A population-based study of the relationship between sexual abuse and back pain: establishing a link.

The aim of the present study was to investigate the prevalence of physical and sexual abuse in the general population as well as to investigate the link between abuse and pain. From a pool of randomly selected people 35-45-years-old, three groups were selected based on their reports of their musculoskeletal pain. These were the No Pain Group (n = 449), the Mild Pain Group (n = 229), and the Pronounced Pain Group (n = 271). A group of 142 consecutive patients with chronic musculoskeletal pain was used as a clinical reference group. A standardized questionnaire was employed to determine self-reported physical and sexual abuse. Sexual abuse was more frequently reported than physical abuse and women tended to report more sexual abuse than did men. For women the prevalence of physical abuse ranged from 2% in the No Pain Group to 8% in the Pronounced Pain Group. The total amount of self-reported sexual abuse ranged from 23% in the No Pain Group to 46% in the Pronounced Pain Group. The prevalence of self-reported abuse for the Patient Group differed little from the Pronounced Pain Group and was 35%. For females only, there was a clear link between self-reported abuse and pain as physical abuse increased the risk of pronounced pain by five-fold and sexual abuse increased this risk by four-fold. These data provide the prevalence of self-reported abuse in a 'normal' population base and moreover demonstrate an important link between self-reported abuse and pain for women. The findings show that self-reported abuse may be an important predictor for chronic pain and provide support for the idea that abuse may indirectly or directly be implicated in the chronification of pain.