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Pain sensitivity profiles in patients with advanced knee osteoarthritis
Journal article   Peer reviewed

Pain sensitivity profiles in patients with advanced knee osteoarthritis

Laura A Frey-Law, Nicole L Bohr, Kathleen A Sluka, Keela Herr, Charles R Clark, Nicolas O Noiseux, John J Callaghan, M Bridget Zimmerman and Barbara A Rakel
Pain (Amsterdam), Vol.157(9), pp.1988-1999
09/2016
DOI: 10.1097/j.pain.0000000000000603
PMCID: PMC4988908
PMID: 27152688

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Abstract

The development of patient profiles to subgroup individuals on a variety of variables has gained attention as a potential means to better inform clinical decision making. Patterns of pain sensitivity response specific to quantitative sensory testing (QST) modality have been demonstrated in healthy subjects. It has not been determined whether these patterns persist in a knee osteoarthritis population. In a sample of 218 participants, 19 QST measures along with pain, psychological factors, self-reported function, and quality of life were assessed before total knee arthroplasty. Component analysis was used to identify commonalities across the 19 QST assessments to produce standardized pain sensitivity factors. Cluster analysis then grouped individuals who exhibited similar patterns of standardized pain sensitivity component scores. The QST resulted in 4 pain sensitivity components: heat, punctate, temporal summation, and pressure. Cluster analysis resulted in 5 pain sensitivity profiles: a "low pressure pain" group, an "average pain" group, and 3 "high pain" sensitivity groups who were sensitive to different modalities (punctate, heat, and temporal summation). Pain and function differed between pain sensitivity profiles, along with sex distribution; however, no differences in osteoarthritis grade, medication use, or psychological traits were found. Residualizing QST data by age and sex resulted in similar components and pain sensitivity profiles. Furthermore, these profiles are surprisingly similar to those reported in healthy populations, which suggests that individual differences in pain sensitivity are a robust finding even in an older population with significant disease.
Pain Threshold - physiology Humans Middle Aged Male Mood Disorders - etiology Osteoarthritis, Knee - psychology Catastrophization - etiology Osteoarthritis, Knee - complications Pain - drug therapy Pain - etiology Pain Threshold - drug effects Adult Female Surveys and Questionnaires Analgesics - therapeutic use Cross-Sectional Studies Hot Temperature - adverse effects Transcutaneous Electric Nerve Stimulation - adverse effects Pressure - adverse effects Mood Disorders - diagnosis Quality of Life Aged Pain Measurement Osteoarthritis, Knee - drug therapy Catastrophization - psychology Cluster Analysis

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