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Cited by 223Fibromyalgia and Chronic Fatigue Syndrome ResearchMusculoskeletal pain and rehabilitationChronic Disease Management Strategies

Widespread body pain and mortality: prospective population based studyCommentary: An interesting finding, but what does it mean?

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Macfarlane, Gary J, Crombie, I K, McBeth, John, Silman, Alan J·2001·BMJ
DOI 10.1136/bmj.323.7314.662PMC PMC55925
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Abstract

Objective: To determine whether there is excess mortality in groups of people who report widespread body pain, and if so to establish the nature and extent of any excess. Design: Prospective follow up study over eight years. Mortality rate ratios were adjusted for age group, sex, and study location. Setting: North west England. Participants: 6569 people who took part in two pain surveys during 1991-2. Main outcome measures: Pain status at baseline and subsequent mortality. Results: 1005 (15%) participants had widespread pain, 3176 (48%) had regional pain, and 2388 (36%) had no pain. During follow up mortality was higher in people with regional pain (mortality rate ratio 1.21, 95% confidence interval 1.01 to 1.44) and widespread pain (1.31, 1.05 to 1.65) than in those who reported no pain. The excess mortality among people with regional and widespread pain was almost entirely related to deaths from cancer (1.55 (1.09 to 2.19) for regional pain and 2.07 (1.37 to 3.13) for widespread pain). The excess cancer mortality remained after exclusion of people in whom cancer had been diagnosed before the original survey and after adjustment for potential confounding factors. There were also more deaths from causes other than disease (for example, accidents, suicide, violence) among people with widespread pain (5.21, 0.94 to 28.78). Conclusion: There is an intriguing association between the report of widespread pain and subsequent death from cancer in the medium and long term. This may have implications for the long term follow up of patients with “unexplained” widespread pain symptoms, such as those with fibromyalgia. What is already known on this topic: Widespread body pain, the cardinal symptom of fibromyalgia, is common An organic basis for symptoms is found in only a small proportion of people Treatment is difficult, and studies with short term follow up have shown that symptoms commonly persist What this study adds: This was the first study with long term follow up of people with widespread pain in the community These people experience an increased mortality and the excess is principally related to deaths from cancer

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  • Sociocultural factors and ethnic background can influence how individuals appraise pain.

    “The meaning of pain (i.e. how individuals appraise pain) can be influenced by sociocultural factors and ethnic background 242, 243.”

    From Evaluating psychosocial contributions to chronic pain outcomes (2018) · cites this paper as [242]

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1 of the 24 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. Anderson HI, Ejertsson G, Leden I, Rosenberg C. Characteristics of sub- jects with chronic pain, in relation to local and widespread pain report. Scand J Rheumatol 1996;25:146-54.
  2. Office for National Statistics. 1998 mortality statistics-general. Review of the registrar general on deaths in England and Wales, 1998. London: Office for National Statistics, 1998 (series DH1 No 31).
  3. McBeth J, Macfarlane GJ, Benjamin S, Silman AJ. Features of somatization predict the onset of chronic widespread pain: results of a large population-based study. Arthritis Rheum 2001;44:940-6.
  4. McBeth J, Morris S, Benjamin S, Silman AJ, Macfarlane GJ. Adverse events in childhood and chronic widespread pain in adulthood: a true association? J Rheumatol (in press).

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Authors
Macfarlane, G. J., Crombie, I. K., McBeth, J., & Silman, A. J.
Affiliations
University of Manchester (GB)
Corresponding author
Macfarlane, Gary J
ORCID
Venue
BMJ
Publisher
BMJ
Published
2001-09-22
Volume
323
Issue
7314
Pages
662
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.323.7314.662
PMC
PMC55925
OpenAlex
W2118879709
Cited by
223
References
24
Citations by year
2026: 5 · 2025: 8 · 2024: 9 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 5 · 2018: 6 · 2017: 8 · 2016: 13 · 2015: 13 · 2014: 16 · 2013: 11 · 2012: 11
Type
journal article
Language
en
Open access
Licence
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations
  • BMJ (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords
widespread pain, mortality, cancer mortality, regional pain, fibromyalgia, excess mortality, accidental death, suicide, violence-related deaths, long-term follow-up
MeSH terms
Adult, Cause of Death, England, Female, Fibromyalgia, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasms, Prospective Studies, Risk Factors, Survival Rate

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