Prevalence of Sarcopenia in Pain Patients and Correlation Between the Two Conditions: A Systematic Review and Meta-Analysis



      Sarcopenia is a generalized and progressive skeletal muscle disorder and has been proven to be associated with many diseases; however, the correlation between sarcopenia and pain has not yet been systematically clarified. This review aimed to investigate the prevalence of sarcopenia in patients with pain and to ascertain whether pain is independently associated with sarcopenia.


      Systematic review and meta-analysis.

      Setting and Participants

      A systematic literature search was performed from the Cochrane Central Register of Controlled Trials, Embase, MEDLINE and Epub Ahead of Print, In-Process, In-Data-Review, and Other Non-Indexed Citations, Daily and Versions for observational studies from inception until February 2021, and our search was updated on December 31, 2021.


      Sarcopenia prevalence was calculated according to the corresponding number of patients with sarcopenia and pain. We performed meta-analyses with random effects models to calculate the pooled prevalence of sarcopenia in pain and its correlations. Subgroup analyses were also performed based on pain classification, pain location, and diagnostic criteria for sarcopenia. Heterogeneity between the studies was described using the I2 statistic.


      Fourteen observational studies (13,953 participants, 44% women, and mean age from 40.1 to 76.6 years) were included. Study quality was rated moderate to high. The overall sarcopenia prevalence in patients with pain was 0.11 (95% CI 0.07–0.15, P < .001; I2 = 92.3%). People with pain were independently associated with a higher risk of sarcopenia than those without pain [odds ratio (OR) 1.35; 95% CI 1.17–1.56; P = .025; I2 = 51.1%]. Subgroup analyses showed that the cumulative prevalence and effect measures of sarcopenia were increased when individuals suffered secondary musculoskeletal pain (Prevalence = 12%; OR 1.45; 95% CI 1.19–1.78) and low back pain (Prevalence = 21%; OR 1.95; 95% CI 1.22–3.12).

      Conclusions and Implications

      The prevalence of sarcopenia in patients with pain is relatively high, and pain is significantly associated with sarcopenia in older adults. Attention is needed to screen sarcopenia among patients with pain and optimize its early detection and management in clinical practice.


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