Factors associated with pain pressure threshold in both local and remote sites in knee osteoarthritis

Abstract

IntroductionKnee osteoarthritis (KOA) is a prevalent condition, and its most frequent symptom is pain that often leads to disability. Pain sensitization is a core feature of KOA, and it can be measured through quantitative sensory testing protocols such as pain pressure threshold (PPT). However, there is a lack of understanding about the factors that may influence changes in PPTs in the KOA population.ObjectiveWe aim to explore the clinical and functional factors associated with PPTs in a sample of chronic KOA pain and to compare models of local (knees) and remote (thenar regions) sites.DesignCross‐sectional analysis of a prospective cohort.SettingPrimary care in public institution.Participants113 adult KOA patients.InterventionN/A.Main Outcome MeasuresWe performed multivariable regression analyses evaluating demographic, clinical, and functional variables that could be associated with local and remote PPTs (main outcomes).ResultsBoth thenar region (adjusted‐R2: 0.29) and knee (adjusted‐R2: 0.45) models had the same significant negative association with being a female, WOMAC pain levels (thenar: β: ‐0.15, p = 0.002; knee: β: ‐0.2, p = 0.000), and the 10‐meter walking test (thenar: β: ‐0.05, p = 0.038; knee: β: ‐0.08, p = 0.004). A small significant positive association with depressive symptoms was identified in both models, which acted as a confounder for WOMAC pain and was likely affected by unmeasured confounders.ConclusionsPPTs in KOA pain are associated with functional outcomes such as the 10MWT and activity‐related pain intensity, thus more disability is associated to smaller pain thresholds. Similarity between models may suggest central sensitization.This article is protected by copyright. All rights reserved.

Osteoarthritis and Depression Update: 2023-Can the Stress and Coping Model Help?

“…unmeasured confounders [28], and pre surgical depression presence [28]. Stress as a standalone factor, while an immense health negating determinant is surprisingly quite rarely mentioned in its own right, if at all, even though these may embrace multiple pathological, biological, mechanical stresses, physical, and emotional as well as economic and social stresses.…”