The role of psychosocial factors in the course of pain—a 1-year follow-up study among women living in Sweden

The understanding of the associations between psychosocial factors and persistent pain and their impact on the course of pain
among women is crucial to identify risk populations and prevent long-term pain from developing. The aim of the study was to
investigate the course of pain among women and the psychosocial factors associated with it. The study was a 1-year follow-up
(FU) among 2,300 women in the general population of Sweden. Sociodemographic and psychosocial factors were analyzed in relation
to the course of pain, assessed as the presence of pain during the last 3 months at baseline (BL) and at FU. Thirty-three
percent of the women with no pain at BL and 77% of those with pain at BL reported pain at FU. Compared to the pain-free women,
those who developed pain at FU reported lower social support and physical quality of life (QoL) and worse mental health. Women
with sustained pain were older and reported worse mental health, lack of social support, and lower levels of QoL compared
to those who recovered from pain. In the multiple logistic regression analyses, only post-traumatic stress symptoms were associated
with the development of pain at FU. Number of pain locations and pain duration at BL and physical QoL were associated with
sustained pain. Moreover, social support was identified as a protective factor against sustained pain. Pain is persistent
or recurrent in a general female population. The results indicate that psychosocial factors do not work as primary predictors
in the course of pain and might be better understood through indirect processes by limiting the individual’s resources for
handling pain in a functional manner.