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Living with disabling chronic pain: results from a face-to-face cross-sectional population-based study
  1. Andrés Cabrera-León1,2,3,4,
  2. Miguel Ángel Cantero-Braojos5,
  3. Llenalia Garcia-Fernandez6,
  4. Juan Antonio Guerra de Hoyos7
  1. 1 Escuela Andaluza de Salud Pública, Granada, Spain
  2. 2 Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
  3. 3 Estadística e Investigación Operativa, Instituto de Matemáticas (IEMath-GR), Universidad de Granada, Granada, Spain
  4. 4 Instituto de Investigación Biosanitaria ibs.Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
  5. 5 Clínica de Psicología y Salud Mensana, Granada, Spain
  6. 6 Seplin Soluciones Estadisticas, Granada, Spain
  7. 7 Médico de Atención Primaria, Sevilla, Spain
  1. Correspondence to Miguel Ángel Cantero-Braojos; miguecant{at}


Objectives To estimate the prevalence of disabling chronic pain (DCP) in Spanish adults, to analyse its characteristics, to determine its multimorbidity and to identify its associated factors.

Settings 2011 Andalusian Health Survey, a cross-sectional population survey based on face-to-face home interviews.

Participants 6507 people aged 16 years or older and living in Andalusia, Spain.

Outcomes The response variable was disabling chronic pain. Multivariate multinomial logistic regression models were used to analyse the association of factors with disabling chronic pain. The sample design was considered throughout the statistical analysis.

Results The prevalence of disabling chronic pain in the Spanish adult population was 11.36% (95% CI 11.23 to 11.49), while that of non-disabling chronic pain was 5.67% (95% CI 5.57 to 5.77). Disabling chronic pain was associated with high multimorbidity (especially in women (51%) and in the elderly (70%) with three or more additional chronic diseases), as well as with disadvantaged social status (such as female gender (OR=2.12), advanced age (OR10-year increase=1.28), unemployment (OR=1.33), manual work (OR=1.26), low income (OR=1.14) and reduced emotional social support (OR=1.04)). Other influential factors were tobacco consumption (OR=1.42), sleeping ≤7 hours (OR=1.2)], environmental or work conditions (OR=1.16) and quality of life (ORmental=1.21, ORphysical=2.37).

Conclusions The population with disabling chronic pain was associated with multimorbidity, vulnerable social status and an impaired quality of life. In contrast, the population with non-disabling chronic pain showed almost no differences when compared with the population without chronic pain. The association between DCP and mental disorders highlights the need for psychosocial services in the management of chronic pain.

  • chronic pain
  • disability
  • multimorbidity
  • activity restriction
  • cross-sectional study
  • quality Of life

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  • Contributors AC-L conceived the original idea with the participation of JAGdH and MAC-B. AC-L designed the analysis plan alongside LG-F. Statistical analysis was conducted by LG-F and subsequently by AC-L. AC-L developed the first version of the manuscript in collaboration with MAC-B for the introduction and discussion and with LG-F for the methodology. All authors participated in the writing of subsequent versions and approved the final article.

  • Funding The Andalusian Health Survey, the source of information in this study, is funded by the Ministry of Health of the Junta de Andalucía, Spain.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The EAS was supervised and approved by the review board of the General Secretariat of Quality and Public Health in the Health Ministry of the Andalusian Regional Government.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Other tables, analyses, statistics and R code not included in the present article are available on demand.