Experiencing painful osteoarthritis: what have we learned from listening?
OBJECTIVE
Despite the central role of pain in osteoarthritis, until recently, relatively little attention was paid to the osteoarthritis pain experience, including the features of osteoarthritis pain that are most important to people living with this disease. The focus of this review is on recent advances in our understanding of the experience of osteoarthritis pain from the patient's perspective.


RESULTS
To gain an understanding of the experience of pain in osteoarthritis, researchers have largely relied on qualitative methodologies. This research indicates that the osteoarthritis pain experience is multidimensional, reflecting the influence of biological (e.g. pain mechanisms), psychological (e.g. mood and coping), and social factors (e.g. social support). Qualitative and quantitative research to date supports the need for measures that distinguish aspects of the pain itself (intensity, frequency, quality, location, etc.) from the consequences of the pain on activity limitations and participation restriction, mood, sleep, and health-related quality of life. This research has underscored the limitations of existing generic and osteoarthritis-specific pain measures, and is driving the development of new tools to better evaluate osteoarthritis-related pain, and thus assessment of its impact and response to various interventions.


CONCLUSIONS
Improved measurement of painful osteoarthritis, including attention to the words people with osteoarthritis use to describe their pain, will undoubtedly lead to an improved understanding of pain mechanisms in osteoarthritis and, in turn, mechanism-based and evidence-based treatment decision making.
Hawker
Gillian A
GA
Division of Rheumatology, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada. g.hawker@utoronto.ca
D020920:Dyssomnias / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D010003:Osteoarthritis / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D010146:Pain / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D011584:Psychology; D012727:Sex Characteristics; D012890:Sleep