Musculoskeletal pain and its treatment among older home-dwelling people: ten-year changes in two Finnish birth cohorts.

The purpose of this study is to evaluate the prevalence of musculoskeletal pain and the use of analgesics in two random cohorts of home-dwelling older people 10 years apart (1999 (N = 2044) and 2009 (N = 1610)) in Helsinki, Finland, and to explore which patients characteristics are associated with potential undertreatment or overtreatment of pain. In 1999, the prevalence of daily joint pain interfering with functioning was 16.4% and that of back pain 13.9% among 75-85-year-old people, the respective figures being 21.9% and 17.1% in 2009 (p < 0.001). The proportion of those patients suffering from joint pain and using prescribed analgesics for that was 35.5% in 1999 and 41.5% in 2009 (p < 0.001). The corresponding figures for patients suffering from back pain with analgesics were 38.2% and 48.2% (p < 0.001), respectively. In 2009, 66.1% suffered from any musculoskeletal pain and 28.7% of them were prescribed analgesics, the figures being more frequent among women than men. In addition to higher age, female gender, and painful conditions, also psychiatric symptoms and dizziness tended to be independently associated with analgesic prescriptions. Among persons not reporting pain (N = 545) psychiatric symptoms were overrepresented in the group using prescribed analgesics (22.4% vs. 8.1%, p < 0.05). In conclusion, musculoskeletal pain is still clearly undertreated, but the coverage has increased during 10 years. In addition to pain, several patient characteristics, functioning and psychiatric symptoms, especially, were associated with analgesic prescriptions.