Modest association of joint hypermobility with disabling and limiting musculoskeletal pain: Results from a large-scale general population-based survey

Matthew R. Mulvey, Gary J. MacFarlane, Marcus Beasley, Deborah P M Symmons, Karina Lovell, Philip Keeley, Steve Woby, John McBeth

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objective To determine the population prevalence of joint hypermobility (JH) and to test the hypothesis that JH would be associated with reporting musculoskeletal pain. Methods We conducted a cross-sectional population survey in Aberdeen and Cheshire. A total of 45,949 questionnaires were mailed that assessed JH and the presence, distribution, duration, and severity of musculoskeletal pain. Based on their pain reports, participants were classified as having chronic widespread pain (CWP), some pain, or no pain. Multinominal logistic regression tested the relationship between JH and pain status. Associations were adjusted for age, sex, and other putative confounders. Participants with no pain were the referent category. Results A total of 12,853 participants (28.0%) returned a questionnaire with complete data; 2,354 participants (18.3%) were classified as hypermobile. A total of 2,094 participants (16.3%) had CWP, 5,801 participants (45.1%) had some pain, and 4,958 participants (38.6%) reported no pain. JH participants were significantly more likely to report CWP than non-JH participants (18.5% versus 15.8%; P < 0.001). After adjusting for age and sex, hypermobile participants were 40% more likely to report the most severe CWP (relative risk ratio [RRR] 1.4, 95% confidence interval [95% CI] 1.1-1.7; P < 0.00). After further adjustments for employment status, smoking, alcohol, and physical activity, JH remained significantly associated with the most severe CWP (RRR 1.6, 95% CI 1.3-2.1; P < 0.000) and some pain (RRR 1.3, 95% CI 1.02-1.6; P = 0.03). Conclusion JH was associated with severe pain; however, this relationship was not specific to CWP. The relationship was relatively modest and may be explained by unmeasured confounding factors such as psychological distress.

LanguageEnglish
Pages1325-1333
Number of pages9
JournalArthritis Care and Research
Volume65
Issue number8
DOIs
Publication statusPublished - 1 Aug 2013
Externally publishedYes

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Joint Instability
Musculoskeletal Pain
Chronic Pain
Pain
Population
Odds Ratio
Confidence Intervals
Surveys and Questionnaires
Arthralgia
Cross-Sectional Studies
Logistic Models
Smoking
Alcohols
Psychology

Cite this

Mulvey, Matthew R. ; MacFarlane, Gary J. ; Beasley, Marcus ; Symmons, Deborah P M ; Lovell, Karina ; Keeley, Philip ; Woby, Steve ; McBeth, John. / Modest association of joint hypermobility with disabling and limiting musculoskeletal pain : Results from a large-scale general population-based survey. In: Arthritis Care and Research. 2013 ; Vol. 65, No. 8. pp. 1325-1333.
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abstract = "Objective To determine the population prevalence of joint hypermobility (JH) and to test the hypothesis that JH would be associated with reporting musculoskeletal pain. Methods We conducted a cross-sectional population survey in Aberdeen and Cheshire. A total of 45,949 questionnaires were mailed that assessed JH and the presence, distribution, duration, and severity of musculoskeletal pain. Based on their pain reports, participants were classified as having chronic widespread pain (CWP), some pain, or no pain. Multinominal logistic regression tested the relationship between JH and pain status. Associations were adjusted for age, sex, and other putative confounders. Participants with no pain were the referent category. Results A total of 12,853 participants (28.0{\%}) returned a questionnaire with complete data; 2,354 participants (18.3{\%}) were classified as hypermobile. A total of 2,094 participants (16.3{\%}) had CWP, 5,801 participants (45.1{\%}) had some pain, and 4,958 participants (38.6{\%}) reported no pain. JH participants were significantly more likely to report CWP than non-JH participants (18.5{\%} versus 15.8{\%}; P < 0.001). After adjusting for age and sex, hypermobile participants were 40{\%} more likely to report the most severe CWP (relative risk ratio [RRR] 1.4, 95{\%} confidence interval [95{\%} CI] 1.1-1.7; P < 0.00). After further adjustments for employment status, smoking, alcohol, and physical activity, JH remained significantly associated with the most severe CWP (RRR 1.6, 95{\%} CI 1.3-2.1; P < 0.000) and some pain (RRR 1.3, 95{\%} CI 1.02-1.6; P = 0.03). Conclusion JH was associated with severe pain; however, this relationship was not specific to CWP. The relationship was relatively modest and may be explained by unmeasured confounding factors such as psychological distress.",
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Modest association of joint hypermobility with disabling and limiting musculoskeletal pain : Results from a large-scale general population-based survey. / Mulvey, Matthew R.; MacFarlane, Gary J.; Beasley, Marcus; Symmons, Deborah P M; Lovell, Karina; Keeley, Philip; Woby, Steve; McBeth, John.

