251
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Alburquerque-Sendín F, Madeleine P, Fernández-de-Las-Peñas C, Camargo PR, Salvini TF. Spotlight on topographical pressure pain sensitivity maps: a review. J Pain Res 2018; 11:215-225. [PMID: 29403305 PMCID: PMC5779713 DOI: 10.2147/jpr.s135769] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Mechanical hyperalgesia defined as decreased pressure pain thresholds (PPTs) is commonly associated with pain. In this narrative review, we report the current state of the art within topographical pressure sensitivity maps. Such maps are based on multiple PPT assessments. The PPTs are assessed by an a priori defined grid with special focus on both spatial and temporal summation issues. The grid covers the muscle or the body region of interest using absolute or relative values determined from anatomical landmarks or anthropometric values. The collected PPTs are interpolated by Shepard or Franke and Nielson interpolation methods to create topographical pressure sensitivity maps. This new imaging technique has proven to be valuable in various disciplines including exercise physiology, neurology, physical therapy, occupational medicine, oncology, orthopedics, and sport sciences. The reviewed papers have targeted different body regions like the scalp, low back, neck-shoulder, and upper and lower extremities. The maps have delineated spatial heterogeneity in the pressure pain sensitivity underlining the different extents of pressure pain hyperalgesia in both experimentally induced and disease-associated pain conditions. Furthermore, various intervention studies have proven the utility of topographical pressure pain sensitivity maps. Topographical pressure pain sensitivity maps have contributed to revealing the efficacy of therapeutic, ergonomic, or training interventions that aim at reducing pain.
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Affiliation(s)
| | - Pascal Madeleine
- Physical Activity and Human Performance Group, SMI, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Madrid, Spain
| | - Paula Rezende Camargo
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Tania Fátima Salvini
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
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252
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Bossmann T, Brauner T, Horstmann T. Differences in pain intensity in anti- and pro-nociceptive pain profile subgroups in patients with knee osteoarthritis. Pain Manag 2018; 8:27-36. [DOI: 10.2217/pmt-2017-0039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Aim: Facilitated temporal summation is one component of central sensitization. The aim of this exploratory study was to classify pro-, eu- and antinociceptive subgroups based on wind-up ratio cut-off scores in patients with knee osteoarthritis (OA). Patients & methods: A total of 56 patients with knee OA met the inclusion criteria. Temporal summation was measured and wind-up ratio was calculated. Reference values of 180 healthy subjects were used to define wind-up ratio cut-off scores. Results: Twenty-seven percent of patients showed a pro-nociceptive pain profile. Sixteen percent of patients showed an anti-nociceptive pain profile. A eu-nociceptive pain profile was present in 57% of patients. Conclusion: Central pain sensitization was present in approximately a third of knee OA patients. The results should be confirmed in larger studies.
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Affiliation(s)
- Tanja Bossmann
- Department of Conservative & Rehabilitative Orthopaedics, Faculty of Sports & Health Sciences, Technical University of Munich, Germany
| | - Torsten Brauner
- Department of Conservative & Rehabilitative Orthopaedics, Faculty of Sports & Health Sciences, Technical University of Munich, Germany
| | - Thomas Horstmann
- Department of Conservative & Rehabilitative Orthopaedics, Faculty of Sports & Health Sciences, Technical University of Munich, Germany
- Medical Park Bad Wiessee, Klinik St. Hubertus, Bad Wiessee, Germany
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253
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Tsai HC, Chen TL, Chen YP, Chen RM. Traumatic osteoarthritis-induced persistent mechanical hyperalgesia in a rat model of anterior cruciate ligament transection plus a medial meniscectomy. J Pain Res 2017; 11:41-50. [PMID: 29317848 PMCID: PMC5743113 DOI: 10.2147/jpr.s154038] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Osteoarthritis (OA) is a degenerative joint disease characterized by progressive cartilage degeneration, subchondral bone changes, osteophyte formation, and synovitis. A major symptom is pain that is triggered by peripheral and central changes within the pain pathways. Some surgery-induced joint instability rat models of OA were described to mimic traumatic OA. Several behavioral tests were developed to access OA-induced pain. However, follow-up in most studies usually only occurred for about 4 weeks. Since traumatic OA is a chronic disease which gradually develops after trauma, the pattern of pain might differ between early and late stages after the trauma. Purpose To observe the time-dependent development of hypersensitivity after traumatic OA and to determine the best timing and methods to investigate traumatic OA-induced pain. Methods Anterior cruciate ligament transection plus medial meniscectomy was used to induce traumatic OA in Sprague-Dawley rats. Traumatic OA-induced pain was evaluated using four different behavioral tests for 15 weeks. Results A significant difference in mechanical hypersensitivity developed throughout the observational period. It was worst in the first 3 weeks after the operation, then became less significant after 5 weeks but persisted. There were no differences in thermal hyperalgesia or motor coordination. Conclusion Traumatic OA induced mechanical hyperalgesia but did not cause thermal hyperalgesia or influence motor coordination. Furthermore, to investigate chronic pain induced by OA, the observational period should be at least 5 weeks after the intervention. These findings may help in further research and improve our understanding of traumatic OA-induced pain mechanisms.
