Does Kashin-beck Disease Present Only Multisite Pain? A Cross-sectional Study of Pain Characteristics in Northwest China

Abstract

BackgroundKashin-Beck Disease (KBD) is an endemic, chronic joint disease. Multisite joint pain is the primary symptom of KBD, which have profound negative effects on individuals and society. However, studies on joint pain characteristics among the KBD population are still limited. The aims of this study were to explore characteristics of joint pain in patients with KBD and determine associated factors with joint pain. MethodsThis cross-sectional study included 167 patients with KBD and 169 patients from the general population with joint pain from Shaanxi Province in northwest China. Subjects were asked about joint pain characteristics and completed the numeric rating scale (NRS), the graded chronic pain scale (GCPS) and the EuroQol (EQ-5D) questionnaire. Differences between groups were determined using Chi-square, Student’s t, Mann–Whitney U and 1-way ANOVA tests.ResultsCompared with the general group, patients with KBD reported a higher number of pain sites (7.2±3.8 vs 3.5± 1.8), a higher frequency of persistent pain (98.8% vs 50.9%), a higher percentage of analgesics usage (89.2% vs 30.7%), a higher pain intensity (73.8±15.2 vs 50.0±20.7) and pain –related disability (61.2±23.3 vs 41.6±23.2), and lower EQ-5D scores (0.34±0.27 vs 0.59±0.16). Among the 167 KBD patients, painful joints were symmetrically distributed between the bilateral limbs; the 5 most frequently reported painful joints for the bilateral sides were the knees (84.8%), ankles (79.2%), wrists (51.2%), shoulders (49.5%) and elbows (47.7%). The most severe pain joint was the knee (NRS:6.6), followed by the ankles (NRS:5.1), the fingers, shoulders and elbows had the similar NRS scores (NRS:4.0). Additionally, KBD patients experienced neuropathic pain to varying degrees. Compared to males, females reported a higher number of total pain sites, higher intensity and lower quality of life. ConclusionsBesides multisite pain, the KBD patients suffered from symmetrical, persistent, and neuropathic pain. Weight-bearing joints (e.g., knee and ankle) were the most painful. These findings will provide scientific basis for establishing joint pain evaluation criteria and future pain intervention strategies for these KBD patients in China.