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Pain in People with Multiple Sclerosis: Associations with Modifiable Lifestyle Factors, Fatigue, Depression, Anxiety, and Mental Health Quality of Life.

Abstract

BACKGROUND

People with multiple sclerosis (MS) often experience pain, which can interfere with mobility, employment, and quality of life (QOL).

METHODS

This cross-sectional study explored associations between pain, demographic, disease, and modifiable lifestyle factors in an international sample of people with MS recruited online.

RESULTS

Substantial pain, of moderate/severe intensity and interfering at least moderately with work/household or enjoyment of life in the past 4 weeks, was reported by 682/2,362 (28.9%). Substantial pain was associated with fatigue (odds ratio (OR): 6.7, 95% confidence interval (CI): 4.9,9.3), depression (OR:4.0, 95% CI:3.2,5.1), anxiety (OR:2.4, 95% CI:1.9,2.9), and lower mental health QOL (Mean Difference: -14.7, 95% CI:-16.6,-12.8). Regression analyses showed that smoking (OR: 2.0, 95% CI:1.35,2.87) and obesity (OR:2.1, 95% CI: 1.5,2.8), moderate alcohol use (OR: 0.7, 95% CI:0.5,0.9), moderate (OR 0.7, 95% CI: 0.55,0.98) or high (OR 0.6, 95% CI: 0.4,0.8) physical activity level, and healthy diet (OR 0.8, 95% CI: 0.75,0.95, per 10 points) were associated with substantial pain.

CONCLUSION

Our results show clear associations with modifiable lifestyle factors and substantial pain in MS. These factors are already considered in the prevention and management of pain in other populations but have not previously been considered in MS. Conversely, pain and associated common MS comorbidities, such as depression, anxiety, and fatigue, may hamper efforts to start or maintain healthy behaviors. Strategies to overcome these barriers need to be considered. Further research should clarify the direction of these associations.

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  • Authors+Show Affiliations

    ,

    Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.

    ,

    Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. Biostatistics Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.

    ,

    Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.

    ,

    Sir Charles Gairdner Hospital, Nedlands, WA, Australia.

    ,

    Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.

    ,

    Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.

    ,

    Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.

    ,

    Australian Rehabilitation Research Centre, Royal Melbourne Hospital, Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia.

    Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.

    Source

    Frontiers in neurology 8: 2017 pg 461

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    28928713

    Citation

    Marck, Claudia H., et al. "Pain in People With Multiple Sclerosis: Associations With Modifiable Lifestyle Factors, Fatigue, Depression, Anxiety, and Mental Health Quality of Life." Frontiers in Neurology, vol. 8, 2017, p. 461.
    Marck CH, De Livera AM, Weiland TJ, et al. Pain in People with Multiple Sclerosis: Associations with Modifiable Lifestyle Factors, Fatigue, Depression, Anxiety, and Mental Health Quality of Life. Front Neurol. 2017;8:461.
    Marck, C. H., De Livera, A. M., Weiland, T. J., Jelinek, P. L., Neate, S. L., Brown, C. R., ... Jelinek, G. A. (2017). Pain in People with Multiple Sclerosis: Associations with Modifiable Lifestyle Factors, Fatigue, Depression, Anxiety, and Mental Health Quality of Life. Frontiers in Neurology, 8, p. 461. doi:10.3389/fneur.2017.00461.
    Marck CH, et al. Pain in People With Multiple Sclerosis: Associations With Modifiable Lifestyle Factors, Fatigue, Depression, Anxiety, and Mental Health Quality of Life. Front Neurol. 2017;8:461. PubMed PMID: 28928713.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Pain in People with Multiple Sclerosis: Associations with Modifiable Lifestyle Factors, Fatigue, Depression, Anxiety, and Mental Health Quality of Life. AU - Marck,Claudia H, AU - De Livera,Alysha M, AU - Weiland,Tracey J, AU - Jelinek,Pia L, AU - Neate,Sandra L, AU - Brown,Chelsea R, AU - Taylor,Keryn L, AU - Khan,Fary, AU - Jelinek,George A, Y1 - 2017/09/05/ PY - 2017/06/19/received PY - 2017/08/21/accepted PY - 2017/9/21/entrez PY - 2017/9/21/pubmed PY - 2017/9/21/medline KW - disability KW - health outcome KW - lifestyle medicine KW - multiple sclerosis KW - pain KW - symptoms SP - 461 EP - 461 JF - Frontiers in neurology JO - Front Neurol VL - 8 N2 - BACKGROUND: People with multiple sclerosis (MS) often experience pain, which can interfere with mobility, employment, and quality of life (QOL). METHODS: This cross-sectional study explored associations between pain, demographic, disease, and modifiable lifestyle factors in an international sample of people with MS recruited online. RESULTS: Substantial pain, of moderate/severe intensity and interfering at least moderately with work/household or enjoyment of life in the past 4 weeks, was reported by 682/2,362 (28.9%). Substantial pain was associated with fatigue (odds ratio (OR): 6.7, 95% confidence interval (CI): 4.9,9.3), depression (OR:4.0, 95% CI:3.2,5.1), anxiety (OR:2.4, 95% CI:1.9,2.9), and lower mental health QOL (Mean Difference: -14.7, 95% CI:-16.6,-12.8). Regression analyses showed that smoking (OR: 2.0, 95% CI:1.35,2.87) and obesity (OR:2.1, 95% CI: 1.5,2.8), moderate alcohol use (OR: 0.7, 95% CI:0.5,0.9), moderate (OR 0.7, 95% CI: 0.55,0.98) or high (OR 0.6, 95% CI: 0.4,0.8) physical activity level, and healthy diet (OR 0.8, 95% CI: 0.75,0.95, per 10 points) were associated with substantial pain. CONCLUSION: Our results show clear associations with modifiable lifestyle factors and substantial pain in MS. These factors are already considered in the prevention and management of pain in other populations but have not previously been considered in MS. Conversely, pain and associated common MS comorbidities, such as depression, anxiety, and fatigue, may hamper efforts to start or maintain healthy behaviors. Strategies to overcome these barriers need to be considered. Further research should clarify the direction of these associations. SN - 1664-2295 UR - https://www.unboundmedicine.com/medline/citation/28928713/Pain_in_People_with_Multiple_Sclerosis:_Associations_with_Modifiable_Lifestyle_Factors_Fatigue_Depression_Anxiety_and_Mental_Health_Quality_of_Life_ L2 - https://dx.doi.org/10.3389/fneur.2017.00461 DB - PRIME DP - Unbound Medicine ER -