Journal Article

P103 Association between alcohol drinking and musculoskeletal pain patterns in the British Whitehall II study: the cross-lagged panel analysis

Lallukka Tea, Zhao Ziyi, Chandola Tarani, Britton, Annie

2025

Overview

BackgroundHeavy drinking and alcohol dependency are associated with a higher prevalence of musculoskeletal (MSK) pain in manual workers; however, such relationship remains less studied in non-manual workers. This longitudinal study investigated the temporality and directionality of the relationship between heavy drinking, alcohol dependency, and MSK pain patterns among current and retired no-manual workers through cross-lagged panel analysis.MethodsData were analyzed from the 7th, 9th, and 12th phases (2000–2016) of the British Whitehall II study (n = 6,967, response rates: 71.6%, 72.3%, 66.6%), with comprehensive MSK and alcohol consumption measures. Alcohol consumption was assessed through average volume consumed and alcohol dependency indicator. MSK pain patterns were identified through multiple-group latent class analysis (LCA) based on self-reported pain sites, RAND-36 pain severity/interference scores, and number of pain sites. People reporting no pain were defined as reference group. Random-intercept cross-lagged panel analysis (RI-CLPM) was implemented to assess the potential reciprocal relationship between alcohol intake and pain patterns, adjusting for potential covariates. We conducted subgroup analyses by age, sex, and employment transition.ResultsAmong 5,928 participants (mean age: 60.7 years; 71.0% men), LCA identified four latent pain classes across three phases, consolidated into two broader classifications: high pain (characterized by ≥3 pain sites, with >50% reporting moderate or higher pain severity/interference across all pain sites, 18.6% at baseline) and low pain (characterized by <3 pain sites in back, cervical region, or upper extremities, with <50% reporting moderate or higher pain severity or interference, 39.7% at baseline). The remaining 38.5% reported no pain at baseline. No significant cross-lagged association between alcohol intake and MSK pain patterns was found. Potential alcohol dependency was associated with pain class with higher severity and more pain-site (standardized beta coefficients: 1.15, 95% CI: 0.43–2.34) among men only. Although the indicator of alcohol dependency was associated with increased pain-site and severity among those who experienced retirement transition (standardized beta coefficients: 0.38, 95% CI: 0.10–0.60), this association diminished after adjusting for covariates.ConclusionWhile average alcohol intake showed no significant relationship with MSK pain patterns in non-manual workers, potential alcohol dependency might be associated with patterns with increased pain-site and severity among men. This finding suggests the potential benefits of integrating alcohol dependence screening and pain prevention programs, particularly among male non-manual workers.

• Publisher: BMJ Publishing Group LTD
• Subject: Alcohol use / Alcoholic beverages / Alcohols / Drinking behavior / Drug dependence / Extremities / Longitudinal studies / Manual workers / Pain / Workers