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Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 2004 Apr;63(4):342–347. doi: 10.1136/ard.2003.010223

Musculoskeletal pain in Europe: its impact and a comparison of population and medical perceptions of treatment in eight European countries

A Woolf 1, H Zeidler 1, U Haglund 1, A Carr 1, S Chaussade 1, D Cucinotta 1, D Veale 1, E Martin-Mola 1
PMCID: PMC1754955  PMID: 15020325

Abstract

Objectives: To describe the impact of musculoskeletal pain (MP); to compare management of MP by the population and by primary care physicians; and to identify misconceptions about treatment.

Methods: 5803 people with MP and 1483 primary care physicians, randomly selected, in eight European countries were interviewed by telephone. A structured questionnaire was used to ask about usual management of MP and perceived benefits and risks of treatment. Current health status (SF-12) was also assessed.

Results: From primary care physicians' perceptions, MP appears to be well managed. All presenting patients are offered some form of treatment, 90% or more doctors are trying to improve patients' quality of life, and most are aware and concerned about the risks of treatment with NSAIDs. From a population perspective, up to 27% of people with pain do not seek medical help and of those who do, several wait months/years before seeing a doctor. 55% or fewer patients who have seen a doctor are currently receiving prescription treatment for their pain. Communication between doctors and patients is poor; few patients are given information about their condition; and many have misconceptions about treatment.

Conclusions: Management of MP is similar across eight European countries, but there is discordance between physician and patient perspectives of care. Some people with pain have never sought medical help despite being in constant/daily pain. Those who do seek help receive little written information or explanation and many have misperceptions about the benefits and risks of treatment that limit their ability to actively participate in decisions about their care.

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Figure 1 .

Figure 1

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Percentage of primary care physicians in each country who recommend non-pharmacological interventions to all or most patients with MP.

Figure 2 .

Figure 2

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Bar chart showing drugs prescribed as first line treatment by primary care physicians and drugs currently taken by patients with MP. The physician bars (Dr) show the percentage of primary care physicians who prescribe analgesics alone, NSAIDs alone, or both NSAIDs and analgesics as first line pharmacological treatment. The patient bars (Pt) show the percentage of patients who take analgesics alone, NSAIDs alone, a combination of analgesics and NSAIDs, non-prescription (non-Rx) drugs alone, unclassified prescription drugs, or no medication.

Figure 3 .

Figure 3

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Bar chart showing the percentage of people with MP in each country who currently take drugs for pain and the type of drug taken (prescription only, non-prescription (NP), or combined prescription and NP drugs).

Figure 4 .

Figure 4

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Bar chart showing the percentage of patients taking NSAIDs who think that their treatment is not at all or only a little effective in managing their pain. The doctors' data represent the percentage of patients whom primary care physicians think will require a change in their treatment because of lack of efficacy.

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