Disclosures: Prabhav P. Deo, MD: No financial relationships or conflicts of interest
Objective: To compare and contrast demographic, psychosocial, and socioeconomic factors that are associated with incident pain at the shoulder, knee, or low back.
Design: Retrospective chart review Setting : Outpatient musculoskeletal practice Participants : 2,045 encounters comprised of patients with knee (n=295), shoulder (n=645), or low back pain (n=1105) who were scheduled for a steroid injection.
Interventions: Not applicable
Main Outcome Measures: Demographic, psychosocial, and socioeconomic data, pain scores
Results: There were statistically significant differences in age (p < 0.001), sex (p < 0.001), race (p < 0.001), BMI (p < 0.001), smoking status (p < 0.001), alcohol consumption (p < 0.001), physical activity (p < 0.001), employment (p < 0.001), marital status (p < 0.001), type of insurance (p < 0.001), and median household income (p < 0.001) among patients receiving knee, shoulder, and lumbar spine epidural injections. Levels of incident pain measured on a Visual Analog Scale (VAS) were similar for all groups (p=0.130). Older age (p < 0.05) and smoking (p < 0.05) were associated with increased knee pain. Older age (p < 0.05), being African American (p < 0.05) and having a higher BMI (p < 0.05) were associated with increased shoulder pain, whereas being African American (p < 0.001), being widowed (p < 0.05), lower household income (p < 0.01), increased alcohol use (p < 0.001), and less physical activity (p < 0.05) were associated with increased low back pain. Conclusions: There are differences in the association of incident pain with demographic, socioeconomic, and psychosocial metrics in individuals presenting for knee, shoulder or low back pain. Although the level of incident pain was similar for all three groups, there are certain modifiable risk factors that may be more pertinent for physicians to address for each diagnosis. For shoulder pain and low back pain, there are additional psychosocial factors that have associations with increased pain; clinicians should keep these social determinants of health in mind when generating efficacious treatment plans.
Level of Evidence: Level IV
To cite this abstract in AMA style:
Deo PP, Huang KI, Malik GR, Jayabalan P. Comparison of Social Determinants of Health and Their Relationship to Shoulder, Knee and Low Back Pain [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/comparison-of-social-determinants-of-health-and-their-relationship-to-shoulder-knee-and-low-back-pain/. Accessed June 28, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/comparison-of-social-determinants-of-health-and-their-relationship-to-shoulder-knee-and-low-back-pain/