Pain Interference and Incident Medical Disorders in the General Population

To investigate the longitudinal relationship between pain interference and incident general medical conditions in a nationally representative sample.

Secondary data analysis comprising chi-square tests and binomial logistic regression analyses were performed on data obtained from the US National Epidemiologic Survey on Alcohol and Related Conditions from 34,465 adult respondents who completed wave 1 (2000-2001) and wave 2 (2004-2005) data collection. Models were adjusted for multiple potentially confounding factors. Respondents were categorized at wave 1 according to past-month pain interference (i.e., no or low pain interference, moderate pain interference, severe pain interference).

In multivariate analyses, moderate or severe pain interference (as compared to no or low pain interference) was associated with the incidence of any medical condition; any heart condition, including angina, tachycardia and other heart disease; any stomach condition, including stomach ulcer and gastritis; arthritis; and hypertension (all P  < 0.05). Severe (but not moderate) pain interference as compared with no or low pain interference was additionally associated with new occurrences of myocardial infarction, any liver disease, other liver disease, and arteriosclerosis (all P  < 0.05).

These findings suggest that the relationship between pain interference and general medical conditions is complex. A more complete understanding of this relationship is likely to involve further exploration of possible mechanisms, including whether it is the pain itself, the ascertainment of pain etiology, or pain treatment that is associated with incident general medical conditions.