Description

Code list aiming to identify individuals consulting complaining of pain.

Methodology

Identified from initial search terms outside of OpenCodelists: "pain" "ache" "myalgia" "arthralgia" "sore" "tender" "stiff" "lumbago" "rheumatism" "joint" "fibromyalgia" "arthritis" "arthropathy" "tendinitis" "tendinopathy" "epicondylitis" "synovitis" "enthesitis" "bursitis" "epicondylitis" "enthesopath" "rotator cuff syndrome" "sprain" "strain" "crick" "arthrosis" "capsulitis" "sciatica" "algia" "radiculitis" "radiculopathy"

Clearly irrelevant codes excluded (not reviewed by a second clinician)

Candidate codelist reviewed outside OpenCodelists by two clinicians. As we reviewed our candidate codelist outside openCodelists, we did not benefit from the tree structures that might have identified additional codes. However, we assume that these are likely to be codes that are not used frequently, e.g., eponymous syndromes.

Aiming to identify any symptoms/diagnosis that likely present with pain. So, have included all osteoarthritis, other unspecified arthritis, tendinitis, bursitis, strains, sprains, enthesitis, etc, as these are likely to present with pain and diagnoses will often be made on the spot.

Excluded joint instability or joint stiffness as these symptoms do not necessarily indicate pain.

Excluded terms suggest clear cause for symptoms, e.g., acromegaly with arthropathy, postthoracotomy pain, familial/hereditary conditions.

Excluded terms about pain management/referral/monitoring. As unclear if pain treated and resolved.

Excluded structural tears, contractures and ruptures as implies traumatic cause.

Excluded all 'history of xxx' codes, as does not imply that pain symptoms are still present.

Excluded non-specific 'joint disorder' or 'joint derangement' or 'stiffness' codes, as do not necessarily suggest pain is present.

Retained ear pain even though it is included in a separate list in this study, as the whole pain list also includes pains in other specific anatomical sites (e.g., face, chest, etc). That is, list is not restricted to musculoskeletal pain only, as it can be difficult to differentiate between musculoskeletal and referred visceral pain when an individual initially presents with symptoms.

Signed off by

• Kate Mansfield, (Feb. 8, 2023)