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Affiliation(s)
- Hsiao-Chien Tsai
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ta-Liang Chen
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Pin Chen
- Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ruei-Ming Chen
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Comprehensive Cancer Center, Taipei Medical University, Taipei, Taiwan
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254
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Gomes CAFDP, Dibai-Filho AV, Biasotto-Gonzalez DA, Politti F, Camillo de Carvalho PDT. Association of Pain Catastrophizing With Static Balance, Mobility, or Functional Capacity in Patients With Knee Osteoarthritis: A Blind Cross-sectional Study. J Manipulative Physiol Ther 2017; 41:42-46. [PMID: 29249415 DOI: 10.1016/j.jmpt.2017.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/10/2017] [Accepted: 08/23/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether catastrophizing is associated with static balance, mobility, and functional capacity in patients with knee osteoarthritis. METHODS A blind, cross-sectional study was conducted involving 60 volunteers (males and females), ages 40 to 80 years, with a diagnosis of knee osteoarthritis. Patients were recruited from a physical therapy clinic in the city of São Paulo, Brazil. The following measures were used for the evaluations: Pain-Related Self-Statement Scale, Functional Reach Test, Timed Up and Go Test, Lower Extremity Functional Scale, and Western Ontario and McMaster University Osteoarthritis Index. In statistical analysis, histograms were created to determine distribution of data. Spearman's correlation coefficients (rs) were then calculated to determine the strength of the associations among the variables. RESULTS No significant correlation was found between the Pain-Related Self-Statement Scale score and the other clinical measures employed in the present study: Functional Reach Test (rs = 0.151; P = .249), Timed Up and Go Test (rs = -0.147; P =.264), Lower Extremity Functional Scale (rs = 0.023; P = .860), and Western Ontario and McMaster University Osteoarthritis (rs = -0.222; P = .088). CONCLUSIONS In this study, catastrophizing was not associated with static balance, mobility, or functional capacity in patients with knee osteoarthritis.
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Affiliation(s)
| | | | | | - Fabiano Politti
- Department of Physical Therapy, Nove de Julho University, São Paulo, SP, Brazil
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255
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Acid-induced experimental knee pain and hyperalgesia in healthy humans. Exp Brain Res 2017; 236:587-598. [PMID: 29250706 DOI: 10.1007/s00221-017-5155-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 12/14/2017] [Indexed: 01/08/2023]
Abstract
Inflammation and the related acidity in peri-articular structures may be involved in pain generation and hyperalgesia in knee osteoarthritis. This study investigated pain and associated hyperalgesia provoked by infusion of acidic saline into the infrapatellar fat pad. Twenty-eight subjects participated in two sessions in which acidic saline (AS, pH 5) or neutral saline (NS, pH 7.4) were infused into the infrapatellar fat pad for 15 min. Pain intensity, pain area, mechanical and thermal sensitivity, and maximal voluntary knee extension force were recorded. Repeated infusions were performed in 14 subjects. Infusion of AS caused significantly higher pain intensity, larger pain areas, induced hyperalgesia around the infused knee, and reduced extension force. No significant pain facilitation or spreading of hyperalgesia was found after repeated infusions as compared with single infusions. Acidic saline infused into the infrapatellar fat pad provoked pain and localized mechanical hyperalgesia. Thus, this acid-induced pain model may mimic the early-stage responses to tissue injury of knee osteoarthritis.
