A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population.

Mansfield, KE. Sim, J. Jordan, JL. Jordan, KP.
Pain, 2016, Jan;157(1):55-64.

Chronic widespread pain (CWP) is common and associated with poor general health. There has been no attempt to derive a robust prevalence estimate of CWP, or assess how this is influenced by socio-demographic factors. This study therefore aimed to determine, through a systematic review and meta-analysis, the prevalence of CWP in the adult general population and explore variation in prevalence by age, gender, geographical location and criteria used to define CWP. Medline, Embase, CINAHL and AMED were searched using a search strategy combining keywords and related database-specific subject terms to identify relevant cohort or cross-sectional studies published since 1990. Included papers were assessed for risk of bias. Prevalence figures for CWP (ACR criteria) were stratified according to geographical location, age and sex. Potential sources of variation were investigated using subgroup analyses and meta-regression. Twenty-five papers met the eligibility criteria. Estimates for CWP prevalence ranged from zero to 24%, with the majority of estimates between 10 and 15%. The random-effects pooled prevalence was 10.6% (95% CI 8.6, 12.9). When only studies at low risk of bias were considered pooled prevalence increased to 11.8% (95% CI 10.3, 13.3), with reduced but still high heterogeneity. Prevalence was higher in women and in those aged 40 years plus. There was some limited evidence of geographic variation and cultural differences. One in ten adults in the general population report chronic widespread pain with possible socio-cultural variation. The possibility of cultural differences in pain reporting should be considered in future research and the clinical assessment of painful conditions.This is an open access article distributed under the terms of the Creative Commons Attribution-Noncommercial No Derivatives 3.0 License, which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially.