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Cited by 206Musculoskeletal pain and rehabilitationSex and Gender in HealthcareFibromyalgia and Chronic Fatigue Syndrome Research

Explaining sex differences in chronic musculoskeletal pain in a general population

Open access
Wijnhoven, Hanneke A.H., de Vet, Henrica C.W., Picavet, Susan J.H.·2006·Pain
DOI 10.1016/j.pain.2006.04.012
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Abstract

Many studies report a female predominance in the prevalence of chronic musculoskeletal pain (CMP) but the mechanisms explaining these sex differences are poorly understood. Data from a random postal questionnaire survey in the Dutch general population were used to examine whether sex differences in the prevalences of CMP are due to sex differences in the distribution of known potential risk factors for CMP (exposure model) and/or to the different importance of risk factors for CMP (i.e. show different strength of association) in men and women (vulnerability model). In the present analyses, 909 men and 1178 women aged 25-65 were included. CMP was defined as pain lasting longer than 3 months and was assessed for 10 anatomical locations (neck, shoulder, higher back, elbow, wrist/hand, lower back, hip, knee, ankle, foot). Sex differences in CMP could not be explained by a different distribution of age, educational level, smoking status, overweight, physical activity, and pain catastrophizing. Having no paid job was associated with CMP, explaining part of the sex differences, but its role seems complex. Risk factors with a sex-specific association were: overweight (all pain locations) and older age (lower extremities)--both having only an effect among women--and pain catastrophizing (upper extremities), which was stronger associated with CMP among men than among women. In conclusion, sex differences in prevalence of CMP may partly be explained by sex differences in vulnerability to risk factors for CMP. Future research towards sex-specific identification of risk factors for CMP is warranted. Eventually this may lead to sex-specific prevention and management of CMP.

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  • Many psychosocial factors, especially pain-specific cognitive and affective processes, have strong associations with functional brain responses to pain.

    “many of the psychosocial factors and, more specifically, pain- specific cognitive and affective processes, have strong associations with functional brain responses to pain.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [387]

  • Studies of the brain's default mode network and other resting-state networks suggest long-lasting functional brain changes related to chronic pain.

    “studies of the brain’s default mode network and other resting state networks suggest long-lasting functional brain changes related to the presence of chronic pain 379, 384–387.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [387]

  • Studies show changes in functional connectivity in chronic pain patients.

    “Further, studies show changes in functional connectivity in chronic pain patients.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [387]

  • Variability in catastrophizing is associated with individual differences in functional brain response to various stimuli and with potential alterations in brain morphology.

    “A growing number of neuroimaging studies have suggested that variability in catastrophizing is associated with individual differences in the functional brain response to a variety of stimuli, as well as potential alterations in brain morphology 359, 384, 387, 389–395.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [387]

  • Response to treatment for chronic pain differs between sexes.

    “In addition, response to treatment differs between sexes [6–10].”

    From Chronic pain and sex-differences; women accept and move, while men feel blue (2017) · cites this paper as [10]

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Related

Authors
Wijnhoven, H. A. H., de Vet, H. C. W., & Picavet, S. J. H.
Affiliations
National Institute for Public Health and the Environment (NL)
ORCID
Wijnhoven, Hanneke A.H.
Venue
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2006-09
Volume
124
Issue
1
Pages
158-166
ISSN
0304-3959 (ISSN-L)
DOI
10.1016/j.pain.2006.04.012
OpenAlex
W1995764137
Cited by
206
References
46
Citations by year
2026: 7 · 2025: 7 · 2024: 8 · 2023: 13 · 2022: 15 · 2021: 13 · 2020: 10 · 2019: 3 · 2018: 8 · 2017: 15 · 2016: 11 · 2015: 5 · 2014: 15 · 2013: 11 · 2012: 5
FWCI
6.26
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Pain (publishedVersion)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
  • Pure Amsterdam UMC (submittedVersion)
  • VU Research Portal (submittedVersion)
  • Rivm Repository (Netherlands National Institute for Public Health and the Environment) (submittedVersion)
  • Rivm (National Institute for Public Health and the Environment) (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Keywords
chronic musculoskeletal pain, sex differences, prevalence, risk factors, exposure models, vulnerability model, pain catastrophizing, overweight, unemployment, age, sex-specific association, general population
MeSH terms
Adult, Age Factors, Aged, Chronic Disease, Cross-Sectional Studies, Educational Status, Female, Humans, Male, Middle Aged, Musculoskeletal Diseases, Pain, Pain Measurement, Risk Factors, Sex Characteristics, Cohort Studies

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