Knee pain and radiographic osteoarthritis interact in the prediction of levels of self‐reported disability

Abstract

Objective. To determine predictors of disability depending on whether joint deformity and pain reporting exist independently or concurrently. Methods. Subjects were 154 volunteers for an osteoarthritis screening examination. Eligible subjects completed questionnaires for physical function, pain, and depressive symptoms; underwent evoked pain testing for tenderness assessment; and had anteroposterior and lateral radiographs taken of both knees. Two blinded rheumatologists scored the images using Kellgren-Lawrence criteria to determine presence of deformity. Results. Subjects were divided into 3 subgroups based on radiographic evidence of deformity and self-reported pain. Disability was greatest when pain and deformity occurred together (F[2,151] ‫؍‬ 18.8, P < 0.0001). Self-reported disability in the absence of deformity was predicted by body mass index, pain threshold, and anxiety symptoms; disability was predicted by the number of osteophytes and depressive symptoms when pain and deformity occurred together. Conclusion. Self-reported disability in osteoarthritis of the knee is greatest with concurrent pain and joint deformity. When pain and deformity do not cooccur, disability appears to be related to separate factors, including anxiety and pain threshold (e.g., tenderness).

Individual differences in pain responses

“…Evidence reviewed above indicates that pain sensitivity assessed through QST is altered in patients with chronic pain resulting from rheumatologic conditions and can predict symptom severity and possibly responses to treatment. For example, one recent study found that lower pressure pain threshold significantly predicted greater disability among OA knee patients who reported clinical pain in the absence of radiographic deformity, but not among patients with radiographic deformity [52]. Thus, QST may be helpful in identifying patient subgroups and may ultimately serve as a useful treatment outcome measure.…”

“…Specifically, many chronic pain populations demonstrate enhanced sensitivity of painful stimuli, and laboratory pain perception often predicts the severity of clinical symptoms. Indeed, enhanced pain sensitivity has been demonstrated in fibromyalgia, rheumatoid arthritis, and OA [51][52][53][54]. In addition, experimental pain perception can predict future pain experiences.…”

Avaliação da magnitude da desvantagem da osteoartrite na vida das pessoas: estudo MOVES

“…2,7,22,27 Além disso, o índice de massa corporal (IMC) parece desempenhar um papel importante na determinação da incapacitação dos indivíduos. 28 Mas no presente estudo, não percebemos associação entre OA e IMC, contrastando com dados obtidos em um levantamento populacional na Noruega, 13 onde IMC estava significativamente associado com OA no quadril e joelho.…”

Relação entre intensidade de dor e capacidade funcional em indivíduos obesos com osteoartrite de joelho

“…Por isso, testes de velocidade são considerados métodos confiáveis e simples, com baixos custos, para avaliar estas alterações objetivas 12 . Além da obesidade, diversos fatores podem influenciar a capacidade funcional em indivíduos com OA de joelho, entre eles a gravidade da doença 13 , a amplitude de movimento e a força muscular 14 , a idade e o sexo 15 . A intensidade de dor é um fator determinante para o relato de dificuldades 16 e pode afetar as velocidades usual e rápida de marcha 17 .…”