Lower urinary tract symptoms are associated with musculoskeletal pain among older men: Preliminary evidence for central sensitization as a mechanism?

Angela Senders; Scott R. Bauer; Yiyi Chen; Barry Oken; Howard A. Fink; Nancy E. Lane; Kamran P. Sajadi; Lynn M. Marshall

doi:10.1002/nau.24767

Lower urinary tract symptoms are associated with musculoskeletal pain among older men: Preliminary evidence for central sensitization as a mechanism?

Angela Senders, Scott R. Bauer, Yiyi Chen, Barry Oken, Howard A. Fink, Nancy E. Lane, Kamran P. Sajadi, Lynn M. Marshall

Medicine - Veteran's Administration Medical Center

Research output: Contribution to journal › Article › peer-review

Abstract

Aims: Features of central sensitization (CS) are present in almost all chronic pain conditions, including painful urinary conditions and back pain. Recently CS was proposed as a mechanism of nonpainful lower urinary tract symptoms (LUTS). Using musculoskeletal pain as an indicator of CS, we investigated whether the prevalence of musculoskeletal pain is greater among community-dwelling men with moderate or severe LUTS compared to those with mild LUTS. Methods: We conducted a cross-sectional study of 5966 men ≥65 years who attended the Osteoporotic Fractures in Men Study baseline visit. LUTS were assessed with the American Urological Association Symptom Index (AUA-SI) and categorized as none/mild (0–7), moderate (8–19), or severe (≥20). Self-reported back, neck, hip, or knee pain within the 12 months before baseline was categorized as any pain and multilocation pain. We tested our hypothesis using odds ratios (OR) and 95% confidence intervals (CI) estimated from multivariable logistic regression models. Results: The adjusted odds of any pain were higher among men with moderate (OR 1.49, 95% CI: 1.29–1.72) and severe LUTS (OR 1.76, 95% CI: 1.28–2.40) compared to those with no/mild LUTS. The adjusted odds of pain at ≥ 2 locations were 69% higher among men with moderate (OR 1.69, 95% CI: 1.45–196) and more than double among men with severe LUTS (OR 2.24, 95% CI: 1.62–3.10) compared to men with no/mild LUTS. Conclusions: Musculoskeletal pain, especially at multiple locations, is associated with greater LUTS severity among older men. CS may represent a novel shared mechanism of pain and LUTS.

Original language	English (US)
Pages (from-to)	1929-1938
Number of pages	10
Journal	Neurourology and Urodynamics
Volume	40
Issue number	8
Early online date	Aug 15 2021
DOIs	https://doi.org/10.1002/nau.24767
State	Published - Nov 2021

Bibliographical note

Funding Information:
Data used in this project is publicly available at https://mrosonline.ucsf.edu/ . This study was supported by the National Center for Complementary and Integrative Health (grant number K23AT008211 to AS) and the National Center for Advancing Translational Sciences (NCATS) National Institutes of Health (grant number UL1TR002369). This study was also supported by grants and awards to SRB from the National Institute of Diabetes, Digestive, and Kidney Disorders (grant number 1K12DK111028), the National Institute on Aging (grant number 1R03AG067937), and the UCSF Claude D. Pepper Older Americans Independence Center funded by National Institute on Aging (grant number P30 AG044281). MrOS is supported by the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and the National Institutes of Health Roadmap for Medical Research (grant numbers U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01AG042168, U01 AR066160, and UL1 TR000128). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Publisher Copyright:
© 2021 Wiley Periodicals LLC

Keywords

central nervous system sensitization
lower urinary tract symptoms
musculoskeletal pain