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256
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Rienstra W, Blikman T, Dijkstra B, van Raay J, Slager G, Bulstra S, Stevens M, van den Akker-Scheek I. Validity of the Dutch modified painDETECT questionnaire for patients with hip or knee osteoarthritis. Disabil Rehabil 2017; 41:941-947. [PMID: 29221427 DOI: 10.1080/09638288.2017.1413429] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The modified painDETECT questionnaire (PDQ) is a self-reported questionnaire to discriminate between nociceptive and neuropathic-like pain in patients with knee/hip osteoarthritis (OA). This study aims to assess the structural and construct validity of this questionnaire. METHODS Confirmatory factor analysis and hypothesis-testing was used. For 168 patients, predefined hypotheses were formulated on the correlation between the modified painDETECT and several other questionnaires, and in a subsample of 46 with pain pressure thresholds (PPTs). RESULTS Two principal components were confirmed. The pain pattern item did not load on any component. Eighty per cent of the hypotheses on the correlation between modified PDQ and the questionnaires were met, as were 50% concerning PPTs measurements. CONCLUSIONS This study is the first to assess structural and construct validity of the modified PDQ knee/hip by using factor analysis and hypothesis-testing. This questionnaire seems to reflect neuropathic-like pain symptoms experienced by hip/knee OA-patients with adequate validity. The item on pain pattern might not reflect the construct. More than 75% of the predefined hypotheses regarding the modified PDQ and the other questionnaires were met. Only 50% of the hypotheses on PPTs measurements were met, probably due to heterogeneity and limited size of this subsample. Implications for rehabilitation Pain in osteoarthritis (OA) is partly caused by modification of pain transmission in the peripheral and central nervous system, leading to sensitisation. This process seems particularly significant in a subgroup of OA patients. Sensitisation in OA is associated with more disability in daily life, lower quality of life and more widespread pain, as well as poorer outcome of total joint surgery. Screening for sensitisation can help to identify the subgroup of patients who could benefit from multidisciplinary treatment options focussing on desensitisation, cognitive- and behavioural therapy and reducing chronification of widespread pain. Therefore, being particularly important in the field of rehabilitation. The Dutch modified PainDETECT-questionnaire is very useful for rehabilitation professionals as it is one of the first questionnaires specifically validated to assess neuropathic-like symptoms (indicating sensitisation) in patients with knee or hip osteoarthritis.
