Chronic Neck Pain, Low Back Pain Prevalent in Patients With COPD

The prevalence of chronic neck pain and chronic low back pain has been shown to be higher in patients with chronic obstructive pulmonary disease (COPD) compared with individuals without COPD. Researchers conducted a population-based, retrospective, case-control study with the use of data obtained from the Spanish National Health Survey conducted in 2017 (SNHS2017). Results of the analysis were published in the Journal of Pain Research.

Investigators sought to evaluate whether patients with COPD experience a higher prevalence of chronic low back pain and chronic neck pain than do age-, sex-, and residence-matched non-COPD control individuals. In addition, they aimed to identify the variables associated with chronic low back pain and chronic neck pain in individuals with COPD. The SNHS2017 included a representative sample of the Spanish population aged 15 years or older who resided in a main family dwelling.

The SNHS2017 compiled the self-reported presence of chronic conditions with the use of 3 consecutive questions: (1) Do you have or have you ever had any of the following diseases or health conditions? (2) Have you suffered this disease/health condition in the past 12 months; and (3) Has this disease/health condition been diagnosed by a doctor? Following the first question, a card containing a list of 32 conditions is shown to the individual being interviewed. For any of the conditions reported by a participant after the first question, the second and third questions are then completed consecutively with respect to each specific disorder. All participants were also asked whether they had COPD, chronic neck pain, and/or chronic low back pain.

Data from a total of 1034 participants with COPD and 1034 matched non-COPD control individuals were analyzed. Results demonstrated that the prevalence of chronic low back pain and chronic neck pain was 45.16% and 38.20%, respectively, in patients with COPD, vs 28.34% and 22.82%, respectively, in non-COPD control individuals (P <.001 for both).  Per multivariable analysis, participants with COPD had 1.83-fold (95% CI, 1.73-1.91) higher risk for chronic low back pain and a 1.62-fold (95% CI, 1.50-1.74) higher risk for chronic neck pain compared with the non-COPD control individuals.

When patients experienced one type of pain, it increased their risk of experiencing the other type of pain. In patients with COPD, factors associated with experiencing both types of pain included female sex, self-rated health as “fair/poor/very poor,” migraine or frequent headaches, and the use of pain medication. Further, having a mental disorder increased a person’s risk for chronic neck pain, whereas being aged 70 to79 years increased an individual’s risk for chronic low back pain.

The investigators concluded that the findings from the current study add new data to our understanding of chronic pain in patients with COPD, thus justifying its inclusion in clinical practice guidelines for the disease.

Reference

Fuentes-Alonso M, López-de-Andrés A, Palacios-Ceña D, et al. COPD is associated with higher prevalence of back pain: results of a population-based case-control study, 2017. J Pain Res. 2020;13:2763-2773. doi:10.2147/JPR.S271713