“Let’s Talk about OA Pain”: A Qualitative Analysis of the Perceptions of People Suffering from OA. Towards the Development of a Specific Pain OA-Related Questionnaire, the Osteoarthritis Symptom Inventory Scale (OASIS)

Abstract

IntroductionPain is the primary outcome measurement in osteoarthritis, and its assessment is mostly based on its intensity. The management of this difficult chronic condition could be improved by using pain descriptors to improve analyses of painful sensations. This should help to define subgroups of patients based on pain phenotype, for more adapted treatment. This study draws upon patients’ descriptions of their pain, to identify and understand their perception of osteoarthritis pain and to categorize pain dimensions.MethodsThis qualitative study was conducted with representative types of patients suffering from osteoarthritis. Two focus groups were conducted with a sample of 14 participants, with either recent or chronic OA, at one or multiple sites. Focus groups were semi-structured and used open-ended questions addressing personal experiences to explore the experiences of patients with OA pain and the meanings they attributed to these pains.ResultsTwo main points emerged from content analyses: -A major difficulty in getting patients to describe their osteoarthritis pain: perception that nobody wants to hear about it; necessity to preserve one’s self and social image; notion of self-imposed stoicism; and perception of osteoarthritis as a complex, changing, illogical disease associated with aging. -Osteoarthritis pains were numerous and differed in intensity, duration, depth, type of occurrence, impact and rhythm, but also in painful sensations and associated symptoms. Based on analyses of the verbatim interviews, seven dimensions of OA pain emerged: pain sensory description, OA-related symptoms, pain variability profile, pain-triggering factors, pain and physical activity, mood and image, general physical symptoms.SummaryIn osteoarthritis, pain analysis should not be restricted to intensity. Our qualitative study identified pain descriptors and defined seven dimensions of osteoarthritis pain. Based on these dimensions, we aim to develop a specific questionnaire on osteoarthritis pain quality for osteoarthritis pain phenotyping: the OsteoArthritis Symptom Inventory Scale (OASIS).

Current understanding of the mixed pain concept: a brief narrative review

“…Further, participants of a qualitative, focus-group study involving representative types of patients suffering from osteoarthritis described a wide variety of painful sensations which differed in terms of intensity (e.g. "pain as an electrical shock"), duration (from ongoing "background pain" to sharp, instantaneous pains brought on by "bad movement"), depth (muscle-deep vs bone-deep), and associated symptoms (most often anxiety related to the sensation of intense pain) 34 . Finally, among patients who had undergone joint replacement and reporting persistent postsurgical pain, pain symptoms ranged from mild to "severe-extreme" (occurring in 15% of study patients post-total knee replacement), with the persistent pain most commonly described as "aching", "tender", and "tiring" 35 .…”

Osteoarthritis pain

“…Although several pain descriptors are proposed in the paper, these descriptors were not intended to be specifically used to define pain phenotypes in OA, as it has been done in neuropathic pain. In this line, we have developed a qualitative analysis of OA pain with a new questionnaire, the OsteoArthritis Symptom Inventory Scale (OASIS), to characterize pain quality in OA, and in the future, to help define different phenotypes of OA pain [50].…”

Analgesic Effect of Duloxetine on an Animal Model of Monosodium Iodoacetate‐Induced Hip Osteoarthritis

“…In many countries, the increasing prevalence of OA is causing an increasing number of individuals with chronic pain, which creates a huge burden. Nevertheless, the pathophysiology of joint pain received little attention for many years, compared with extensive research on inflammation and immunity in joint diseases, and many important research questions remain unresolved. Many patients suffer from pain at rest or at night despite lower mechanical stress.…”