Prevalence and Characteristics of Widespread Pain in Female Primary Health Care Patients With Chronic Low Back Pain

Objectives: To estimate the prevalence of widespread pain (WP) according to the American College of Rheumatology, 1990, in women with chronic low back pain (CLBP) consulting primary health care and to evaluate the differences in body function, activity, participation, environmental factors, health-related quality of life, and other health-related aspects between patients having CLBP with or without WP. Methods: A cross-sectional study of women with CLBP including clinical assessment and questionnaires was conducted. Patients were categorized as having CLBP with or without WP and differences between these groups were evaluated. Results: One hundred thirty patients were assessed. Twenty-eight percent (n=37) had WP. Patients with CLBP+WP showed more impaired physical performance (6-min walk test, handgrip strength), higher numbers of tender points, more severe pain, fatigue, and depression compared with CLBP (P<0.05). The CLBP+WP showed greater activity limitation (P=0.00047). Work disability was 35% (n=13/37) in CLBP+WP compared with 16% (n=15/93) in CLBP (P=0.032). Private social support was negatively impacted in CLBP+WP (P=0.010). The CLBP+WP showed lower health-related quality of life (SF-36) in the physical function, bodily pain, and vitality dimension (P<0.05). More severe clinical stress symptoms and risk for future disability were registered for the CLBP+WP (P<0.001). Discussion: Twenty-eight percent fulfilled the American College of Rheumatology 1990 criteria for WP. When WP was present, patients reported significantly more impaired body functions, more severe activity limitations, and participation restrictions. Environmental factors, health-related quality of life, and other health-related aspects were also negatively impacted. It is suggested that the presence of WP should be evaluated in female patients with CLBP.