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Association Between Alcohol Consumption and Chronic Pain: A Systematic Review and Meta-Analysis Publisher Pubmed



Karimi R1 ; Mallah N1, 2, 3, 4 ; Nedjat S5 ; Beasley MJ6, 7 ; Takkouche B1, 8
Authors
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Authors Affiliations
  1. 1. Department of Preventive Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
  2. 2. WHO Collaborating Centre for Vaccine Safety, Santiago de Compostela, Spain
  3. 3. Genetics, Vaccines and Pediatric Infectious Diseases Research Group (GENVIP), Instituto de Investigacion Sanitaria de Santiago de Compostela, Santiago de Compostela, Spain
  4. 4. Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBER-ES), Madrid, Spain
  5. 5. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
  7. 7. Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, United Kingdom
  8. 8. Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain

Source: British Journal of Anaesthesia Published:2022


Abstract

Introduction: Chronic pain represents a global health problem with a considerable economic burden. The relation of alcohol intake and chronic pain conditions was assessed in several studies with conflicting results. We used dose–response meta-analysis techniques to answer the question of whether alcohol intake is related to chronic pain occurrence. Methods: We searched MEDLINE, Embase, and other databases to identify cohort and case-control studies on alcohol consumption and chronic pain. Sixteen studies were eligible with a total population of 642 587 individuals. Fixed-effects and random-effects pooled estimates were obtained by weighting log odds ratios (ORs) in case-control studies and log incidence rate ratios in cohort studies by the inverse of their variance. A heterogeneity assessment and a dose–response analysis were carried out. Quality scoring was also performed. Results: Our results show that any alcohol consumption was related to lower odds of chronic pain (pooled OR=0.76; 95% confidence interval [CI], 0.61–0.95). The association was non-linear. The ORs by quartile of alcohol doses were as follows: OR2nd quartile=0.74; 95% CI, 0.64–0.87; OR3rd quartile=0.67; 95% CI, 0.53–0.86; and OR4th quartile=0.75; 95% CI, 0.50–1.14. This association was observed for cohort studies (OR=0.77; 95% CI, 0.61–0.98) and European studies (OR=0.65; 95% CI, 0.48–0.87) only. Studies with complete adjustment for confounding factors showed a stronger relation than those with incomplete adjustment (OR=0.69; 95% CI, 0.48–0.99 and OR=0.85; 95% CI, 0.65–1.11, respectively). Conclusion: Alcohol consumption presents a non-linear inverse association with the occurrence of chronic pain. Although plausible mechanisms could explain this protective effect, other explanations, including reverse causation, are probable. © 2022 British Journal of Anaesthesia
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