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Affiliation(s)
- Wietske Rienstra
- a Department of Orthopaedic Surgery , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Tim Blikman
- a Department of Orthopaedic Surgery , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Baukje Dijkstra
- b Department of Orthopaedic Surgery , Medical Center Leeuwarden , Leeuwarden , The Netherlands
| | - Jos van Raay
- c Department of Orthopaedic Surgery , Martini Hospital , Groningen , The Netherlands
| | - Geranda Slager
- d Department of Physical Therapy, School of Health Care Studies , Hanze University of Applied Sciences , Groningen , The Netherlands
| | - Sjoerd Bulstra
- a Department of Orthopaedic Surgery , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Martin Stevens
- a Department of Orthopaedic Surgery , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
| | - Inge van den Akker-Scheek
- a Department of Orthopaedic Surgery , University of Groningen, University Medical Center Groningen , Groningen , The Netherlands
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257
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Miller RE, Kim YS, Tran PB, Ishihara S, Dong X, Miller RJ, Malfait AM. Visualization of Peripheral Neuron Sensitization in a Surgical Mouse Model of Osteoarthritis by In Vivo Calcium Imaging. Arthritis Rheumatol 2017; 70:88-97. [PMID: 28992367 DOI: 10.1002/art.40342] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 09/29/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To develop a method for analyzing sensory neuron responses to mechanical stimuli in vivo, and to evaluate whether these neuronal responses change after destabilization of the medial meniscus (DMM). METHODS DMM or sham surgery was performed in 10-week-old male C57BL/6 wild-type or Pirt-GCaMP3+/- mice. All experiments were performed 8 weeks after surgery. Knee and hind paw hyperalgesia were assessed in wild-type mice. The retrograde label DiI was injected into the ipsilateral knee to quantify the number of knee-innervating neurons in the L4 dorsal root ganglion (DRG) in wild-type mice. In vivo calcium imaging was performed on the ipsilateral L4 DRG of Pirt-GCaMP3+/- mice as mechanical stimuli (paw pinch, knee pinch, or knee twist) were applied to the ipsilateral hind limb. RESULTS Eight weeks after surgery, mice subjected to DMM had more hyperalgesia in the knee and hind paw compared to mice subjected to sham surgery. Intraarticular injection of DiI labeled similar numbers of neurons in the L4 DRG of mice subjected to sham surgery and mice subjected to DMM. Increased numbers of sensory neurons responded to all 3 mechanical stimuli in mice subjected to DMM, as assessed by in vivo calcium imaging. The majority of responses in mice subjected to sham surgery and mice subjected to DMM were in small to medium-sized neurons, consistent with the size of nociceptors. The magnitude of responses was similar between mice subjected to sham surgery and mice subjected to DMM. CONCLUSION Our findings indicate that increased numbers of small to medium-sized DRG neurons respond to mechanical stimuli 8 weeks after DMM surgery, suggesting that nociceptors have become sensitized by lowering the response threshold.
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Affiliation(s)
| | - Yu Shin Kim
- Johns Hopkins University School of Medicine, Baltimore, Maryland, and University of Texas, Medical Branch School of Medicine, Galveston
| | | | | | - Xinzhong Dong
- Johns Hopkins University School of Medicine, Baltimore, Maryland
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258
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Krüger S, Boettger MK, Hilberg T. Somatosensory profile of patients with haemophilia. Haemophilia 2017; 24:97-103. [DOI: 10.1111/hae.13370] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2017] [Indexed: 12/19/2022]
Affiliation(s)
- S. Krüger
- Steffen Krüger, Department of Sports Medicine; University of Wuppertal; Wuppertal Nordrhein-Westfalen Germany
| | - M. K. Boettger
- Steffen Krüger, Department of Sports Medicine; University of Wuppertal; Wuppertal Nordrhein-Westfalen Germany
- Bayer AG; Nordrhein-Westfalen, Wuppertal Germany
| | - T. Hilberg
- Steffen Krüger, Department of Sports Medicine; University of Wuppertal; Wuppertal Nordrhein-Westfalen Germany
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259
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Eitner A, Hofmann GO, Schaible HG. Mechanisms of Osteoarthritic Pain. Studies in Humans and Experimental Models. Front Mol Neurosci 2017; 10:349. [PMID: 29163027 PMCID: PMC5675866 DOI: 10.3389/fnmol.2017.00349] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 10/13/2017] [Indexed: 12/12/2022] Open
Abstract
Pain due to osteoarthritis (OA) is one of the most frequent causes of chronic pain. However, the mechanisms of OA pain are poorly understood. This review addresses the mechanisms which are thought to be involved in OA pain, derived from studies on pain mechanisms in humans and in experimental models of OA. Three areas will be considered, namely local processes in the joint associated with OA pain, neuronal mechanisms involved in OA pain, and general factors which influence OA pain. Except the cartilage all structures of the joints are innervated by nociceptors. Although the hallmark of OA is the degradation of the cartilage, OA joints show multiple structural alterations of cartilage, bone and synovial tissue. In particular synovitis and bone marrow lesions have been proposed to determine OA pain whereas the contribution of the other pathologies to pain generation has been studied less. Concerning the peripheral neuronal mechanisms of OA pain, peripheral nociceptive sensitization was shown, and neuropathic mechanisms may be involved at some stages. Structural changes of joint innervation such as local loss and/or sprouting of nerve fibers were shown. In addition, central sensitization, reduction of descending inhibition, descending excitation and cortical atrophies were observed in OA. The combination of different neuronal mechanisms may define the particular pain phenotype in an OA patient. Among mediators involved in OA pain, nerve growth factor (NGF) is in the focus because antibodies against NGF significantly reduce OA pain. Several studies show that neutralization of interleukin-1β and TNF may reduce OA pain. Many patients with OA exhibit comorbidities such as obesity, low grade systemic inflammation and diabetes mellitus. These comorbidities can significantly influence the course of OA, and pain research just began to study the significance of such factors in pain generation. In addition, psychologic and socioeconomic factors may aggravate OA pain, and in some cases genetic factors influencing OA pain were found. Considering the local factors in the joint, the neuronal processes and the comorbidities, a better definition of OA pain phenotypes may become possible. Studies are under way in order to improve OA and OA pain monitoring.
