Sex moderates the effects of positive and negative affect on clinical pain in patients with knee osteoarthritis

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_j.sjpain.2017.03.005_s_006_w2aab3b7c61b1b6b1aab1c16b1Aa"><jats:title>Background and aims</jats:title><jats:p>Sex differences in clinical pain severity and response to experimental pain are commonly reported, with women generally showing greater vulnerability. Affect, including state (a single rating) and stable (average daily ratings over two weeks) positive affect and negative affect has also been found to impact pain sensitivity and severity, and research suggests that affect may modulate pain differentially as a function of sex. The current study aimed to examine sex as a moderator of the relationships between affect and pain-related outcomes among participants with knee osteoarthritis (KOA).</jats:p></jats:sec><jats:sec id="j_j.sjpain.2017.03.005_s_007_w2aab3b7c61b1b6b1aab1c16b2Aa"><jats:title>Methods</jats:title><jats:p>One hundred and seventy-nine participants (59 men) with KOA completed electronic diaries assessing clinical pain, positive affect, and negative affect. A subset of participants (<jats:italic>n</jats:italic> = 120) underwent quantitative sensory testing, from which a single index of central sensitization to pain was derived. We used multiple regression models to test for the interactive effects of sex and affect (positive versus negative and stable versus state) on pain-related outcomes. We used mixed effects models to test for the moderating effects of sex on the relationships between state affect and pain over time.</jats:p></jats:sec><jats:sec id="j_j.sjpain.2017.03.005_s_008_w2aab3b7c61b1b6b1aab1c16b3Aa"><jats:title>Results</jats:title><jats:p>Sex differences in affect and pain were identified, with men reporting significantly higher stable positive affect and lower central sensitization to pain indexed by quantitative sensory testing, as well as marginally lower KOA-specific clinical pain compared to women. Moreover, there was an interaction between stable positive affect and sex on KOA-specific clinical pain and average daily non-specific pain ratings. Post hoc analyses revealed that men showed trends towards an inverse relationship between stable positive affect and pain outcomes, while women showed no relationship between positive affect and pain. There was also a significant interaction between sex and stable negative affect and sex on KOA-specific pain such that men showed a significantly stronger positive relationship between stable negative affect and KOA-specific pain than women. Sex did not interact with state affect on pain outcomes.</jats:p></jats:sec><jats:sec id="j_j.sjpain.2017.03.005_s_009_w2aab3b7c61b1b6b1aab1c16b4Aa"><jats:title>Conclusions</jats:title><jats:p>Findings suggest that men may be particularly sensitive to the effects of stable positive affect and negative affect on clinical pain. Future work with larger samples is needed in order to identify potential mechanisms driving the sex-specific effects of affect on pain.</jats:p></jats:sec><jats:sec id="j_j.sjpain.2017.03.005_s_010_w2aab3b7c61b1b6b1aab1c16b5Aa"><jats:title>Implications</jats:title><jats:p>The current study provides novel data that suggesting that the association of positive affect, negative affect, and pain are different in men versus women with KOA. Further understanding of the difference in affective expression between men and women may lead to the development of novel therapeutic interventions and help to identify additional modifiable factors in the prevention and management of pain.</jats:p></jats:sec>

Relationships Between Psychological, Sleep, and Physical Activity Measures and Somatosensory Function in People With Peripheral Joint Pain: A Systematic Review and Meta‐Analysis

“…QST measures in the included studies were PPT and temporal summation (TS) ( n = 11 studies); heat pain threshold (HPT) ( n = 10); cold pain threshold (CPT) ( n = 6). TS was examined using heat, 55,57–60 mechanical, 22,28,52 and both heat and mechanical stimuli 51,54,61 . CPM was measured in 3 studies with heat 54,57 and pressure 52 as test stimuli.…”

“…A potential limitation of the current meta‐analysis is that data from 8 studies 51,53,54,56–59,61,102 were not pooled either due to unfitting data or absence of data in the included studies. The majority of data included in the meta‐analysis were obtained from studies conducted on individuals with knee pain, with less data available for patients with shoulder pain.…”

Comparison of Arthroscopic and Conservative Treatments for Knee Osteoarthritis: A 5-Year Retrospective Comparative Study

“…K nee osteoarthritis (KOA) is the most common orthopaedic condition, with a prevalence of 12% to 35% in the general population and is considered to be the leading cause of disability old individuals. [1][2][3] There is still no curative treatment for KOA and only a small number of limited treatments, which aim to reduce pain and control inflammation to improve function. The treatment of KOA in the early stages includes physical therapy, [4][5][6] pain relief by nonsteroidal anti-inflammatory drugs, 7 cell-based therapy, 8,9 and intra-articular injection of hyaluronan or corticosteroids.…”

Effects of Vitamin D Supplementation on Disabling Foot Pain in Patients With Symptomatic Knee Osteoarthritis

“…In patients with OA, differences in sex existed in the experience of pain, and psychological factors (34) and other factors, such as foot and ankle shape, footwear habit, obesity, decline in muscle strength with aging, and ligamentous laxity, may underline the differences in sex in regard to pain. In our study, female patients reported higher MFPDI scores and more disabling foot pain at baseline.…”