Musculoskeletal Pain Outcomes Predicted by Generic Factors as Well as Location

Generic factors-such as pain intensity, levels of disability, and psychological factors-appear to play an important role in the prognosis of acute and chronic nonspinal musculoskeletal pain. This is regardless of the location of pain.

Henschke and associates used data from a prospective observational cohort of primary care patients with acute or chronic nonspinal musculoskeletal pain to develop predictive models. They carried out the analysis in 3 steps: derivation of predictive models, including generic factors only; investigation of the added predictive value of pain location; and investigation of effect modification by pain location.

Generic factors predicted outcome over different time periods (3 months and 12 months) and for both acute and chronic musculoskeletal pain. The most consistent predictors of poor outcome were having had the same complaint in the previous year, a lower level of education, lower scores on the Short Form 36 vitality subscale, using pain medication at baseline, and being bothered by the complaint more often in the past 3 months.

The authors noted that pain location variables only slightly improved the predictive ability of the models over generic factors and were inconsistent across the models.