O21.1 UPPER LIMB, BACK, AND KNEE PAIN AND THEIR RELATIONSHIP TO SOMATISATION: A COMMUNITY BASED SURVEY

K. T. Palmer¹, M. Calnan², J. Poole¹, D. Coggon¹.¹MRC Environmental Epidemiology Unit, University of Southampton, Southampton SO16 6YD, UK; ²MRC HSRC, Department of Social Medicine, Canynge Hall, Bristol BS8 2PR, UK

Introduction: The occupational psychosocial determinants of musculoskeletal pain have been much studied. By contrast, personal response to bodily symptoms (somatisation) has rarely been examined as a potential risk factor.

Methods: To investigate, we mailed a questionnaire to 5000 subjects aged 25–64 years, selected at random from the registers of five general practices in north Somerset, UK. Inquiries were made about pain in the upper limb, low back, and knee lasting ⩾1 day in the past 12 months; its duration and impact; depressive symptoms (SF-36 scale); and tendency to somatise (using the Brief Symptom Inventory; BSI). Associations of pain with psychological wellbeing were examined by Cox regression and expressed as prevalence ratios (PRs).

Results: Among 2550 respondents, 1257 reported upper limb pain in the past 12 months, including 343 whose pain was ‘longlived’ (lasted ⩾6 months) and 240 who had ‘disabling’ pain (found it difficult to sleep and get dressed and do daily chores). Longlived and disabling arm pain were more common in women, with increasing age, and among the unemployed. After adjustment, being in the highest versus the lowest third of the distribution for BSI score was associated with a PR of 5.3 (95% confidence interval I 3.6 to 7.9) for longlived pain, and 15.3 (7.8 to 30.0) for disabling pain. Back and knee pain were similarly common in the study group and showed similarly strong associations with BSI score. Substantially weaker …