IADR Abstract Archives

Burden of Chronic Pain Comorbidity: OPPERA-2 Prospective Cohort

Objectives: Chronic idiopathic pain conditions (IPCs) are often treated regionally, as a single index condition, despite the frequent occurrence of comorbid IPCs elsewhere in the body. This treatment strategy is rational to the extent that symptoms of an index IPC are independent of comorbid IPCs. This study tested the hypothesis that such symptoms are independent.
Methods: Data were from a convenience sample of 403 U.S. adults in the OPPERA-2 (Orofacial Pain: Prospective Evaluation and Risk Assessment) study who had ≥1 of 5 IPCs: painful temporomandibular disorder (TMD), headache (HA), low back pain (LBP), irritable bowel syndrome (IBS), and fibromyalgia (FM). Subjects rated pain intensity and interference symptoms specific to each IPC using the Graded Chronic Pain Scale (GCPS). For each index IPC, the percentage of subjects reporting high-impact chronic pain (%HICP), computed as those with moderate/severe pain-related limitation (i.e., grade 2b or greater), was compared according to number of comorbid IPCs. Log-binomial regression models evaluated contribution of each non-index IPC to %HICP.
Results: Among index cases of TMD (n=180), LBP (n=139) and IBS (n=158), %HICP increased monotonically with each additional comorbid IPC (P<0.01). For index cases of HA (n=269), %HICP was greater (P<0.01) only in the presence of ≥3 comorbid IPCs. The largest independent contribution to high-impact chronic pain among TMD cases came from LBP (39% increase in %HICP, P<0.01); among HA cases, from LBP (21% increase in %HICP, P<0.01); among LBP cases, from TMD (22% increase in %HICP, P=0.02); and among IBS cases, from FM (22% increase in %HICP, P=0.09). Among FM cases (n=52), the estimates of %HICP at each level of the IPC gradient were unreliable due to small numbers of subjects with only 1 or 2 comorbid IPCs.
Conclusions: High-impact chronic pain associated with an index IPC is influenced by type and number of comorbid IPCs, largely in a gradient-specific manner.
IADR/PER General Session
2018 IADR/PER General Session (London, England)
London, England
2018
0148
Neuroscience
  • Ohrbach, Richard  ( University at Buffalo , Buffalo , New York , United States )
  • Fillingim, Roger  ( University of Florida , Gainesville , Florida , United States )
  • Bair, Eric  ( University of North Carolina-Chape Hill , Chapel Hill , North Carolina , United States )
  • Greenspan, Joel  ( University of Maryland , Baltimore , Maryland , United States )
  • Maixner, William  ( Duke University , Durham , North Carolina , United States )
  • Slade, Gary  ( University of North Carolina , Chapel Hill , North Carolina , United States )
  • NIH/NIDCR U01-DE017018
    NONE
    Oral Session
    Orofacial Pain: Assessment, Study and Treatment
    Wednesday, 07/25/2018 , 09:30AM - 11:00AM