Becoming more sensitive to pain increases the risk that knee pain will not go away

Becoming more sensitive to pain, or sensitizing to pain, is an important risk factor for the development of persistent knee pain due to osteoarthritis, according to a new study by researchers at the University of Toronto. Montreal and its research center affiliated with Hôpital Maisonneuve Rosemont (CRHMR), in collaboration with researchers at Boston University. Their conclusions were published on October 11 in the journal Arthritis and Rheumatology.

Osteoarthritis is a common cause of pain and impairment of joint function. It affects 302 million adults in the world. This can lead to chronic disability, often in the knee joint. Previous research suggests that a number of factors outside the structural pathology could contribute to pain in patients with osteoarthritis.

"Understanding the factors that contribute to the development of persistent pain is essential to improve our ability to prevent the onset and transition to more persistent pain," said lead author Lisa Carlesso, assistant professor at the School of Rehabilitation of UdeM and scientist at CRHMR. , part of the CIUSSS of East-Island-of-Montreal.

She and her team analyzed data from a multicenter study of 852 adults (aged 50 to 79 years) with or with knee osteoarthritis but no persistent knee pain at the start of the study. Sociodemographic data, pain awareness measures, and risk factors traditionally associated with knee pain, such as psychological factors, generalized pain, and lack of sleep, were collected from participants, who then followed to develop persistent knee pain over two years.

Researchers used risk factor and pain awareness data to identify four distinct subgroups called pain susceptibility phenotypes (PSPs). They found that these PSPs were primarily characterized by varying degrees of pain awareness. PPS with the highest degree of sensitization had the highest risk of developing persistent knee pain. Females, the non-Caucasian race and the age of 65 years and over were significant sociodemographic predictors of PSP membership with the highest degree of awareness.

The researchers believe that the identification of these PSPs is an important step in understanding the complex pathology of osteoarthritis of the knee. "Our findings suggest that therapy aimed at preventing or improving pain awareness could be a new approach to preventing persistent knee pain," said co-author, Tuhina Neogi, a professor of medicine and neuroscience. Epidemiology at the Boston School of Medicine and the Faculty of Public Health. . "Preventing pain is essential to improving the quality of life and functioning of patients with osteoarthritis."