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Affiliation(s)
- Annett Eitner
- Department of Physiology, University Hospital Jena, Friedrich Schiller University, Jena, Germany
| | - Gunther O Hofmann
- Department of Traumatology and Orthopedic Surgery, University Hospital Jena, Friedrich Schiller University, Jena, Germany.,Trauma Center Bergmannstrost Halle, Halle, Germany
| | - Hans-Georg Schaible
- Department of Physiology, University Hospital Jena, Friedrich Schiller University, Jena, Germany
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260
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The association of knee structural pathology with pain at the knee is modified by pain at other sites in those with knee osteoarthritis. Clin Rheumatol 2017; 36:2549-2555. [PMID: 28918594 DOI: 10.1007/s10067-017-3838-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 08/28/2017] [Accepted: 09/08/2017] [Indexed: 10/18/2022]
Abstract
The objective of this study was to investigate the associations of knee structural abnormalities with different patterns of pain. A total of 891 participants (average age 63 years; range 50 to 80 years) participated in this study. Presence of pain at the neck, back, hands, shoulders, hips, knees, and feet was assessed by questionnaire. Participants were categorized as having no pain at any site (no pain), pain only at the knee (KP), pain at other sites but not the knee (OP), and pain at the knee and other sites (KOP). T1-weighted or T2-weighted MRI of the right knee was performed to measure cartilage defects, bone marrow lesions (BMLs), and effusion-synovitis. Osteophytes and joint space narrowing were assessed by X-ray. KP, KOP, and OP were, respectively, present in 3, 43, and 42% of the participants. In multivariable analyses, KOP was associated with the presence of cartilage defects, BMLs, and osteophytes (OR 3.57 (95% CI 1.78 to 7.14), 2.37 (1.27 to 4.43), and 2.87 (1.10 to 7.51), respectively) in those with radiographic knee OA. KP was also associated with presence of these structural abnormalities as well as effusion-synovitis, and these associations were much stronger. The associations between structural abnormalities and KOP were weaker than those with KP in those with radiographic knee OA. This suggests that mechanisms mediating the association between structural pathology, localized, and generalized pain may be different, and central sensitization is possibly involved in generalized pain. Pain at other sites needs to be considered in the management and treatment of OA-related pain.
