Does weight-bearing versus non-weight-bearing pain reflect different pain mechanisms in knee osteoarthritis?: the Multicenter Osteoarthritis Study (MOST)

K. Aoyagi; J.W. Liew; J.T. Farrar; N. Wang; L. Carlesso; D. Kumar; L. Frey Law; C.E. Lewis; M. Nevitt; T. Neogi

doi:10.1016/j.joca.2021.10.014

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Does weight-bearing versus non-weight-bearing pain reflect different pain mechanisms in knee osteoarthritis?: the Multicenter Osteoarthritis Study (MOST)

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Does weight-bearing versus non-weight-bearing pain reflect different pain mechanisms in knee osteoarthritis?: the Multicenter Osteoarthritis Study (MOST)

K. Aoyagi, J.W. Liew, J.T. Farrar, N. Wang, L. Carlesso, D. Kumar, L. Frey Law, C.E. Lewis, M. Nevitt and T. Neogi

Osteoarthritis and cartilage, Vol.30(4), pp.545-550

04/2022

DOI: 10.1016/j.joca.2021.10.014

PMCID: PMC8940656

PMID: 34801670

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Abstract

Knee osteoarthritis (OA) is predominantly characterized by pain with weight-bearing activities. Pain at rest also occurs but the mechanisms for this are not clear. We evaluated the relations of nociceptive signal alterations to weight-bearing and non-weight-bearing pain in knee OA. We used data from a NIH–funded longitudinal cohort of older adults with or at risk of knee OA. We evaluated quantitative sensory testing (QST) measures (pressure pain threshold (PPT) at patellae and the wrist; mechanical temporal summation (TS); conditioned pain modulation (CPM)). Each WOMAC pain question was dichotomized as having at least moderate pain, and we further categorized them as weight-bearing pain and non-weight-bearing pain. We evaluated the relation of QST measures to each pain outcome using logistic regression, adjusting for potential confounders. 2,749 participants (5,479 knees) were included (mean age 64 ± 11, 57% female). Each SD unit decrease in patellar PPT was associated with greater odds of both weight-bearing pain (OR 1.51 (95% CI 1.27, 1.79)) and non-weight-bearing pain (OR 1.46 (1.20–1.77)), while wrist PPT was associated with greater odds of weight-bearing pain (OR 1.27 (1.15, 1.39)) but only with pain during sitting/lying (OR 1.20 (1.01, 1.43)). TS was significantly associated with greater odds of pain with walking and stairs (OR 1.11 (1.01, 1.23), 1.11 (1.03, 1.20), respectively). CPM was not associated with any pain outcomes. Our findings challenge the hypothesis that non-weight-bearing pain may reflect greater pain sensitization and/or inefficient CPM than weight-bearing pain in knee OA, suggesting other mechanisms are likely responsible.

Knee OA

Non-weight-bearing pain

Pain sensitization

Weight-bearing pain

Details

Title: Subtitle: Does weight-bearing versus non-weight-bearing pain reflect different pain mechanisms in knee osteoarthritis?: the Multicenter Osteoarthritis Study (MOST)
Creators: K. Aoyagi - Boston University
J.W. Liew - Boston University
J.T. Farrar - University of Pennsylvania
N. Wang - Boston University
L. Carlesso - McMaster University
D. Kumar - Boston University
L. Frey Law - University of Iowa, Iowa City, IA, USA
C.E. Lewis - University of Alabama at Birmingham
M. Nevitt - University of California, San Francisco
T. Neogi - Boston University
Resource Type: Journal article
Publication Details: Osteoarthritis and cartilage, Vol.30(4), pp.545-550
DOI: 10.1016/j.joca.2021.10.014
PMID: 34801670
PMCID: PMC8940656
NLM abbreviation: Osteoarthritis Cartilage
ISSN: 1063-4584
eISSN: 1522-9653
Publisher: Elsevier Ltd
Language: English
Date published: 04/2022
Academic Unit: Nursing; Physical Therapy and Rehabilitation Science
Record Identifier: 9984295056402771

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