There was a study done here in Canada with 4000 participants that demonstrated in patients with chronic pain, one third of them have comorbid chronic pain conditions. However, there was no pattern to this comorbidity. The study was published in the Journal of Pain Research. It reminded me of what a doctor once said to me: Pain begets pain. He was talking about migraines and how they become more sensitive to triggers over time. But you have to wonder if you are predisposed to getting one pain condition does that entail you are then more likely to have something else go chronic?
In people with comorbid pain conditions there was lower quality of life, longer pain duration and associations with older age, and being female. However, it didn’t significantly impact treatment responses, therefore treatment protocols would remain the same. The results did show that sex, age, pain duration, and quality of life were associated with the number of pain conditions. But there was no real pattern to the occurrence of pain comorbidities. So there was nothing to show any comorbidities were linked together in any way. The mean diagnosis of pain conditions was 1.45.
- Chronic musculoskeletal pain – 37.9%
- Chronic neuropathic pain – 32.2%
- Chronic primary pain – 25.4%
- Chronic postsurgical and posttraumatic pain – 20.5%
Chronic cancer pain (76.5%), chronic headache and orofacial pain (63.7%), and chronic visceral pain (63.6%) had more than half of patients with a coexisting pain diagnosis from other pain categories. AJMC
I think we can all agree that more than one pain condition is going to impact pain duration and quality of life. Certainly when I added chronic migraines to fibromyalgia my quality of life really took a hit. I agree that it doesn’t affect treatment though. The treatment of pain, or specific pain, is still the same, such as it is. Migraine pain for example has very specific treatments. Fibromyalgia, other sorts of protocols. They may complicate each other in certain ways though. Exercise for FM is compromised by migraines, for example.
The fact that one third have comorbid pain doesn’t entirely surprise me after some of the research I have read on the chronicifcation of pain. Although we are a long way off from truly understanding why some people go chronic, while others do not. And if there are structural abnormalities that least to someone being more prone to chronic pain, once, then it can happen again.