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Graded chronic pain status—An epidemiologic evaluation
Abstract
In epidemiologic research on chronic pain, differentiation of recurrent, persistent and disabling pain states is critical in the investigation of burden, natural history, effective intervention and causal processes. We report population-based data concerning the development and evaluation of a graded classification of pain status. In a probability sample of 1016 health maintenance organization enrollees, recurrent or persistent pain was observed in 45%; severe and persistent pain in 8%; severe and persistent pain with 7 or more days of pain-related activity limitation in 2.7%; and severe, persistent pain with activity limitation and 3 or more indicators of pain dysfunction in 1.0% of the population sample. Graded chronic pain status was associated with psychological impairment, unfavorable appraisal of health status, and frequency of use of pain medications and health care. The presence of severe and persistent pain increased the likelihood of multiple indicators of pain dysfunction, but there was considerable heterogeneity in pain dysfunction among persons with comparable pain experience. Our data suggest grading chronic pain in terms of 3 axes: time (persistence); severity; and impact (disability and dysfunctional illness behaviors).
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“Although conceptually appealing, this hotly debated7 approach does not consider the multidimensional nature of chronic pain, namely, the presence of activity limitations and participation restrictions,5,17,30–36 classifications recognized by the World Health Organization.37”
From Prevalence and Profile of High-Impact Chronic Pain in the United States (2019) · cites this paper as [32]
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Metadata
- Authors
- Von Korff, M., Dworkin, S. F., & Le Resche, L.
- Affiliations
- University of Washington (US)
- Venue
- Pain
- Published
- 1990-03
- Volume
- 40
- Issue
- 3
- Pages
- 279-291
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2073924607
- Cited by
- 488
- References
- 23
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 7 · 2023: 9 · 2022: 12 · 2021: 23 · 2020: 12 · 2019: 10 · 2018: 15 · 2017: 7 · 2016: 17 · 2015: 18 · 2014: 18 · 2013: 25 · 2012: 23
- FWCI
- 9.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01de007197-03)
- National Institute of Dental and Craniofacial Research (DE07197)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- chronic pain, pain intensity, pain persistence, pain-related disability, activity limitation, psychological impairment, analgesic use, health care utilization, natural history of pain
- MeSH terms
- Chronic Disease, Disability Evaluation, Female, Health Maintenance Organizations, Humans, Male, Pain, Pain Measurement, Surveys and Questionnaires, Sick Role, Socioeconomic Factors, Time Factors, Confounding Factors, Epidemiologic, Prevalence
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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