Association between pain, radiographic severity, and centrally-mediated symptoms in women with knee osteoarthritis

Authors

  • Susan L. Murphy,

    Corresponding author
    1. VA Ann Arbor Health Care System and University of Michigan, Ann Arbor
    • University of Michigan, Ann Arbor, 300 North Ingalls, 9th Floor, Ann Arbor, MI 48109-2007
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    • Dr. Murphy has received consultant fees, speaking fees, and/or honoraria (less than $10,000) from Forest Industries.

  • Angela K. Lyden,

    1. University of Michigan, Ann Arbor
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  • Kristine Phillips,

    1. University of Michigan, Ann Arbor
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  • Daniel J. Clauw,

    1. University of Michigan, Ann Arbor
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    • Dr. Clauw has received consultant fees, speaking fees, and/or honoraria (more than $10,000 each) from Cypress Biosciences, Eli Lilly, Forest Laboratories, Merck, Pierre Fabre, Pfizer, UCB, and Jazz Pharmaceuticals.

  • David A. Williams

    1. University of Michigan, Ann Arbor
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    • Dr. Williams has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Eli Lilly, Jazz Pharmaceuticals, Forest Laboratories, and Pfizer.


Abstract

Objective

To examine the relationship between pain, radiographic severity, and a common set of co-occurring centrally-mediated symptoms (fatigue, sleep quality, and depression) in women with knee osteoarthritis.

Methods

Participants underwent knee radiographs, and had repeated assessments of pain severity and other centrally-mediated symptoms during a 5-day home monitoring period. To examine associations between pain severity (the average of pain over the home monitoring period), measures of osteoarthritis radiographic severity (Kellgren/Lawrence grade, minimum joint space width), centrally-mediated symptoms, and demographics (age) were used. Symptoms of fatigue, sleep efficiency, and depression were used in a composite measure representing centrally-mediated symptoms.

Results

Using a series of linear regression models in which each variable was entered hierarchically (n = 54), the final model showed that 27% of the variance in pain severity was explained by age, radiographic severity, and centrally-mediated symptoms. Centrally-mediated symptoms explained an additional 10% of the variance in pain severity after the other 2 variables were entered.

Conclusion

Both radiographic severity and centrally-mediated symptoms were independently and significantly associated with pain severity in women with knee osteoarthritis. In addition to more severe radiographic features, women with higher centrally-mediated symptoms had greater pain severity. Treatments for women with symptomatic knee osteoarthritis may be optimized by addressing both peripheral and central sources of pain.

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