目的:本文调查了疼痛在美国残疾趋势中的作用,在最近不利的残疾趋势和同时疼痛上升的背景下。
方法:我们使用2002年至2018年的国家健康访谈调查数据对45-84岁的美国成年人进行了两部分分析。首先,我们评估了五种特定部位疼痛类型(头痛/偏头痛,接头,低背,脖子,和面部/颌骨疼痛)与残疾趋势相关。第二,我们使用了自我报告的致残原因,并检查了将致残归因于5种慢性或急性疼痛疾病之一的患者比例是否发生了变化.
结果:五种部位特定类型的疼痛,个人和集体,与残疾增加显著相关。如果特定部位的慢性疼痛在研究期间没有增加,功能限制的趋势会降低40%,对于活动限制,将会显示出轻微的下降而不是增加。在2002-2018年期间,功能限制对痛苦状况的归因增加了23%,代表了另外982万美国人经历疼痛导致的残疾。关节炎/风湿病,背部/颈部问题,和其他肌肉骨骼/结缔组织疾病是疼痛相关残疾的主要来源。
结论:我们的研究提供了第一个系统的,对疼痛如何导致美国残疾趋势的国家检查。这些发现对减少残疾政策有影响,并阐明了疼痛对总体人口健康的深远影响。
OBJECTIVE: This article investigates the role of pain in disability trends in the United States, within the context of recent unfavorable disability trends and the concurrent rise in pain.
METHODS: We conducted a two-part analysis using National Health Interview Survey data from 2002 to 2018 for US adults aged 45-84. First, we assessed how changes in the prevalence of five site-specific types of pain (headaches/migraines, joint, low back, neck, and facial/jaw pain) associate with disability trends. Second, we used self-reported causes of disability and examined whether there has been a change in the proportion of individuals who attribute their disability to one of five chronic or acute painful conditions.
RESULTS: The five site-specific types of pain, individually and collectively, were significantly associated with increases in disability. If site-specific chronic pain had not increased during the study period, the trend for functional limitations would have been 40% lower, and that for activity limitations would have shown a slight decline instead of an increase. Attributions of functional limitations to painful conditions increased by 23% during the 2002-2018 period, representing an additional 9.82 million Americans experiencing pain-attributable disability. Arthritis/rheumatism, back/neck problems, and other musculoskeletal/connective conditions were the primary sources of pain-related disability.
CONCLUSIONS: Our research provides the first systematic, national examination of how pain is contributing to disability trends in the United States. The findings have implications for disability reduction policies and shed light on the far-reaching consequences of pain for overall population health.