Disease-specific pain and function predict future pain impact in hip and knee osteoarthritis.
The objective of this study is to determine if osteoarthritis (OA) pain and function, persistent low back pain (LBP) and psychosocial factors predict future pain impact (PI) in people with hip and knee OA. In a population-based cohort with hip/knee OA, a standardized telephone questionnaire was used to assess baseline sociodemographics, baseline PI, patient-reported OA severity (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) summary score), psychosocial factors (fatigue, pain catastrophizing (PC), anxiety, social network, and depression), and self-reported persistent LBP. Two years post-baseline, PI was assessed using the Pain Impact Questionnaire. The association of key independent variables with PI was evaluated through multivariable linear regression, adjusting for covariates (e.g., age, sex, baseline PI, etc.) In 462 participants, the mean age was 76 years (range 58 to 96), 78 % were female and 35 % reported LBP at baseline. Mean scores for PC (9.4), and anxiety (3.7) were low and social network (20.1) high. In multivariable regression analyses, only the WOMAC summary score (unstandardized ß 0.181 95% CI (0.12, 0.24) p < 0.001) was independently associated with greater PI at follow-up. In a population-based cohort with hip/knee OA, only the baseline WOMAC summary score was an independent predictor of future PI. This suggests that treatment needs to be focused on limiting pain severity and functional limitations in individuals with hip and knee OA. However, scores for the psychosocial factors are indicative of a healthy cohort and therefore results may not be generalizable to those with poorer psychosocial health.
École de réadaptation, Faculté de médecine, Université de Montréal, C.P. 6128, succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada. lisa.carlesso@umontreal.ca.|Unité de recherche clinique en orthopédie, Centre de Recherche Hôpital Maisonneuve-Rosemont, Montréal, Canada. lisa.carlesso@umontreal.ca.
Lisa C
LC
Carlesso
Department of Medicine and Institute for Health Policy, Management and Evaluation, University of Toronto; Women's College Research Institute, Women's College Hospital; Institute for Clinical Evaluative Sciences, 190 Elizabeth St., RFE, 3-805, Toronto, ON, M5G 2C4, Canada.
Gillian A
GA
Hawker
Department of Physical Therapy, University of Toronto; Women's College Hospital, c/o Dept of Medicine, Rm 3467,76 Grenville St, Toronto, ON, M5S 1B2, Canada.
Esther J
EJ
Waugh
Department of Physical Therapy and Institute of Rehabilitation Science and Institute of Health, Policy, Management and Evaluation, University of Toronto, Toronto, Canada.|Division of Health Care and Outcomes, Krembil Research Institute, MP11-322, 399 Bathurst Street, Toronto, ON, M5T2S8, Canada.
Aileen M
AM
Davis
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D003863:Depression / Q000150:complications; D005221:Fatigue / Q000150:complications; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D017116:Low Back Pain / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009864:Ontario; D015207:Osteoarthritis, Hip / Q000175:diagnosis* / Q000503:physiopathology; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000503:physiopathology; D010146:Pain / Q000175:diagnosis*; D010147:Pain Measurement / Q000379:methods*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
Knee osteoarthritis; Low back pain; Psychosocial; WOMAC