Session Information
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Musculoskeletal pain has been shown to commonly occur at multiple sites. This is likely to have a greater impact on abilities to undertake activities of daily living, work and quality of life in general. While obesity has been shown to impact on the occurrence of musculoskeletal conditions, body composition may also play a role. Few studies have examined the association between body composition and multiple pain sites although a recent study of 133 participants demonstrated that fat mass and fat mass index were associated with pain at a greater number of weight-bearing sites1. The aim of this study was to examine the association between pain sites and pain at weight-bearing and non-weight-bearing sites.
Methods: The North West Adelaide Health Study (NWAHS) is a longitudinal cohort study with three stages of data collection. Each stage comprised a self-complete questionnaire, clinic assessment and Computer Assisted Telephone Interview (CATI). In Stage 2 (2004-2006), Dual Energy X-ray Absorptiometry (DXA) scans were undertaken on those aged 50 years and over (n=1066), which enabled the calculation of fat mass index and fat free mass index. Additional data included demographics and body mass index (BMI). As part of the telephone interview, participants were asked if they had ever had back, hip, knee, shoulder and hand pain and/or stiffness on most days for at least a month and whether they had pain or stiffness in the feet on most days. The association with areas of pain and BMI, fat mass (kg), fat mass index, fat free mass (kg) and fat free mass index were examined using logistic regression analysis.
Results: Among those aged 50 years and over, the prevalence of pain and/or stiffness in the feet was 20.2%, shoulder 27.8%, hip 15.6%, back 40.8%, hand 21.5% and knee 18.0%. The unadjusted and adjusted associations between areas of pain, BMI and body composition measurements are presented in Table 1. There were significant associations for both weightbearing and non-weightbearing joints between BMI and body composition variables even after adjustment for age, sex and the appropriate body composition measure.
Table 1: Unadjusted and adjusted association between areas of musculoskeletal pain, BMI and body composition
|
BMI |
Fat mass |
Fat mass index |
Fat free mass |
Fat free mass index |
Unadjusted *denotes significant p<0.05 |
OR (95% CI) p-value |
OR (95% CI) p-value |
OR (95% CI) p-value |
OR (95% CI) p-value |
OR (95% CI) p-value |
Foot |
1.07 (1.04-1.11)* |
1.04 (1.02-1.05)* |
1.10 (1.06-1.14)* |
0.99 (0.98-1.00) |
1.00 (0.94-1.06) |
Shoulder |
1.03 (1.00-1.06)* |
1.01 (1.00-1.02) |
1.03 (1.00-1.07) |
1.00 (0.99-1.01) |
1.03 (0.97-1.08) |
Hip |
1.07 (1.03-1.10)* |
1.04 (1.02-1.06)* |
1.11 (1.07-1.16)* |
0.99 (0.97-1.00) |
0.98 (0.92-1.05) |
Hand |
1.06 (1.02-1.09)* |
1.03 (1.01-1.04)* |
1.09 (1.05-1.14)* |
0.98 (0.96-0.99)* |
0.97 (0.92-1.03) |
Back |
1.06 (1.04-1.09)* |
1.03 (1.02-1.05)* |
1.08 (1.05-1.12)* |
1.00 (0.99-1.01) |
1.03 (0.98-1.08) |
Knee |
1.07 (1.04-1.10)* |
1.03 (1.02-1.05)* |
1.08 (1.04-1.12)* |
1.01 (1.00-1.03) |
1.07 (1.00-1.14)* |
Adjusted for age and sex *denotes significant p<0.05 |
BMI |
Fat mass |
Fat mass index |
Fat free mass |
Fat free mass index |
Foot |
1.07 (1.04-1.10)* |
1.03 (1.02-1.05)* |
1.09 (1.05-1.14)* |
1.04 (1.01-1.07)* |
1.14 (1.05-1.24)* |
Shoulder |
1.03 (1.00-1.06) |
1.01 (0.99-1.02) |
1.02 (0.98-1.06) |
1.03 (1.01-1.05)* |
1.12 (1.04-1.21)* |
Hip |
1.07 (1.03-1.10)* |
1.04 (1.02-1.06)* |
1.11 (1.05-1.16)* |
1.03 (1.00-1.06) |
1.13 (1.03-1.24)* |
Hand |
1.06 (1.02-1.09)* |
1.02 (1.00-1.04)* |
1.07 (1.03-1.12)* |
1.01 (0.98-1.03) |
1.13 (1.04-1.23)* |
Back |
1.06 (1.04-1.09)* |
1.03 (1.02-1.05)* |
1.09 (1.05-1.14)* |
1.03 (1.01-1.05)* |
1.12 (1.04-1.20)* |
Knee |
1.07 (1.03-1.10)* |
1.03 (1.02-1.05)* |
1.09 (1.04-1.14)* |
1.05 (1.03-1.08)* |
1.18 (1.08-1.29)* |
Adjusted for age and sex and relevant body composition measure *denotes significant p<0.05 |
BMI |
Fat massa |
Fat mass indexa |
Fat free massb |
Fat free mass index |
Foot |
|
1.03 (1.00-1.05)* |
1.08 (1.02-1.13)* |
1.02 (0.99-1.05) |
1.05 (0.95-1.16) |
Shoulder |
|
0.99 (0.98-1.01) |
0.98 (0.94-1.03) |
1.03 (1.01-1.06)* |
1.14 (1.04-1.25)* |
Hip |
|
1.04 (1.02-1.06)* |
1.10 (1.04-1.16)* |
1.00 (0.96-1.03) |
1.01 (0.91-1.14) |
Hand |
|
1.02 (1.01-1.04)* |
1.05 (1.00-1.11)* |
0.99 (0.96-1.02) |
1.07 (0.97-1.18) |
Back |
|
1.03 (1.02-1.05)* |
1.09 (1.04-1.13)* |
1.01 (0.98-1.03) |
1.03 (0.95-1.12) |
Knee |
|
1.02 (1.00-1.04)* |
1.06 (1.00-1.12)* |
1.04 (1.01-1.07)* |
1.11 (1.00-1.23) |
aModels with fat mass and fat mass index adjusted for fat free mass and fat free mass index respectively bModels with fat free mass and fat free mass index adjusted for fat mass and fat mass index respectively |
Conclusion: The prevalence of joint pain is high in community dwelling people aged 50 years and over. BMI and body composition measurements are associated with reports of pain, in both weightbearing and non-weightbearing joints. The association with fat mass and fat mass index in particular may be associated with metabolic effects. However, body composition does need to be considered when treating those with musculoskeletal pain.
1 Brady SRE et al. Body composition is associated with multisite lower body musculoskeletal pain in a community-based study. Journal of Pain. 2015, doi:10.1016/j.pain.2015.04.006
To cite this abstract in AMA style:
Gill TK, Walsh TP, Shanahan EM, Hill C. Association Between Musculoskeletal Pain, Fat Mass and Fat Free Mass: Results from a Population-Based Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/association-between-musculoskeletal-pain-fat-mass-and-fat-free-mass-results-from-a-population-based-study/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-musculoskeletal-pain-fat-mass-and-fat-free-mass-results-from-a-population-based-study/