No strong temporal relationship between obesity and multisite pain – results from a population-based 20-year follow-up study


  • Funding sources

    The Norwegian Fund for Post-Graduate Training in Physiotherapy supported the work.

  • Conflicts of interest

    None declared.



Multisite pain and obesity are cross-sectionally related and are common conditions that may influence each other through socio-demographic, lifestyle and/or health-related factors. The aim of the present study was to examine the cross-sectional and prospective associations between overweight/obesity and multisite pain in a general population.


In a 20-year population-based prospective cohort study, persons aged 20–62 years in 1990 participated in postal surveys in 1990, 1994, 2004 and 2010 (n = 855). Multisite pain was defined as reporting ≥ 2 number of pain sites (NPS) on the Standardized Nordic Questionnaire. Overweight was defined as body mass index (BMI) 25–30 kg/m2 and obesity as BMI ≥ 30 kg/m2. To exploit all measurement times, generalized estimating equation analyses adjusting for age, sex, educational and occupational status, smoking, sleep quality, mental distress and physical activity were employed.


The mean age was 41 years at baseline and 57% were women. Overweight/obesity and NPS were significantly associated cross-sectionally. Being overweight/obese was associated with reporting future NPS ≥ 2 [overweight: odds ratio (OR), 1.40, 95% confidence interval (CI), 1.12–1.75, obese: OR, 1.54, 95% CI, 1.04–2.28]. Having NPS ≥ 2 was not associated with becoming overweight, but increased the OR for future obesity (OR 1.27, 95% CI, 1.02, 1.59). Smoking was a confounder in this relationship.


Being overweight or obese was associated with future multisite pain, although the magnitude of the association was small and the dose-response relationship observed in cross-sectional analyses disappeared in prospective analyses. There was less evidence that having multisite pain was a predictor of future overweight/obesity.