Characteristics associated with comorbid lumbar spinal stenosis symptoms in people with knee or hip osteoarthritis: an analysis of 9,136 good life with osteoArthritis in Denmark (GLA:D®) participants

Abstract

Background Previous studies have found that lumbar spinal stenosis (LSS) often co-occurs with knee or hip OA and can impact treatment response. However, it is unclear what participant characteristics may be helpful in identifying individuals with these co-occurring conditions. The aim of this cross-sectional study was to explore characteristics associated with comorbid symptoms of lumbar spinal stenosis (LSS) in people with knee or hip osteoarthritis (OA) enrolled in a primary care education and exercise program. Methods Sociodemographic, clinical characteristics, health status measures, and a self-report questionnaire on the presence of LSS symptoms was collected at baseline from the Good Life with osteoArthritis in Denmark primary care program for knee and hip OA. Cross-sectional associations between characteristics and the presence of comorbid LSS symptoms were assessed separately in participants with primary complaint of knee and hip OA, using domain-specific logistic models and a logistic model including all characteristics. Results A total of 6,541 participants with a primary complaint of knee OA and 2,595 participants with a primary complaint of hip OA were included, of which 40% and 50% reported comorbid LSS symptoms, respectively. LSS symptoms were associated with similar characteristics in knee and hip OA. Sick leave was the only sociodemographic variable consistently associated with LSS symptoms. For clinical characteristics, back pain, longer symptom duration and bilateral or comorbid knee or hip symptoms were also consistently associated. Health status measures were not consistently related to LSS symptoms. Conclusion Comorbid LSS symptoms in people with knee or hip OA undergoing a primary care treatment program of group-based education and exercise were common and associated with a similar set of characteristics. These characteristics may help to identify people with co-occurring LSS and knee or hip OA, which can be used to help guide clinical decision-making.

Similar improvements in patient-reported outcomes for non-specific low back pain patients with and without lumbar spinal stenosis symptoms following a structured education and exercise therapy program

“…Confirmation of our results using the alternate age cut-point increases confidence in our findings. We were unable to include imaging confirmation of LSS since this is not collected in GLA:D® Back, but our approach is sufficient for preliminary estimates in this field [ 17 , 18 ], considering LSS is a clinical diagnosis [ 27 ].…”

“…While not diagnostic, these items are commonly-used in the self-report of LSS and are able to adequately differentiate leg pain from LSS from other sources of back-related leg pain [ 5 ]. Similar LSS definitions have been used in recent LSS studies [ 15 – 18 ].…”

The GLA:D® Canada program for knee and hip osteoarthritis: A comprehensive profile of program participants from 2017 to 2022

“…It is the hope that making these already collected data available to the larger research community will foster opportunities for primary and collaborative OA research, for trainees to established investigators, with the ultimate goal of improved care and quality of life for the millions of individuals living with hip and knee OA. There are many examples of the use of international GLA:D 1 datasets by researchers undertaking OA-related investigations [30,[32][33][34][48][49][50][51][52][53], including qualitative investigations in people with OA and/or health care providers [31,54,55]. Furthermore, participant data in the GLA:D 1 Canada registry can be linked via Personal Health Number to provincial public administrative health systems data, such as from the Alberta Health Care Insurance Plan or Ontario Health Insurance Plan, offering the opportunity to examine health care utilization among GLA:D 1 participants.…”