Spine and Hip Fractures Raise Risk of Chronic Body Pain

By Pat Anson, Editor

Breaking a bone in your spine or hip may be so traumatic that it doubles your chances of developing chronic widespread body pain such as fibromyalgia, according to a large new study by British researchers.

The study, published in the Archives of Osteoporosis, utilized an existing health database of over half a million adults to investigate associations between fractures of the spine, hip or upper and lower limbs, and the development later in life of chronic widespread body pain. Researchers at the University of Southampton also considered the possible effects of other factors, including diet, lifestyle, body build, and psychological health.

They found that men and women who had a spine fracture and women who had a hip fracture were more than twice as likely to experience long term widespread pain than those who did not have a fracture.

"The causes of chronic widespread pain are poorly characterized, and this study is the first to demonstrate an association with past fracture. If confirmed in further studies, these findings might help us to reduce the burden of chronic pain following such fractures," said lead researcher Nicholas Harvey, Professor of Rheumatology and Clinical Epidemiology at the University of Southampton.

"Chronic widespread pain is common, and leads to substantial health related problems and disability. Past studies have demonstrated an increased risk of chronic widespread pain following traumatic events, but none have directly linked to skeletal fractures."

Physical and emotional traumas have long been identified as risk factors for chronic widespread pain. For example, people involved in motor vehicle accidents are at greater risk of developing fibromyalgia, and rates of chronic widespread pain are known to increase after major disasters such as a hurricane or earthquake. Until now, there was no evidence that bone fractures could trigger such a response.

“Interestingly, the associations appeared strongest for fractures at the hip and spine, compared with fractures in the upper or lower limbs,” wrote Harvey. “High levels of morbidity and decreased survival following a hip and spine fractures is well documented, as are the potential changes in body shape, such as kyphosis, leading to pain and respiratory difficulties following vertebral fracture.”

Data for the research was collected from the UK Biobank study, which maintains records on almost everyone who utilizes the UK National Health Service.

Can Alcohol Help Treat Chronic Pain?

By Pat Anson, Editor

Treating chronic pain with a glass of wine or beer may not sound like a good idea, but an intriguing new study in the U.K. found that alcohol consumption is associated with lower levels of disability in pain patients.

Researchers at the University of Aberdeen in Scotland surveyed over 2,200 people with fibromyalgia and other chronic widespread pain conditions about their alcohol consumption. About a quarter of the respondents were teetotalers, the rest drank rarely, moderately or heavily – the latter consuming as much as 21 to 35 “units” of alcohol a week.

A “unit” was defined as 10 ounces of beer, a small glass of wine or a single beverage with hard liquor – meaning the heaviest drinkers averaged three to five drinks a day.

Drinkers overall reported less disability than people who never drank alcohol, but it was the heaviest drinkers who reported the least disability. They were 67% less likely to experience disability than the teetotalers.

“As well as an association between alcohol consumption and lower levels of disability in pain patients, we also found that the population prevalence of chronic pain was lower in drinkers than in non-drinkers. It’s clear that non-drinkers are more likely to have pain, and more likely to be disabled by it if they have it, compared to drinkers,” said Marcus Beasley, study coordinator at the University of Aberdeen.

Does alcohol act as an analgesic and simply dull pain sensations? Or does it treat and help prevent chronic pain? The researchers are cautious about drawing any conclusions.

“This study has demonstrated strong associations between level of alcohol consumption and CWP (chronic widespread pain). However the available evidence does not allow us to conclude that the association is causal. The strength of the associations means that specific studies to examine this potential relationship are warranted,” wrote Professor Gary Macfarlane, lead author of the study published in the journal Arthritis Care & Research.

“The design of this study cannot tell us whether drinking causes people to have less problems with pain, or if people who have pain make the choice not to drink. In any case people that drink are very different on a wide range of health measures than those that do not drink,” said Beasley.

“For primary care practitioners these findings mean that the fact a patient does not drink could be considered a potential marker for having other health problems, including with chronic pain. Otherwise, the advice that practitioners give to patients should remain the same – drink less if possible, and if consuming alcohol then do so within recommended safe limits.”

Previous research has linked moderate alcohol consumption with a lower risk of heart disease, stroke and diabetes. But drinking too much alcohol can lead to a variety of serious health problems.

How much is too much?

According to the Mayo Clinic, moderate alcohol consumption for healthy adults means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

The UK study isn’t the first to find an association between alcohol and a reduced risk of chronic pain. A large study conducted in Sweden, published in the British Medical Journal, found that women who had more than three drinks a week had about half the risk of developing rheumatoid arthritis than non-drinkers.

Another study, published in Arthritis Research & Therapy, found that low and moderate drinkers suffering from fibromyalgia had less pain, less fatigue and missed fewer days of work than non-drinkers.