Association between pain, radiographic severity, and centrally-mediated symptoms in women with knee osteoarthritis

Arthritis Care Res (Hoboken). 2011 Nov;63(11):1543-9. doi: 10.1002/acr.20583.

Abstract

Objective: To examine the relationship between pain, radiographic severity, and a common set of co-occurring centrally-mediated symptoms (fatigue, sleep quality, and depression) in women with knee osteoarthritis.

Methods: Participants underwent knee radiographs, and had repeated assessments of pain severity and other centrally-mediated symptoms during a 5-day home monitoring period. To examine associations between pain severity (the average of pain over the home monitoring period), measures of osteoarthritis radiographic severity (Kellgren/Lawrence grade, minimum joint space width), centrally-mediated symptoms, and demographics (age) were used. Symptoms of fatigue, sleep efficiency, and depression were used in a composite measure representing centrally-mediated symptoms.

Results: Using a series of linear regression models in which each variable was entered hierarchically (n = 54), the final model showed that 27% of the variance in pain severity was explained by age, radiographic severity, and centrally-mediated symptoms. Centrally-mediated symptoms explained an additional 10% of the variance in pain severity after the other 2 variables were entered.

Conclusion: Both radiographic severity and centrally-mediated symptoms were independently and significantly associated with pain severity in women with knee osteoarthritis. In addition to more severe radiographic features, women with higher centrally-mediated symptoms had greater pain severity. Treatments for women with symptomatic knee osteoarthritis may be optimized by addressing both peripheral and central sources of pain.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Arthralgia / diagnosis*
  • Arthralgia / physiopathology
  • Cross-Sectional Studies
  • Depression / diagnosis*
  • Depression / psychology
  • Disability Evaluation
  • Fatigue / diagnosis*
  • Fatigue / physiopathology
  • Female
  • Humans
  • Knee Joint / diagnostic imaging*
  • Knee Joint / physiopathology
  • Linear Models
  • Michigan
  • Middle Aged
  • Osteoarthritis, Knee / diagnosis*
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / psychology
  • Pain Measurement
  • Predictive Value of Tests
  • Radiography
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Sleep
  • Time Factors