In: Arthritis Care and Research, Vol. 65, No. 8, 01.08.2013, p. 1325-1333.

Research output: Contribution to journalArticle

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T1 - Modest association of joint hypermobility with disabling and limiting musculoskeletal pain

T2 - Arthritis care and research : the official journal of the Arthritis Health Professions Association

AU - Mulvey, Matthew R.

AU - MacFarlane, Gary J.

AU - Beasley, Marcus

AU - Symmons, Deborah P M

AU - Lovell, Karina

AU - Keeley, Philip

AU - Woby, Steve

AU - McBeth, John

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N2 - Objective To determine the population prevalence of joint hypermobility (JH) and to test the hypothesis that JH would be associated with reporting musculoskeletal pain. Methods We conducted a cross-sectional population survey in Aberdeen and Cheshire. A total of 45,949 questionnaires were mailed that assessed JH and the presence, distribution, duration, and severity of musculoskeletal pain. Based on their pain reports, participants were classified as having chronic widespread pain (CWP), some pain, or no pain. Multinominal logistic regression tested the relationship between JH and pain status. Associations were adjusted for age, sex, and other putative confounders. Participants with no pain were the referent category. Results A total of 12,853 participants (28.0%) returned a questionnaire with complete data; 2,354 participants (18.3%) were classified as hypermobile. A total of 2,094 participants (16.3%) had CWP, 5,801 participants (45.1%) had some pain, and 4,958 participants (38.6%) reported no pain. JH participants were significantly more likely to report CWP than non-JH participants (18.5% versus 15.8%; P < 0.001). After adjusting for age and sex, hypermobile participants were 40% more likely to report the most severe CWP (relative risk ratio [RRR] 1.4, 95% confidence interval [95% CI] 1.1-1.7; P < 0.00). After further adjustments for employment status, smoking, alcohol, and physical activity, JH remained significantly associated with the most severe CWP (RRR 1.6, 95% CI 1.3-2.1; P < 0.000) and some pain (RRR 1.3, 95% CI 1.02-1.6; P = 0.03). Conclusion JH was associated with severe pain; however, this relationship was not specific to CWP. The relationship was relatively modest and may be explained by unmeasured confounding factors such as psychological distress.

AB - Objective To determine the population prevalence of joint hypermobility (JH) and to test the hypothesis that JH would be associated with reporting musculoskeletal pain. Methods We conducted a cross-sectional population survey in Aberdeen and Cheshire. A total of 45,949 questionnaires were mailed that assessed JH and the presence, distribution, duration, and severity of musculoskeletal pain. Based on their pain reports, participants were classified as having chronic widespread pain (CWP), some pain, or no pain. Multinominal logistic regression tested the relationship between JH and pain status. Associations were adjusted for age, sex, and other putative confounders. Participants with no pain were the referent category. Results A total of 12,853 participants (28.0%) returned a questionnaire with complete data; 2,354 participants (18.3%) were classified as hypermobile. A total of 2,094 participants (16.3%) had CWP, 5,801 participants (45.1%) had some pain, and 4,958 participants (38.6%) reported no pain. JH participants were significantly more likely to report CWP than non-JH participants (18.5% versus 15.8%; P < 0.001). After adjusting for age and sex, hypermobile participants were 40% more likely to report the most severe CWP (relative risk ratio [RRR] 1.4, 95% confidence interval [95% CI] 1.1-1.7; P < 0.00). After further adjustments for employment status, smoking, alcohol, and physical activity, JH remained significantly associated with the most severe CWP (RRR 1.6, 95% CI 1.3-2.1; P < 0.000) and some pain (RRR 1.3, 95% CI 1.02-1.6; P = 0.03). Conclusion JH was associated with severe pain; however, this relationship was not specific to CWP. The relationship was relatively modest and may be explained by unmeasured confounding factors such as psychological distress.

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