Activity-related pain predicts pain and functional outcomes in people with knee osteoarthritis: A longitudinal study

Mark Overton; Nicola Swain; Carrie Falling; David Gwynne-Jones; Roger Fillingim; Ramakrishnan Mani

doi:10.3389/fpain.2022.1082252

Activity-related pain predicts pain and functional outcomes in people with knee osteoarthritis: A longitudinal study

Front Pain Res (Lausanne). 2023 Jan 13:3:1082252. doi: 10.3389/fpain.2022.1082252. eCollection 2022.

Authors

Mark Overton¹, Nicola Swain¹, Carrie Falling¹, David Gwynne-Jones², Roger Fillingim³, Ramakrishnan Mani¹

Affiliations

¹ Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
² Department of Surgical Sciences, Otago School of Medicine, University of Otago, Dunedin, New Zealand.
³ Pain Research and Intervention Center of Excellence (PRICE), Department of Community Dentistry and Behavioural Science, University of Florida, Gainesville, FL, United States.

Abstract

Knee Osteoarthritis (OA) is a prevalent musculoskeletal condition, commonly resulting in pain and disability. However, pain and disability in this population are poorly related with the degree of structural joint damage. Underlying pain mechanisms, including activity-related pain and sensitization assessed via Quantitative Sensory Testing (QST), may better predict pain and functional outcomes of those with knee OA. Therefore, the aim of this study was to explore whether activity-related pain and sensitization assessed via QST predict future pain, function, fatigue, physical performance and quality of life outcomes in those living in the community with knee OA. Eighty-six participants with knee OA were recruited in Dunedin, New Zealand. Those eligible to participate underwent baseline testing including QST as well as measures of activity-related pain including Movement-evoked Pain (MEP) and Sensitivity to Physical Activity (SPA). Outcome measures exploring pain, function, fatigue and quality of life outcomes were collected at baseline, and two follow-up periods (two and nine weeks). Univariable linear regression models were developed followed by multivariable linear regression models for each prognostic marker adjusting for age, gender, BMI, OA duration, baseline pain intensity and socioeconomic status. Activity-related measures of pain, including MEP and SPA, demonstrated predictive associations with pain and functional outcomes prospectively in those with knee OA. Therefore, those demonstrating activity-related pain are at future risk of greater pain, disability and reduced quality of life. Larger, externally validated longitudinal studies are required which include individuals with more severe knee OA.

Keywords: activity-related pain; knee osteoarthritis; longitudinal; pain; quantitative sensory testing; sensitization.

Grants and funding

This research was funded by the Otago Medical Research Foundation (grant number: JT-387). This funding enabled participant recruitment advertising online and in local newspapers as well as $100 supermarket vouchers to recognise participant contribution. Some of this funding is also being used for open access publication fees.