Lisa C Carlesso1,2, Jingbo Niu3,4, Neil A Segal3,4, Laura A Frey-Law3,4, Cora E Lewis3,4, Michael C Nevitt3,4, Tuhina Neogi3,4. 1. From the School of Rehabilitation, Faculty of Medicine, Université de Montréal, Hôpital Maisonneuve Rosemont Research Institute, Montreal, Quebec, Canada; Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts; Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, Kansas; Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa, Iowa City, Iowa; Division of Preventive Medicine, University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama; Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA. lisa.carlesso@umontreal.ca. 2. L.C. Carlesso, BSc PT, MSc PT, PhD, Assistant Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Hôpital Maisonneuve Rosemont Research Institute; J. Niu, DSc, Boston University School of Medicine; N.A. Segal, MD, MS, Department of Rehabilitation Medicine, University of Kansas Medical Center; L.A. Frey-Law, MPT, MS, PhD, Associate Professor, Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa; C.E. Lewis, MD, MSPH, Division of Preventive Medicine, University of Alabama at Birmingham, School of Medicine; M.C. Nevitt, PhD, Adjunct Professor, Department of Epidemiology and Biostatistics, University of California; T. Neogi, MD, PhD, Associate Professor of Medicine, Clinical Epidemiology Research and Training Unit, Boston University School of Medicine. lisa.carlesso@umontreal.ca. 3. From the School of Rehabilitation, Faculty of Medicine, Université de Montréal, Hôpital Maisonneuve Rosemont Research Institute, Montreal, Quebec, Canada; Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts; Department of Rehabilitation Medicine, University of Kansas Medical Center, Kansas City, Kansas; Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa, Iowa City, Iowa; Division of Preventive Medicine, University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama; Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA. 4. L.C. Carlesso, BSc PT, MSc PT, PhD, Assistant Professor, School of Rehabilitation, Faculty of Medicine, Université de Montréal, Hôpital Maisonneuve Rosemont Research Institute; J. Niu, DSc, Boston University School of Medicine; N.A. Segal, MD, MS, Department of Rehabilitation Medicine, University of Kansas Medical Center; L.A. Frey-Law, MPT, MS, PhD, Associate Professor, Department of Physical Therapy and Rehabilitation Science, College of Medicine, University of Iowa; C.E. Lewis, MD, MSPH, Division of Preventive Medicine, University of Alabama at Birmingham, School of Medicine; M.C. Nevitt, PhD, Adjunct Professor, Department of Epidemiology and Biostatistics, University of California; T. Neogi, MD, PhD, Associate Professor of Medicine, Clinical Epidemiology Research and Training Unit, Boston University School of Medicine.
Abstract
OBJECTIVE: Whether widespread pain (WSP) affects the risk of developing knee pain or knee osteoarthritis (OA) is unknown and could enhance understanding of pain mechanisms in OA. METHODS: Subjects from the Multicenter OA (MOST) study, a US National Institutes of Health-funded prospective cohort of older adults with or at risk of knee OA, were characterized regarding WSP, defined as pain above and below the waist on both sides of the body and axially using a standard homunculus, excluding knee pain at 60 months (baseline). Followup occurred 2 years later. We assessed the relation of WSP to odds of knee pain worsening (≥ 2-point increase in the Western Ontario and McMaster Universities Arthritis Index pain subscale) using logistic regression, and to odds of incident radiographic knee OA (ROA; Kellgren-Lawrence arthritis scale ≥ grade 2 of either knee among those free of ROA at baseline) and incident consistent frequent knee pain (CFKP; knee pain on most days during the past month among participants free of knee pain at baseline) in 1 or both knees using multinomial regression adjusting for potential confounders. RESULTS: There were 1752 participants available for analysis [mean age (SD) 67.0 yrs (7.7), body mass index 30.5 kg/m2 (5.9), 59% women]. Baseline presence of WSP was not associated with worsened knee pain (adjusted OR 1.15, 95% CI 0.89-1.48, p = 0.30), ROA (adjusted OR 0.86, 95% CI 0.46-1.63, p = 0.65), or incident CFKP (adjusted OR 1.69, 95% CI 0.96-2.96, p = 0.07). CONCLUSION: WSP was not significantly associated with worsening knee pain, incident ROA, or CFKP. Development of knee pain and ROA does not appear to be influenced by underlying WSP.
OBJECTIVE: Whether widespread pain (WSP) affects the risk of developing knee pain or knee osteoarthritis (OA) is unknown and could enhance understanding of pain mechanisms in OA. METHODS: Subjects from the Multicenter OA (MOST) study, a US National Institutes of Health-funded prospective cohort of older adults with or at risk of knee OA, were characterized regarding WSP, defined as pain above and below the waist on both sides of the body and axially using a standard homunculus, excluding knee pain at 60 months (baseline). Followup occurred 2 years later. We assessed the relation of WSP to odds of knee pain worsening (≥ 2-point increase in the Western Ontario and McMaster Universities Arthritis Index pain subscale) using logistic regression, and to odds of incident radiographic knee OA (ROA; Kellgren-Lawrence arthritis scale ≥ grade 2 of either knee among those free of ROA at baseline) and incident consistent frequent knee pain (CFKP; knee pain on most days during the past month among participants free of knee pain at baseline) in 1 or both knees using multinomial regression adjusting for potential confounders. RESULTS: There were 1752 participants available for analysis [mean age (SD) 67.0 yrs (7.7), body mass index 30.5 kg/m2 (5.9), 59% women]. Baseline presence of WSP was not associated with worsened knee pain (adjusted OR 1.15, 95% CI 0.89-1.48, p = 0.30), ROA (adjusted OR 0.86, 95% CI 0.46-1.63, p = 0.65), or incident CFKP (adjusted OR 1.69, 95% CI 0.96-2.96, p = 0.07). CONCLUSION: WSP was not significantly associated with worsening knee pain, incident ROA, or CFKP. Development of knee pain and ROA does not appear to be influenced by underlying WSP.
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