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The impact of multisite pain on functional outcomes in older adults: biopsychosocial considerations

Authors Butera KA, Roff SR, Buford TW, Cruz-Almeida Y

Received 30 October 2018

Accepted for publication 23 January 2019

Published 29 March 2019 Volume 2019:12 Pages 1115—1125

DOI https://doi.org/10.2147/JPR.S192755

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Dr Katherine Hanlon


Katie A Butera,1 Shannon R Roff,2 Thomas W Buford,3 Yenisel Cruz-Almeida4

1Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32610, USA; 2Charles River Laboratories Inc., Frederick, MD 21701, USA; 3Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA; 4Department of Aging & Geriatric Research, Institute on Aging, Pain Research & Intervention Center of Excellence, Center for Cognitive Aging & Memory, University of Florida, Gainesville, FL 32610, USA

Abstract: Multisite pain, or pain that occurs simultaneously at >1 anatomical site, is more prevalent than single-site pain. While multisite pain affects over half of older adults, it remains an understudied pain entity that may have important functional implications in an aging population. Greater understanding of this complex pain entity from a biopsychosocial perspective is critical for optimizing clinical and functional outcomes in older adults with pain. Therefore, the primary purpose of this review is to summarize the relationship between multisite pain and functional outcomes in older adults to further elucidate the impact of multisite pain as a distinct entity within this population. A comprehensive literature search revealed 17 peer-reviewed articles. Multisite pain in older individuals is associated with reductions in several physical function domains: 1) lower-extremity mobility; 2) upper-extremity impairments; 3) balance and increased fall risk; and 4) general disability and poor physical function. Further, multisite pain in older individuals is associated with psychological dysfunction (eg, anxiety and depressive symptoms) and social factors (eg, income and education). Overall, this review highlights the scant literature investigating the functional implications of multisite pain in an aging population. Further, while multisite pain appears to have functional consequences, the neurobiological mechanisms contributing to this relationship are unknown. Thus, how this pain characteristic may contribute to the variability in pain-related functional outcomes among older adults is not clear. Future investigations are strongly warranted to advance the understanding of multisite pain and its broad impact on physical and psychosocial function in older adults.

Keywords: multiple pain locations, multiple pain sites, social function, dysfunction, disability, physical function, social factors

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