The prevalence, characteristics, and associated factors of pain in individuals with and without chronic obstructive pulmonary disease

Physiother Theory Pract. 2024 Nov 21:1-13. doi: 10.1080/09593985.2024.2431206. Online ahead of print.

Abstract

Background: The coexistence of pain and chronic obstructive pulmonary disease (COPD) is acknowledged, yet the pain prevalence and associated factors of the common pain area in the COPD population are unknown.

Objective: This study aims to examine the prevalence of pain in individuals with and without COPD and to explore the connections between common pain areas and related factors.

Methods: Data was gathered through spirometry tests and surveys, including demographics, pain characteristics, Shoulder Pain and DisabilityIndex (SPADI), Neck Disability Index (NDI), COPD assessment test, and dyspnea score.

Results: Comparing pain characteristics between 85 individuals with COPD and 85 age- and gender-matched non-COPD subjects, results showed significantly higher pain prevalence (75.3% versus 42.4%, p < .001), pain severity (3.9 ± 3.1 versus 2.1 ± 2.8, p < .001), pain locations (2 [IQR 0.5, 4.0] versus 0 [IQR 0.0, 2.0], p < .001), NDI (1.9 ± 5.3 versus 0.3 ± 1.7, p < .001), and SPADI (10.1 ± 17.4 versus 4.4 ± 10.6, p < .001) in individuals with COPD. The shoulder is the most common area of pain, followed by the thoracic region and the lower extremities. Notably, individuals with COPD with shoulder pain were more likely to have multiple pain locations (OR = 1.53 [95% CI 1.17, 2.01], p = .002), a high SPADI score (OR = 1.10 [95% CI 1.03, 1.16], p = .003), and a reduced % predicted of forced expiratory volume in the first second (%predicted FEV1) (OR = 0.96[95% CI 0.92, 0.99], p = .018).

Conclusion: Individuals with COPD exhibit higher pain prevalence than those without, especially in the shoulder area. Multiple pain locations, SPADI score, and % predicted FEV1may predict shoulder pain in individuals with COPD. The findings suggest further research on shoulder pain causes to develop better treatments for individuals with COPD.

Keywords: Chronic obstructive pulmonary disease; disability; pain; prevalence; shoulder pain.