Date sent:      	Tue, 19 Jun 2001 

The prevalence of musculoskeletal pain and fibromyalgia in patients
hospitalized on internal medicine wards.

Semin Arthritis Rheum 2001 Jun;30(6):411-417

Buskila D, Neumann L, Odes LR, Schleifer E, Depsames R, Abu-Shakra M.

PMID: 11404824

Rheumatic Disease Unit and Epidemiology Department, Ben-Gurion University of
the Negev and Soroka Medical Center, Beer Sheva, Israel., Dan Buskila, MD:
Professor in Internal Medicine, Head of Rheumatic Disease Unit, Soroka
Medical Center, Beer Sheva, Israel; Lily Neumann, PhD: Professor in
Biostatistics, Epidemiology Department, Faculty of Health Sciences,
Ben-Gurion University of the Negev, Beer Sheva, Israel; Lisa R. Odes, MD:
Resident in Internal Medicine, Soroka Medical Center, Beer Sheva, Israel;
Elena Schleifer, MD: Instructor in Internal Medicine, Soroka Medical Center,
Beer Sheva, Israel; Roman Depsames, MD: Resident in Internal Medicine,
Soroka Medical Center, Beer Sheva, Israel; Mahmoud Abu-Shakra, MD: Associate
Professor in Internal Medicine, Soroka Medical Center, Beer Sheva, Israel.

Summary:

OBJECTIVES: To estimate the prevalence of nonarticular pain complaints
(chronic widespread pain, chronic localized pain, transient pain) and
fibromyalgia in hospitalized patients and to study utilization patterns of
health services associated with pain related problems.

METHODS: Five hundred twenty-two patients hospitalized on internal medicine
wards were enrolled. Data were collected with a questionnaire covering
demographic background, information on pain and other symptoms, utilization
of health services, and drug consumption. All subjects were classified into
four pain groups: those with no pain, transient pain, chronic regional pain,
and chronic widespread pain. Tenderness was assessed by thumb palpation, and
patients were diagnosed as having fibromyalgia if they met the 1990 American
College of Rheumatology criteria.

RESULTS: Sixty-two percent of the patients reported pain; 36% reported
chronic regional pain, 21% reported chronic widespread pain, and 5% reported
transient pain. Fifteen percent of all patients had fibromyalgia, most of
whom (91%) were women. The prevalence of chronic widespread pain and of
fibromyalgia in women increased with age. Sleep problems, headache, and
fatigue were highly prevalent, especially among those with chronic
widespread pain. Patients with chronic widespread pain reported more visits
to family physicians (6.2 visits per year) and more frequent use of drugs.
They also were more frequently referred to rheumatologists, and they
reported more hospitalizations.

CONCLUSIONS: Pain syndromes and related symptoms are prevalent among
hospitalized patients on the medicine wards. The internist taking care of
these patients should be aware of the presence of these syndromes and
realize that some of the reported symptoms are partly related to these
(undiagnosed) pain syndromes rather than to the cause of hospitalization.

Copyright 2001 by W.B. Saunders Company