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Prevalence of Pain in COPD Patients and Associated Factors: Report From a Population-based Study

de Miguel-Díez, Javier, PhD*; López-de-Andrés, Ana, PhD; Hernandez-Barrera, Valentín, MsD; Jimenez-Trujillo, Isabel, PhD; del Barrio, José L., PhD; Puente-Maestu, Luis, PhD*; Martinez-Huedo, Maria A., PhD; Jimenez-García, Rodrigo, PhD

doi: 10.1097/AJP.0000000000000598
Original Articles

Objectives: To assess the prevalence of chronic neck pain (CNP), chronic low back pain (CLBP), and migraine among Spanish adults with chronic obstructive pulmonary disease (COPD) compared with non-COPD patients matched by age and sex; and to identify predictors for each of these types of pains among COPD sufferers.

Materials and Methods: A cross-sectional study conducted with data collected from the European Health Interview Surveys for Spain (EHSS) conducted in years 2009/2010 (n=22,188) and 2014 (n=22,842). Data were analyzed using multivariable logistic models.

Results: The prevalence of COPD among patients aged 35 years or above were 7.6% (n=1328) for the EHSS 2009 and 5.4% (n=1008) for the EHSS 2014. We matched 2251 COPD patients with age and sex controls. The prevalence of all types of pain were significantly higher among those suffering COPD than those without COPD. For CNP the figures were 40.5% versus 26.1%, for CLBP 44.8% versus 28.4%, and for migraine 22.5% versus 13.2%. Multivariable analysis showed that COPD was associated to a 1.21 (95% confidence interval [CI], 1.02-1.45) higher risk of CNP, 1.38 (95% CI, 1.16-1.64) of CLBP, and 1.36 (95% CI, 1.12-1.65) of migraine. Associated factors with the presence of these types of pain among COPD patients included younger age (not for CLBP), female sex (not for CLBP), “fair/poor/very poor” self-rated health (not for migraine), high blood pressure (not for CNP), mental disorders, obesity (not for migraine), and use of pain medication.

Discussion: The prevalence of CNP, CLBP, and migraine was significantly higher among COPD patients in comparison with controls. Associated factors to suffering these types of pain in patients with COPD included age, sex, self-rated health, certain comorbidities including mental disorders, obesity, and using pain medication.

*Respiratory Department, University Hospital Gregorio Marañón, School of Medicine, Complutense University, Institute of Health Research Gregorio Marañón (IiSGM)

Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcon

Preventive Medicine and Public Health, Teaching Unit, University Hospital La Paz, Madrid, Spain

Supported by FIS (Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III: grant number PI16/00564), co-financed by the European Union through the Fondo Europeo de Desarrollo Regional (FEDER, “Una manera de hacer Europa”) and by the Grupo de Excelencia Investigadora URJC-Banco Santander N°30VCPIGI03: Investigación traslacional en el proceso de salud—enfermedad (ITPSE). The authors declare no conflict of interest.

Reprints: Ana López-de-Andrés, PhD, Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, Avda de Atenas s/n, 28922 Alcorcón, Madrid, Spain (e-mail:

Received August 9, 2017

Received in revised form December 21, 2017

Accepted December 26, 2017

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