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261
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Trouvin AP, Perrot S. Pain in osteoarthritis. Implications for optimal management. Joint Bone Spine 2017; 85:429-434. [PMID: 28889010 DOI: 10.1016/j.jbspin.2017.08.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 08/24/2017] [Indexed: 02/08/2023]
Abstract
Pain is an ubiquitous symptom in osteoarticular diseases, occurring much more commonly than stiffness or disability. OA of the knee, hand, or hip affects around 20% of adults in various populations and is dramatically increasing in many countries, mostly related to age and obesity, leading to an increased number of people having OA pain, and creating a huge burden related to disability and health care costs. OA-related pain, has been classically considered to be a nociceptive pain condition. Clinicians have considered pain to be an alarm signal, correlated to the intensity of joint degradation. In OA, most authors have focused their studies on joint architecture and local degradation, considering pain as only a symptom, a consequence of joint damage. However, OA-related pain is a specific disease, with a complex pathophysiology, including neuropathic peripheral and central abnormalities, together with local inflammation involving all joint structures. Clinical findings emphasize that it is not a stable and linear condition, that pain experience is independent of structural modifications, and that the quality of pain in OA is important to consider, aside from its intensity. OA-related pain is modulated by many factors, including the individual patient's psychological and genetic factors, as well as the theoretical role of meteorological influences. Recent neuroimaging findings have improved our knowledge about central mechanisms of OA pain, especially in persistent cases.
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Affiliation(s)
- Anne-Priscille Trouvin
- Pain Department, Cochin-Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; Inserm U987, Paris Descartes University, 75014 Paris, France
| | - Serge Perrot
- Pain Department, Cochin-Hôtel Dieu Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; Inserm U987, Paris Descartes University, 75014 Paris, France.
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262
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Do Psychosocial Factors Predict Muscle Strength, Pain, or Physical Performance in Patients With Knee Osteoarthritis? J Clin Rheumatol 2017; 23:308-316. [DOI: 10.1097/rhu.0000000000000560] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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263
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Lluch E, Nijs J, Courtney CA, Rebbeck T, Wylde V, Baert I, Wideman TH, Howells N, Skou ST. Clinical descriptors for the recognition of central sensitization pain in patients with knee osteoarthritis. Disabil Rehabil 2017; 40:2836-2845. [DOI: 10.1080/09638288.2017.1358770] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Enrique Lluch
- Department of Physical Therapy, University of Valencia, Valencia, Spain
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Pain in Motion International Research Group, Brussel, Belgium
| | - Jo Nijs
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Pain in Motion International Research Group, Brussel, Belgium
| | - Carol A. Courtney
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Trudy Rebbeck
- Faculty of Health Sciences, Discipline of Physiotherapy, John Walsh Centre for Rehabilitation Research, Royal North Shore Hospital, University of Sydney, Sydney, Australia
| | - Vikki Wylde
- Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Bristol, UK
| | - Isabel Baert
- Pain in Motion International Research Group, Brussel, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Timothy H. Wideman
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| | - Nick Howells
- Avon Orthopaedic Centre, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK
| | - Søren T. Skou
- Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Naestved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
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264
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French HP, Smart KM, Doyle F. Prevalence of neuropathic pain in knee or hip osteoarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum 2017; 47:1-8. [DOI: 10.1016/j.semarthrit.2017.02.008] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/19/2017] [Accepted: 02/15/2017] [Indexed: 12/01/2022]
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265
