Diana M Higgins1,2, Eugenia Buta3, Alicia A Heapy4,5, Mary A Driscoll4,5, Robert D Kerns4,5, Robin Masheb4,5, William C Becker4,5, Leslie R M Hausmann6,7, Matthew J Bair8,9, Laura Wandner10, E Amy Janke11, Cynthia A Brandt4,5, Joseph L Goulet4,5. 1. Anesthesiology, Critical Care, and Pain Medicine Service, VA Boston Healthcare System, Boston, Massachusetts. 2. Boston University School of Medicine, Boston, Massachusetts. 3. Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, Connecticut. 4. Pain Research Informatics Multimorbidities and Education (PRIME) Center of Innovation, VA Connecticut Healthcare System, West Haven, Connecticut. 5. Yale School of Medicine, New Haven, Connecticut. 6. Center for Health Equity Research and Promotion (CHERP), Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. 7. University of Pittsburgh, Pittsburgh, Pennsylvania. 8. Center for Health Information and Communication (CHIC), VA Health Services Research and Development, Indianapolis, Indiana. 9. Indiana University School of Medicine and Regenstrief Institute, Indianapolis, Indiana. 10. National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Bethesda, Maryland. 11. University of the Sciences, Philadelphia, Pennsylvania, USA.
Abstract
OBJECTIVE: To examine the relationship between body mass index (BMI) and pain intensity among veterans with musculoskeletal disorder diagnoses (MSDs; nontraumatic joint disorder; osteoarthritis; low back, back, and neck pain). SETTING: Administrative and electronic health record data from the Veterans Health Administration (VHA). SUBJECTS: A national cohort of US military veterans with MSDs in VHA care during 2001-2012 (N = 1,759,338). METHODS: These cross-sectional data were analyzed using hurdle negative binomial models of pain intensity as a function of BMI, adjusted for comorbidities and demographics. RESULTS: The sample had a mean age of 59.4, 95% were male, 77% were white/Non-Hispanic, 79% were overweight or obese, and 42% reported no pain at index MSD diagnosis. Overall, there was a J-shaped relationship between BMI and pain (nadir = 27 kg/m2), with the severely obese (BMI ≥ 40 kg/m2) being most likely to report any pain (OR vs normal weight = 1.23, 95% confidence interval = 1.21-1.26). The association between BMI and pain varied by MSD, with a stronger relationship in the osteoarthritis group and a less pronounced relationship in the back and low back pain groups. CONCLUSIONS: There was a high prevalence of overweight/obesity among veterans with MSD. High levels of BMI (>27 kg/m2) were associated with increased odds of pain, most markedly among veterans with osteoarthritis.
OBJECTIVE: To examine the relationship between body mass index (BMI) and pain intensity among veterans with musculoskeletal disorder diagnoses (MSDs; nontraumatic joint disorder; osteoarthritis; low back, back, and neck pain). SETTING: Administrative and electronic health record data from the Veterans Health Administration (VHA). SUBJECTS: A national cohort of US military veterans with MSDs in VHA care during 2001-2012 (N = 1,759,338). METHODS: These cross-sectional data were analyzed using hurdle negative binomial models of pain intensity as a function of BMI, adjusted for comorbidities and demographics. RESULTS: The sample had a mean age of 59.4, 95% were male, 77% were white/Non-Hispanic, 79% were overweight or obese, and 42% reported no pain at index MSD diagnosis. Overall, there was a J-shaped relationship between BMI and pain (nadir = 27 kg/m2), with the severely obese (BMI ≥ 40 kg/m2) being most likely to report any pain (OR vs normal weight = 1.23, 95% confidence interval = 1.21-1.26). The association between BMI and pain varied by MSD, with a stronger relationship in the osteoarthritis group and a less pronounced relationship in the back and low back pain groups. CONCLUSIONS: There was a high prevalence of overweight/obesity among veterans with MSD. High levels of BMI (>27 kg/m2) were associated with increased odds of pain, most markedly among veterans with osteoarthritis.
Authors: Diana M Higgins; Robert D Kerns; Cynthia A Brandt; Sally G Haskell; Harini Bathulapalli; Wesley Gilliam; Joseph L Goulet Journal: Pain Med Date: 2014-02-18 Impact factor: 3.750
Authors: Wei Yu; Arliene Ravelo; Todd H Wagner; Ciaran S Phibbs; Aman Bhandari; Shuo Chen; Paul G Barnett Journal: Med Care Res Rev Date: 2003-09 Impact factor: 3.929
Authors: Diana M Higgins; Eugenia Buta; Lindsey Dorflinger; Robin M Masheb; Christopher B Ruser; Joseph L Goulet; Alicia A Heapy Journal: J Rehabil Res Dev Date: 2016
Authors: Adam G Culvenor; Britt Elin Øiestad; Harvi F Hart; Joshua J Stefanik; Ali Guermazi; Kay M Crossley Journal: Br J Sports Med Date: 2018-06-09 Impact factor: 13.800
Authors: Jade I Basem; Robert S White; Stephanie A Chen; Elizabeth Mauer; Michele L Steinkamp; Charles E Inturrisi; Lisa R Witkin Journal: Pain Manag Date: 2021-06-09