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10.1002/nau.24767

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@article{4373a8ab3ce74cbe86ff83a0e376e7bf,

title = "Lower urinary tract symptoms are associated with musculoskeletal pain among older men: Preliminary evidence for central sensitization as a mechanism?",

abstract = "Aims: Features of central sensitization (CS) are present in almost all chronic pain conditions, including painful urinary conditions and back pain. Recently CS was proposed as a mechanism of nonpainful lower urinary tract symptoms (LUTS). Using musculoskeletal pain as an indicator of CS, we investigated whether the prevalence of musculoskeletal pain is greater among community-dwelling men with moderate or severe LUTS compared to those with mild LUTS. Methods: We conducted a cross-sectional study of 5966 men ≥65 years who attended the Osteoporotic Fractures in Men Study baseline visit. LUTS were assessed with the American Urological Association Symptom Index (AUA-SI) and categorized as none/mild (0–7), moderate (8–19), or severe (≥20). Self-reported back, neck, hip, or knee pain within the 12 months before baseline was categorized as any pain and multilocation pain. We tested our hypothesis using odds ratios (OR) and 95% confidence intervals (CI) estimated from multivariable logistic regression models. Results: The adjusted odds of any pain were higher among men with moderate (OR 1.49, 95% CI: 1.29–1.72) and severe LUTS (OR 1.76, 95% CI: 1.28–2.40) compared to those with no/mild LUTS. The adjusted odds of pain at ≥ 2 locations were 69% higher among men with moderate (OR 1.69, 95% CI: 1.45–196) and more than double among men with severe LUTS (OR 2.24, 95% CI: 1.62–3.10) compared to men with no/mild LUTS. Conclusions: Musculoskeletal pain, especially at multiple locations, is associated with greater LUTS severity among older men. CS may represent a novel shared mechanism of pain and LUTS.",

keywords = "central nervous system sensitization, lower urinary tract symptoms, musculoskeletal pain",

author = "Angela Senders and Bauer, {Scott R.} and Yiyi Chen and Barry Oken and Fink, {Howard A.} and Lane, {Nancy E.} and Sajadi, {Kamran P.} and Marshall, {Lynn M.}",

note = "Funding Information: Data used in this project is publicly available at https://mrosonline.ucsf.edu/ . This study was supported by the National Center for Complementary and Integrative Health (grant number K23AT008211 to AS) and the National Center for Advancing Translational Sciences (NCATS) National Institutes of Health (grant number UL1TR002369). This study was also supported by grants and awards to SRB from the National Institute of Diabetes, Digestive, and Kidney Disorders (grant number 1K12DK111028), the National Institute on Aging (grant number 1R03AG067937), and the UCSF Claude D. Pepper Older Americans Independence Center funded by National Institute on Aging (grant number P30 AG044281). MrOS is supported by the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and the National Institutes of Health Roadmap for Medical Research (grant numbers U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01AG042168, U01 AR066160, and UL1 TR000128). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Publisher Copyright: {\textcopyright} 2021 Wiley Periodicals LLC",

year = "2021",

month = nov,

doi = "10.1002/nau.24767",

language = "English (US)",

volume = "40",

pages = "1929--1938",

journal = "Neurourology and Urodynamics",

issn = "0733-2467",

publisher = "Wiley-Liss Inc.",

number = "8",

}

TY - JOUR

T1 - Lower urinary tract symptoms are associated with musculoskeletal pain among older men

T2 - Preliminary evidence for central sensitization as a mechanism?

AU - Senders, Angela

AU - Bauer, Scott R.

AU - Chen, Yiyi

AU - Oken, Barry

AU - Fink, Howard A.

AU - Lane, Nancy E.

AU - Sajadi, Kamran P.

AU - Marshall, Lynn M.

