The relations of obesity indicators and early metabolic disturbance with upper extremity pain.

Objectives: To determine whether signs of metabolic disturbance and especially visceral obesity are associated with upper extremity pain.

Design: Cohort study.

Subjects: One hundred and seventy-seven workers (154 women, 23 men; age 20-64 years, mean 45) seeking medical advice in the occupational health service for incipient upper extremity disorders were included.

Measures: Weight, height, waist circumference, and hip circumference were measured. Visceral and liver fat content and carotid artery intima-media thickness were estimated with ultrasound. Pain intensity and pain interference with sleep were assessed with visual analog scales at baseline and after 2, 8, 12, 52, and 104 weeks follow-up. Generalized estimating equation approach was used to analyze the repeated measures data.

Results: All obesity indicators were associated with both pain intensity and pain interference with sleep. Visceral fat thickness was the strongest predictor of pain intensity and pain interference with sleep. Carotid intima-media thickness was neither associated with pain intensity nor with pain interference with sleep.

Conclusions: Visceral obesity seems to be a risk factor for upper extremity pain. Further studies are needed to elucidate the underlying mechanisms and to clarify whether weight loss can be helpful in pain management.