Pressure pain sensitivity is more strongly associated with musculoskeletal pain among women and those with chronic diseases: results from a large population-based birth cohort study

OBJECTIVE: Individuals affected by chronic pain often have greater pain sensitivity compared to pain-free subjects, but there is a lack of population-based evidence in this regard. The factors playing a role in this relationship are rarely examined. The aims were to evaluate 1) whether pressure pain sensitivity is associated with a) the presence of musculoskeletal (MSK) pain and b) worse pain and 2) whether sex and the presence of chronic diseases moderate these associations. METHODS: This population-based Northern Finland Birth Cohort 1966 study obtained data on pain frequency (daily, nondaily, and absent), number of pain sites (range 1-8), bothersomeness of pain (Numerical Rating Scale [NRS]-11), and intensity (NRS-11) from 5178 participants (43 % males) aged 46 born in 1966. Measured pressure pain threshold (PPT) and pressure pain tolerance (PPTol) were dichotomized as the lowest quartile vs. the other quartiles (the reference). Logistic and linear regressions with adjustments were utilized. RESULTS: Lower PPT and PPTol were associated with daily MSK pain only among females (adjusted odds ratio 1.26, 95 % confidence interval 1.00-1.58 for PPT; 1.29, 1.02-1.61 for PPTol). A positive relationship with bothersomeness of pain among individuals with daily or nondaily MSK pain was observed only among females. After stratification by chronic diseases, the associations between PPT/PPTol and daily MSK pain remained significant only among females with chronic diseases. CONCLUSIONS: The associations between pressure pain sensitivity and MSK pain varied according to sex and presence of chronic diseases. However, clinical relevance of our findings can be questioned.