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La Touche R, Paris-Alemany A, Hidalgo-Pérez A, López-de-Uralde-Villanueva I, Angulo-Diaz-Parreño S, Muñoz-García D. Evidence for Central Sensitization in Patients with Temporomandibular Disorders: A Systematic Review and Meta-analysis of Observational Studies. Pain Pract 2017; 18:388-409. [DOI: 10.1111/papr.12604] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 05/25/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Roy La Touche
- Department of Physiotherapy; Centro Superior de Estudios Universitarios La Salle; Universidad Autónoma de Madrid; Madrid Spain
- Motion in Brains Research Group; Centro Superior de Estudios Universitarios La Salle; Universidad Autónoma de Madrid; Madrid Spain
- Institute of Neuroscience and Craniofacial Pain (INDCRAN); Madrid Spain
- Hospital La Paz Institute for Health Research; IdiPAZ; Madrid Spain
| | - Alba Paris-Alemany
- Department of Physiotherapy; Centro Superior de Estudios Universitarios La Salle; Universidad Autónoma de Madrid; Madrid Spain
- Motion in Brains Research Group; Centro Superior de Estudios Universitarios La Salle; Universidad Autónoma de Madrid; Madrid Spain
- Institute of Neuroscience and Craniofacial Pain (INDCRAN); Madrid Spain
- Hospital La Paz Institute for Health Research; IdiPAZ; Madrid Spain
| | - Amanda Hidalgo-Pérez
- Department of Physiotherapy; Centro Superior de Estudios Universitarios La Salle; Universidad Autónoma de Madrid; Madrid Spain
| | - Ibai López-de-Uralde-Villanueva
- Department of Physiotherapy; Centro Superior de Estudios Universitarios La Salle; Universidad Autónoma de Madrid; Madrid Spain
- Motion in Brains Research Group; Centro Superior de Estudios Universitarios La Salle; Universidad Autónoma de Madrid; Madrid Spain
- Institute of Neuroscience and Craniofacial Pain (INDCRAN); Madrid Spain
- Hospital La Paz Institute for Health Research; IdiPAZ; Madrid Spain
| | - Santiago Angulo-Diaz-Parreño
- Motion in Brains Research Group; Centro Superior de Estudios Universitarios La Salle; Universidad Autónoma de Madrid; Madrid Spain
- Faculty of Medicine; San Pablo CEU University; Madrid Spain
| | - Daniel Muñoz-García
- Department of Physiotherapy; Centro Superior de Estudios Universitarios La Salle; Universidad Autónoma de Madrid; Madrid Spain
- Motion in Brains Research Group; Centro Superior de Estudios Universitarios La Salle; Universidad Autónoma de Madrid; Madrid Spain
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Scheper MC, Pacey V, Rombaut L, Adams RD, Tofts L, Calders P, Nicholson LL, Engelbert RHH. Generalized Hyperalgesia in Children and Adults Diagnosed With Hypermobility Syndrome and Ehlers-Danlos Syndrome Hypermobility Type: A Discriminative Analysis. Arthritis Care Res (Hoboken) 2017; 69:421-429. [PMID: 27483212 DOI: 10.1002/acr.22998] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 06/22/2016] [Accepted: 07/19/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Lowered pressure-pain thresholds have been demonstrated in adults with Ehlers-Danlos syndrome hypermobility type (EDS-HT), but whether these findings are also present in children is unclear. Therefore, the objectives of the study were to determine whether generalized hyperalgesia is present in children with hypermobility syndrome (HMS)/EDS-HT, explore potential differences in pressure-pain thresholds between children and adults with HMS/EDS-HT, and determine the discriminative value of generalized hyperalgesia. METHODS Patients were classified in 1 of 3 groups: HMS/EDS-HT, hypermobile (Beighton score ≥4 of 9), and healthy controls. Descriptive data of age, sex, body mass index, Beighton score, skin laxity, and medication usage were collected. Generalized hyperalgesia was quantified by the average pressure-pain thresholds collected from 12 locations. Confounders collected were pain locations/intensity, fatigue, and psychological distress. Comparisons between children with HMS/EDS-HT and normative values, between children and adults with HMS/EDS-HT, and corrected confounders were analyzed with multivariate analysis of covariance. The discriminative value of generalized hyperalgesia employed to differentiate between HMS/EDS-HT, hypermobility, and controls was quantified with logistic regression. RESULTS Significantly lower pressure-pain thresholds were found in children with HMS/EDS-HT compared to normative values (range -22.0% to -59.0%; P ≤ 0.05). When applying a threshold of 30.8 N/cm2 for males and 29.0 N/cm2 for females, the presence of generalized hyperalgesia discriminated between individuals with HMS/EDS-HT, hypermobility, and healthy controls (odds ratio 6.0). CONCLUSION Children and adults with HMS/EDS-HT are characterized by hypermobility, chronic pain, and generalized hyperalgesia. The presence of generalized hyperalgesia may indicate involvement of the central nervous system in the development of chronic pain.
