociodemographics, women were more likely to have diagnoses of fibromyalgia, temporomandibular disorders, and neck pain. Almost one in five women (19.4%) had more than one MSD diagnosis, compared with 15.7% of men; this higher risk of MSD multimorbidity remained in adjusted analyses. Adjusting for sociodemographics, women with MSD were more likely to have migraine headache and depressive, anxiety, and bipolar disorders. Women had lower odds of cardiovascular diseases, substance use disorders, and several MSDs, including back pain conditions. Men were more likely to report "no pain" on the pain intensity Numeric Rating Scale, whereas more women (41%) than men (34%) reported moderate to severe pain (Numeric Rating Scale 4+).



Because women veterans are more likely to have conditions such as fibromyalgia and mental health conditions, along with greater pain intensity in the setting of MSD, women-specific pain services may be needed.
Anesthesiology, Critical Care, and Pain Medicine Service, VA Boston Healthcare System, Boston, Massachusetts; Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts. Electronic address: diana.higgins2@va.gov.
Diana M
DM
Higgins
Department of Psychology, VA Connecticut Healthcare System, West Haven, Connecticut; Yale School of Public Health, New Haven, CT.
Brenda T
BT
Fenton
Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, VA Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Mary A
MA
Driscoll
Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, VA Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Alicia A
AA
Heapy
Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, VA Connecticut Healthcare System, West Haven, CT; Departments of Psychiatry, Psychology, Neurology, Yale School of Medicine, New Haven, Connecticut.
Robert D
RD
Kerns
Center for Health Information and Communication Health Services Research and Development Center of Innovation, Roudebush VA Medical Center, Indianapolis, Indiana; Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Matthew J
MJ
Bair
Yale School of Medicine, New Haven, Connecticut.
Constance
C
Carroll
Institute for Health and Aging, University of California, San Francisco.
Penny L
PL
Brennan
Center for Chronic Disease Outcomes Research Health Services Research and Development Center of Innovation, VA Minneapolis Healthcare System, Minneapolis, Minnesota; Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Diana J
DJ
Burgess
Center for Clinical Management Research Health Services Research and Development Center of Innovation, VA Ann Arbor, Ann Arbor, Michigan; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan.
John D
JD
Piette
Department of Medicine, VA Connecticut Healthcare System, West Haven, Connecticut; Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
Sally G
SG
Haskell
Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, VA Connecticut Healthcare System, West Haven, CT; Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
Cynthia A
CA
Brandt
Pain Research, Informatics, Multimorbidities, and Education (PRIME) Health Services Research and Development Center of Innovation, VA Connecticut Healthcare System, West Haven, CT; Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut.
Joseph L
JL
Goulet
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology; D059350:Chronic Pain; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology; D009140:Musculoskeletal Diseases / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D059352:Musculoskeletal Pain / Q000175:diagnosis* / Q000453:epidemiology; D059408:Pain Management; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data