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What factors contribute to persistent knee pain?

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Preventing or relieving pain sensitisation may help prevent the onset of persistent knee pain in people with osteoarthritis (OA), new research suggests.

OA causes joint pain and stiffness and is the most common type of arthritis in the UK. Becoming more sensitive to pain, or pain sensitisation, is an important risk factor for developing persistent knee pain in OA, according to a study by researchers at Université de Montréal and its affiliated Maisonneuve Rosemont Hospital Research Centre, in collaboration with researchers at Boston University.

Their findings have been published in the journal Arthritis & Rheumatology.

The research team analysed data from a multicentre OA study that followed 852 adults (aged 50-79) with or at risk of knee OA but who were free of persistent knee pain at the beginning of the study.

Sociodemographic data and pain sensitisation measurements, as well as risk factors traditionally associated with knee pain such as psychological factors, widespread pain and poor sleep, were collected on the participants, who then were followed for development of persistent knee pain over two years.

The researchers used the risk factors and pain sensitisation data to identify four distinct subgroups called pain susceptibility phenotypes (PSPs). These were primarily characterised by varying degrees of pain sensitisation.

The PSP with the highest degree of sensitisation had the highest risk of developing persistent knee pain. A typical member of this group was female, non-Caucasian and over the age of 65.

Identifying these PSPs may be an important step in understanding the complex pathology of knee osteoarthritis.

“Our findings suggest that therapy aimed at prevention or improvement of pain sensitisation may be a novel approach to preventing persistent knee pain,” said co-author Tuhina Neogi, a professor of medicine and epidemiology at Boston University’s School of Medicine and School of Public Health. “Preventing pain is crucial to improving quality of life and function in patients who suffer from OA.”

https://nouvelles.umontreal.ca/en/article/2018/10/30/becoming-more-sensitive-to-pain-increases-the-risk-of-knee-pain-not-going-away/

https://onlinelibrary.wiley.com/doi/abs/10.1002/art.40752