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Neuropathic-like knee pain and associated risk factors: a cross-sectional study in a UK community sample.

ABSTRACT: BACKGROUND:Neuropathic-like knee pain (NKP) is often reported in individuals with knee pain (KP), but the contribution of specific central and peripheral risk factors to NKP has not been studied previously. The aims of the present study were to determine the prevalence of NKP in a community-derived sample with KP and to identify risk factors associated with NKP. METHODS:A cross-sectional study was undertaken (n =?9506) in the East Midlands community among responders (aged 40+ years) to a postal questionnaire. Questions included KP severity (numerical rating scale) and type (neuropathic versus nociceptive) using the modified painDETECT questionnaire, as well as age, body mass index (BMI), significant knee injury, widespread pain, pain catastrophising and fatigue. Multinomial regression analysis was used to determine ORs and 95% CIs. Risk factors were categorised into central and peripheral, and proportional risk contribution (PRC) and 95% CI were estimated using ROC. RESULTS:KP was reported in 28.2% of responders, of whom 13.65% had NKP (i.e., 3.9% of the total population). Women reported more NKP. After adjustment for age, gender, BMI and pain severity, definite NKP showed associations (aOR, 95% CI) with fibromyalgia (4.07, 2.49-6.66), widespread pain (1.93, 1.46-2.53), nodal osteoarthritis (1.80, 1.28-2.53), injury (1.50, 1.12-2.00), pain catastrophising (5.37, 2.93-9.84) and fatigue (5.37, 3.08-9.35) compared with non-NKP participants. Although only central risk factors contributed to NKP (PRC 8%, 95% CI 2.5-12.5 for central vs. PRC 3%, 95% CI -0.25 to 7.5 for peripheral), both central and peripheral risk factors contributed equally to non-NKP (PRC 10%, 95% CI 5-20 for both). CONCLUSIONS:NKP appears to be driven largely by central risk factors and may require different prevention/treatment strategies. TRIAL REGISTRATION:ClinicalTrials.gov , NCT02098070 . Registered on 27 March 2014.

SUBMITTER: Fernandes GS

PROVIDER: S-EPMC6161431 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Neuropathic-like knee pain and associated risk factors: a cross-sectional study in a UK community sample.

Fernandes Gwen Sascha GS Valdes Ana Marie AM Walsh David Andrew DA Zhang Weiya W Doherty Michael M

Arthritis research & therapy 20180927 1

<h4>Background</h4>Neuropathic-like knee pain (NKP) is often reported in individuals with knee pain (KP), but the contribution of specific central and peripheral risk factors to NKP has not been studied previously. The aims of the present study were to determine the prevalence of NKP in a community-derived sample with KP and to identify risk factors associated with NKP.<h4>Methods</h4>A cross-sectional study was undertaken (n = 9506) in the East Midlands community among responders (aged 40+ year ...[more]

PMID: 30261907

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Project description:BACKGROUND:This study aimed to a) describe the prevalence of knee and hip osteoarthritis risk factors in a population of 29-59 year old individuals, b) estimate the association between persistent knee/hip pain and osteoarthritis risk factors, and c) describe the prevalence of osteoarthritis risk factors, including specific biomechanical risk factors, in individuals with prolonged persistent knee or hip pain. METHODS:Participants completed the "Early Detection and Prevention" pilot study questionnaire, including items on presence of knee/hip pain within the last month and osteoarthritis risk factors. Individuals reporting knee/hip problems completed a second questionnaire, including items about most problematic joint and specific biomechanical osteoarthritis risk factors. After describing the prevalence of persistent knee/hip pain and osteoarthritis risk factors among respondents stratified for sex and age, logistic regression was used to estimate the strength of associations between osteoarthritis risk factors and presence of knee/hip pain. The prevalence of prolonged persistent pain (i.e. knee/hip pain reported at both questionnaires) and osteoarthritis risk factors among respondents with prolonged persistent knee and hip pain, were described. RESULTS:Two thousand six hundred sixty-one respondents completed the first survey. The one-month prevalence of persistent knee/hip pain was 27%. Previous knee/hip injury was associated with persistent knee/hip pain for both sexes in all age groups, while a family history of osteoarthritis was associated with persistent knee/hip pain in all age groups except for 29-39 year old men. A higher BMI was associated with persistent knee/hip pain in 40-59 year old women, and 50-59 year old men. Eight hundred sixty seven respondents completed the second questionnaire. Knee/hip injuries and surgeries were more common in individuals with prolonged persistent knee than hip pain. CONCLUSIONS:Knee/hip pain within the last month was frequent among individuals aged 29-59 years. Multiple known osteoarthritis risk factors were associated with presence of knee/hip pain. Joint injury and previous surgery were more common in individuals with knee than hip pain. The results support the notion that joint injury and overweight during early adulthood are signs of a trajectory towards symptomatic osteoarthritis later in life and may help earlier identification of groups at high risk of future symptomatic osteoarthritis. TRIAL REGISTRATION:ClinicalTrials.gov ( NCT02797392 ). Registered April 29,2016.

Project description:Pain in osteoarthritis (OA) has been classically attributed to joint structural damage. Disparity between the degree of radiographic structural damage and the severity of symptoms implies that factors other than the joint pathology itself contribute to the pain. Peripheral and central sensitization have been suggested as two of the underlying mechanisms that contribute to pain in OA. The aim of this study was to explore in symptomatic knee OA patients, the structural changes assessed by magnetic resonance imaging (MRI) that could be used as markers of neuropathic pain (NP).This cross-sectional observational pilot study included 50 knee OA patients with moderate to severe pain (VAS ?40) in the target knee. The presence of NP was determined based on the PainDETECT questionnaire. Among the 50 patients included, 25 had PainDETECT score ?12 (unlikely NP), 9 had PainDETECT score between 13 and 18 (uncertain NP) and 16 had PainDETECT score ?19 (likely NP). WOMAC, PainDETECT, and VAS pain scores as well as knee MRI were assessed.Data showed no significant difference in demographic characteristics between the three groups. However, a positive and statistically significant association was found between the WOMAC pain (P <0.001), function (P <0.001), stiffness (P?=?0.007) and total (P <0.001) scores as well as higher VAS pain score (P?=?0.023), and PainDETECT scores. Although no difference was found in the cartilage volume between groups, the presence of meniscal extrusion in both medial (P?=?0.006) and lateral (P?=?0.023) compartments, and presence of meniscal tears in the lateral compartment (P?=?0.011), were significantly associated with increasing PainDETECT score. Moreover, the presence of bone marrow lesions in the lateral plateau and the extent of the synovial membrane thickness in the lateral recess were associated with increasing PainDETECT scores (P?=?0.032, P?=?0.027, respectively).In this study, meniscal lesions, particularly extrusion, were found to be among the strongest risk factors for NP in knee OA patients.ClinicalTrials.gov NCT01733277. Registered 16 November 2012.

Dataset Information

Neuropathic-like knee pain and associated risk factors: a cross-sectional study in a UK community sample.

Publications

Neuropathic-like knee pain and associated risk factors: a cross-sectional study in a UK community sample.

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