Staging joint pain and disability: a brief method using persistence and global severity.
OBJECTIVE
Joint pain in older adults is a problem commonly presented to primary care. In contrast to methods for defining and staging the most likely underlying disease (osteoarthritis), clinically practicable methods for staging pain and associated disability are lacking. Our objective was to test a method of brief pain assessment and clinical staging based on recognized focal features of chronic pain and preexisting measurement tools.


METHODS
A total of 781 adults ages > or =50 years who were registered with 3 general practices and were experiencing knee pain within the previous 6 months attended research clinics between August 2002 and September 2003. Pain and associated disability were staged on the basis of self-completed questions on knee pain persistence and global severity (Chronic Pain Grade). These were then compared with participants' appraisals of their knee problem, its perceived importance, negative health states, and consultation behavior.


RESULTS
Knee pain global severity was associated with symptom dissatisfaction, patient prioritizing, oral analgesic intake, mood, mobility limitation, poorer general health, and consultation behavior. Fewer independent associations were found with knee pain persistence. Staging could be performed using only 4 simple questions.


CONCLUSIONS
Although the usefulness of this approach still needs to be determined in routine clinical settings and across other joint pain sites, our findings suggest that focal characteristics of chronic pain (persistence, global severity) can be used as the basis of brief, simple assessment and staging of joint pain in older adults.
Peat
George
G
Primary Care Sciences Research Centre, Keele University, Keele, Staffordshire, United Kingdom. g.m.peat@cphc.keele.ac.uk
Thomas
Elaine
E
Croft
Peter
P
D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D008297:Male; D010146:Pain / Q000145:classification* / Q000175:diagnosis* / Q000503:physiopathology; D010147:Pain Measurement / Q000379:methods*; D011320:Primary Health Care; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires