Reporting of pain by people with chronic obstructive pulmonary disease (COPD): Comparative results from the HUNT3 population-based survey

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is often associated with chronic pain, but pain in COPD remains poorly understood, particularly in comparison to pain in other groups. We compared the pain reported by people with COPD with that reported by arthritis, heart disease, diabetes, and those not reporting any disease, while adjusting for the effects of selected sociodemographic and lifestyle factors, comorbidities, anxiety, and depression. Methods: Using cross-sectional data from a population-based health survey in Norway (HUNT3; n=50,807), we included participants with COPD (n=1199), participants without COPD, but with arthritis (n=8582), heart disease (n=4109), or diabetes (n=1254), and participants without any disease (n=18,811). Logistic and linear regression analyses were performed to estimate the probability of reporting chronic pain and the level of pain intensity in the different groups adjusting for other relevant factors. Results: Approximately half (51.8%) of people with COPD reported chronic pain, which was a significantly higher rate than in the diabetes and non-disease groups, and similar to the heart disease group. People with arthritis had a chronic pain rate of 75.4%, which was higher than all other groups, including COPD. Analyses of pain intensity yielded similar findings, with the COPD group having higher pain intensity than the diabetes and non-disease groups, similar pain intensity as the heart disease group, and less pain intensity than the arthritis group. The likelihood of chronic pain and the intensity of pain were generally higher among women, people employed in occupations with low educational requirements, smokers, and those with comorbidity. Chronic pain rates and pain intensity increased with age and higher anxiety and depression scores, and were inversely related to physical activity. Conclusions: People with COPD are at increased risk for chronic pain and higher pain intensity, second only to those with arthritis among the disease groups included in this study. The findings indicate a close relationship between pain and anxiety and depression. The relationships between pain and socioeconomic and lifestyle factors (e.g., smoking and exercise) suggest the need for efforts at the societal level to reduce inequality in health.