{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T08:47:13Z","timestamp":1778575633482,"version":"3.51.4"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T00:00:00Z","timestamp":1561420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T00:00:00Z","timestamp":1566172800000},"content-version":"vor","delay-in-days":55,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["302204"],"award-info":[{"award-number":["302204"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008158","name":"Arthritis Foundation of Australia","doi-asserted-by":"publisher","award":["MRI06161"],"award-info":[{"award-number":["MRI06161"]}],"id":[{"id":"10.13039\/100008158","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Musculoskeletal pain is common and typically occurs at multiple sites. Pain has been shown to be associated with falls risk; however, whether an increased risk for falls associated with multisite pain (MSP) translates into an increased risk of fractures has not been investigated. This study aimed to examine the association of number of painful sites with prevalent and incident fractures. Data from a longitudinal population-based study of older adults (mean age 63 years) were utilized. Follow-up was performed at 2.6, 5.1, and 10.7 years later, respectively. Presence\/absence of pain at the neck, back, hands, shoulders, hips, knees, and feet was assessed by questionnaire at baseline. Participants were classified into three groups according to the total number of painful sites: zero to two, three to four, and five to seven. Fractures were self-reported at each time point. BMD was measured by DXA. Falls risk was calculated based on the Short-Form Physiological Profile Assessment. Log-binomial regression was used for the analyses. There were 450 fractures at baseline and 154 new fractures reported during a mean follow-up period of 10.7 years (range 9.2 to 12.5 years). In multivariable analyses, number of painful sites was associated with prevalent fractures at any and nonvertebral site. Furthermore, participants with five to seven painful sites had an increased risk of incident fractures at any site (RR 1.69; 95% CI, 1.13 to 2.53); major site, including the femur, radius, ulnar, vertebral, rib, and humerus (RR 2.17; 95% CI 1.12 to 4.22); and vertebral site (RR 6.44, 95% CI, 1.64 to 25.33) compared with those with pain at zero to two sites. These associations remained statistically significant after further adjustment for falls risk and BMD. Pain at multiple sites was associated with incident fracture risk in a dose-response manner, suggesting that widespread pain is an independent contributor to fracture risk. The potential for pain management in fracture prevention warrants further exploration. \u00a9 2019 American Society for Bone and Mineral Research.<\/jats:p>","DOI":"10.1002\/jbmr.3817","type":"journal-article","created":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T21:39:07Z","timestamp":1561498747000},"page":"2012-2018","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Pain at Multiple Sites Is Associated With Prevalent and Incident Fractures in Older Adults"],"prefix":"10.1093","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3403-0094","authenticated-orcid":false,"given":"Feng","family":"Pan","sequence":"first","affiliation":[{"name":"Menzies Institute for Medical Research University of Tasmania Private Bag 23 Hobart Tasmania 7000 Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Tian","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research University of Tasmania Private Bag 23 Hobart Tasmania 7000 Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn","family":"Aitken","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research University of Tasmania Private Bag 23 Hobart Tasmania 7000 Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavia","family":"Cicuttini","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine Monash University Medical School Commercial Road, Melbourne 3181 VIC Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graeme","family":"Jones","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research University of Tasmania Private Bag 23 Hobart Tasmania 7000 Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,6,25]]},"reference":[{"issue":"1","key":"2024021014454811200_jbmr3817-bib-0001","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/AJP.0000000000000089","article-title":"Persistence of noncancer-related musculoskeletal chronic pain among community-dwelling older people: a population-based longitudinal study in Finland","volume":"31","author":"Karttunen","year":"2015","journal-title":"Clin J Pain"},{"issue":"1\u20132","key":"2024021014454811200_jbmr3817-bib-0002","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.pain.2004.04.017","article-title":"The prevalence of pain and pain interference in a general population of older adults: cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP)","volume":"110","author":"Thomas","year":"2004","journal-title":"Pain."},{"issue":"12","key":"2024021014454811200_jbmr3817-bib-0003","doi-asserted-by":"crossref","first-page":"2649","DOI":"10.1016\/j.pain.2013.07.029","article-title":"Prevalence and impact of pain among older adults in the United States: findings from the 2011 National Health and Aging Trends Study","volume":"154","author":"Patel","year":"2013","journal-title":"Pain."},{"issue":"2","key":"2024021014454811200_jbmr3817-bib-0004","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.berh.2017.10.004","article-title":"Chronic musculoskeletal pain and its impact on older people","volume":"31","author":"Blyth","year":"2017","journal-title":"Best Pract Res Clin Rheumatol"},{"issue":"10100","key":"2024021014454811200_jbmr3817-bib-0005","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"2016 Disease and Injury Incidence and Prevalence Collaborators. 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