N1 - Funding Information: Data used in this project is publicly available at https://mrosonline.ucsf.edu/ . This study was supported by the National Center for Complementary and Integrative Health (grant number K23AT008211 to AS) and the National Center for Advancing Translational Sciences (NCATS) National Institutes of Health (grant number UL1TR002369). This study was also supported by grants and awards to SRB from the National Institute of Diabetes, Digestive, and Kidney Disorders (grant number 1K12DK111028), the National Institute on Aging (grant number 1R03AG067937), and the UCSF Claude D. Pepper Older Americans Independence Center funded by National Institute on Aging (grant number P30 AG044281). MrOS is supported by the National Institute on Aging (NIA), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Center for Advancing Translational Sciences (NCATS), and the National Institutes of Health Roadmap for Medical Research (grant numbers U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01AG042168, U01 AR066160, and UL1 TR000128). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Publisher Copyright: © 2021 Wiley Periodicals LLC

PY - 2021/11

Y1 - 2021/11

N2 - Aims: Features of central sensitization (CS) are present in almost all chronic pain conditions, including painful urinary conditions and back pain. Recently CS was proposed as a mechanism of nonpainful lower urinary tract symptoms (LUTS). Using musculoskeletal pain as an indicator of CS, we investigated whether the prevalence of musculoskeletal pain is greater among community-dwelling men with moderate or severe LUTS compared to those with mild LUTS. Methods: We conducted a cross-sectional study of 5966 men ≥65 years who attended the Osteoporotic Fractures in Men Study baseline visit. LUTS were assessed with the American Urological Association Symptom Index (AUA-SI) and categorized as none/mild (0–7), moderate (8–19), or severe (≥20). Self-reported back, neck, hip, or knee pain within the 12 months before baseline was categorized as any pain and multilocation pain. We tested our hypothesis using odds ratios (OR) and 95% confidence intervals (CI) estimated from multivariable logistic regression models. Results: The adjusted odds of any pain were higher among men with moderate (OR 1.49, 95% CI: 1.29–1.72) and severe LUTS (OR 1.76, 95% CI: 1.28–2.40) compared to those with no/mild LUTS. The adjusted odds of pain at ≥ 2 locations were 69% higher among men with moderate (OR 1.69, 95% CI: 1.45–196) and more than double among men with severe LUTS (OR 2.24, 95% CI: 1.62–3.10) compared to men with no/mild LUTS. Conclusions: Musculoskeletal pain, especially at multiple locations, is associated with greater LUTS severity among older men. CS may represent a novel shared mechanism of pain and LUTS.

AB - Aims: Features of central sensitization (CS) are present in almost all chronic pain conditions, including painful urinary conditions and back pain. Recently CS was proposed as a mechanism of nonpainful lower urinary tract symptoms (LUTS). Using musculoskeletal pain as an indicator of CS, we investigated whether the prevalence of musculoskeletal pain is greater among community-dwelling men with moderate or severe LUTS compared to those with mild LUTS. Methods: We conducted a cross-sectional study of 5966 men ≥65 years who attended the Osteoporotic Fractures in Men Study baseline visit. LUTS were assessed with the American Urological Association Symptom Index (AUA-SI) and categorized as none/mild (0–7), moderate (8–19), or severe (≥20). Self-reported back, neck, hip, or knee pain within the 12 months before baseline was categorized as any pain and multilocation pain. We tested our hypothesis using odds ratios (OR) and 95% confidence intervals (CI) estimated from multivariable logistic regression models. Results: The adjusted odds of any pain were higher among men with moderate (OR 1.49, 95% CI: 1.29–1.72) and severe LUTS (OR 1.76, 95% CI: 1.28–2.40) compared to those with no/mild LUTS. The adjusted odds of pain at ≥ 2 locations were 69% higher among men with moderate (OR 1.69, 95% CI: 1.45–196) and more than double among men with severe LUTS (OR 2.24, 95% CI: 1.62–3.10) compared to men with no/mild LUTS. Conclusions: Musculoskeletal pain, especially at multiple locations, is associated with greater LUTS severity among older men. CS may represent a novel shared mechanism of pain and LUTS.

KW - central nervous system sensitization

KW - lower urinary tract symptoms

KW - musculoskeletal pain

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SN - 0733-2467

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JO - Neurourology and Urodynamics

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ER -

Lower urinary tract symptoms are associated with musculoskeletal pain among older men: Preliminary evidence for central sensitization as a mechanism?

Abstract

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