University of Oulu

Heikkala, E., Merikanto, I., Tanguay-Sabourin, C., Karppinen, J., & Oura, P. (2023). Eveningness is associated with persistent multisite musculoskeletal pain: A 15-year follow-up study of northern finns. The Journal of Pain, 24(4), 679–688.

Eveningness is associated with persistent multisite musculoskeletal pain : a 15-year follow-up study of Northern Finns

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Author: Heikkala, Eveliina1,2,3; Merikanto, Ilona1,4,5,6; Tanguay-Sabourin, Christophe7,8;
Organizations: 1Research Unit of Population Health, University of Oulu, Oulu, Finland
2Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
3Rovaniemi Health Center, Rovaniemi, Finland
4SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
5Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
6Orton Orthopaedics Hospital, Helsinki, Finland
7Alan Edwards Pain Centre for Research on Pain, McGill University, Montreal, Quebec, Canada
8Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
9Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
10Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link:
Language: English
Published: Elsevier, 2023
Publish Date: 2023-12-10


Chronotype, a phenotype representing a person’s 24-hour circadian rhythm, has been increasingly acknowledged as playing a role in musculoskeletal (MSK) pain. Most prior research on chronotype and MSK pain have been based on cross-sectional data, and no study has explored multisite MSK pain (2 or more pain locations) as the outcome. We drew the study sample from the 31- and 46-year data collections (baseline and follow-up, respectively) of the Northern Finland Birth Cohort 1966 and collected self-reported data on chronotype at follow-up (morning [M]-type, intermediate [I]-type, and evening [E]-type) and longitudinal multisite MSK pain trajectories (n = 3,294). Multinomial logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) in multisite MSK pain trajectories between the chronotypes. We conducted additional sensitivity analyses that 1) accounted for several confounders, and 2) examined the potential moderating role of sex, mental distress, and sleep disturbance status in the chronotype–multisite MSK pain associations. The E-types had two-and-a-half-times higher odds of multisite MSK pain at baseline and follow-up (OR 2.47, 95% CI 1.84–3.32) than the M-types. Having severe mental distress or poor sleep at baseline and follow-up, or sex did not change the strength of this association. Our examination of this longitudinal birth cohort study suggested that evening types, in comparison to morning types, are more likely to experience multisite MSK pain between ages 31 and 46 years. Chronotype should be recognized as a predictor of multisite pain and thus taken into account in the evaluation of a patient’s risk for multisite pain.

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Series: Journal of pain
ISSN: 1526-5900
ISSN-E: 1528-8447
ISSN-L: 1526-5900
Volume: 24
Issue: 4
Pages: 679 - 688
DOI: 10.1016/j.jpain.2022.12.003
Type of Publication: A1 Journal article – refereed
Field of Science: 3112 Neurosciences
Funding: The NFBC1966 received financial support from the University of Oulu Grant no. 65354 and 24000692; Oulu University Hospital Grant no. 2/97, 8/97, and 24301140; Ministry of Health and Social Affairs Grant no. 23/251/97, 160/97, 190/97; Finnish Institute for Health and Welfare, Helsinki Grant no. 54121; Regional Institute of Occupational Health, Oulu, Finland Grant no. 50621, 54231; ERDF European Regional Development Fund Grant no. 539/2010 A31592. I. Merikanto received financial support from the Gyllenberg Foundation and the Finnish Cultural Foundation.
Copyright information: © 2023. This manuscript version is made available under the CC-BY-NC-ND 4.0 license