Life course trajectories of musculoskeletal pain

Abstract

A life course perspective can help identify critical periods and high-risk groups for musculoskeletal pain. However, how musculoskeletal pain develops over the adult life course and the extent to which this development varies among individuals remain largely unexplored. This Swedish population-representative survey followed a sample of 6328 individuals over 7 waves and 42 years, from ages 15 to 101 years, including about 25,000 observations. Reported musculoskeletal pain in the joints, back, or shoulders over the past year was categorized as follows: no pain (0), light pain in 1 to 3 sites (1), severe pain in one site (2), and severe pain in 2 to 3 sites (3). Age-related pain trajectories were identified through a sex-stratified latent class growth analysis. For both women and men, 2 distinct trajectories emerged. In the high-risk group, pain increased consistently throughout working age before declining postretirement. In the other group, pain levels were generally low, surpassing light pain only after retirement age. Although the trajectory patterns were similar for women and men, the high-risk group was twice as large among women (20%) as among men (9%). The general increase in pain towards the end of the life course likely reflects normal ageing processes, including disease onset and frailty, while the trajectory of the high-risk group may indicate the cumulative effect of risk factors associated with working life. Average trends across the entire sample mask the unique experience of this high-risk group and obscure the distinct effects of ageing on the development of musculoskeletal pain.