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Affiliation(s)
- M C Scheper
- University of Applied Sciences and Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - V Pacey
- The Children's Hospital at Westmead and Macquarie University, Sydney, New South Wales, Australia
| | - L Rombaut
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - R D Adams
- University of Sydney, Sydney, New South Wales, Australia
| | - L Tofts
- The Children's Hospital at Westmead and University of Sydney, Sydney, New South Wales, Australia
| | | | - L L Nicholson
- The Children's Hospital at Westmead and University of Sydney, Sydney, New South Wales, Australia
| | - R H H Engelbert
- University of Applied Sciences and Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Addition of transcranial direct current stimulation to quadriceps strengthening exercise in knee osteoarthritis: A pilot randomised controlled trial. PLoS One 2017; 12:e0180328. [PMID: 28665989 PMCID: PMC5493377 DOI: 10.1371/journal.pone.0180328] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 06/13/2017] [Indexed: 12/11/2022] Open
Abstract
A randomised, assessor- and participant-blind, sham-controlled trial was conducted to assess the safety and feasibility of adding transcranial direct current stimulation (tDCS) to quadriceps strengthening exercise in knee osteoarthritis (OA), and provide data to inform a fully powered trial. Participants were randomised to receive active tDCS+exercise (AT+EX) or sham tDCS+exercise (ST+EX) twice weekly for 8 weeks whilst completing home exercises twice per week. Feasibility, safety, patient-perceived response, pain, function, pressure pain thresholds (PPTs) and conditioned pain modulation (CPM) were assessed before and after treatment. Fifty-seven people were screened for eligibility. Thirty (52%) entered randomisation and 25 (84%) completed the trial. One episode of headache in the AT+EX group was reported. Pain reduced in both groups following treatment (AT+EX: p<0.001, partial η2 = 0.55; ST+EX: p = 0.026, partial η2 = 0.18) but no between-group differences were observed (p = 0.18, partial η2 = 0.08). Function improved in the AT+EX (p = 0.01, partial η2 = 0.22), but not the ST+EX (p = 0.16, partial η2 = 0.08) group, between-group differences did not reach significance (p = 0.28, partial η2 = 0.052). AT+EX produced greater improvements in PPTs than ST+EX (p<0.05) (superolateral knee: partial η2 = 0.17; superior knee: partial η2 = 0.3; superomedial knee: partial η2 = 0.26). CPM only improved in the AT+EX group but no between-group difference was observed (p = 0.054, partial η2 = 0.158). This study provides the first feasibility and safety data for the addition of tDCS to quadriceps strengthening exercise in knee OA. Our data suggest AT+EX may improve pain, function and pain mechanisms beyond that of ST+EX, and provides support for progression to a fully powered randomised controlled trial.
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Nishigami T, Mibu A, Tanaka K, Yamashita Y, Yamada E, Wand BM, Catley MJ, Stanton TR, Moseley GL. Development and psychometric properties of knee-specific body-perception questionnaire in people with knee osteoarthritis: The Fremantle Knee Awareness Questionnaire. PLoS One 2017. [PMID: 28650969 PMCID: PMC5484477 DOI: 10.1371/journal.pone.0179225] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Recent systematic reviews have demonstrated that pain associated with knee osteoarthritis (OA) is a complex phenomenon that involves various contributors. People with knee OA exhibit symptoms of impaired body-perception, including reduced tactile acuity, impairments in limb laterality recognition, and degraded proprioceptive acuity. The Fremantle Back Awareness Questionnaire (FreBAQ) was developed to assess body-perception specific to the back in people with chronic low back pain. The aim of this study was to develop and assess the psychometric properties of a knee-specific version of the FreBAQ-J (FreKAQ-J), determine whether people with knee pain experience perceptual impairments and investigate the relationship between disturbed self-perception and clinical status. Methods Sixty-five people with knee OA completed the FreKAQ-J. A subset of the participants completed the FreKAQ-J again two-weeks later. Rasch analysis was used to assess item order, targeting, category ordering, unidimensionality, person fit, internal consistency, and differential item functioning. Validity was investigated by examining the relationship between the FreKAQ-J and clinical valuables. Results The FreKAQ-J had acceptable internal consistency, unidimensionality, good test-retest reliability, and was functional on the category rating scale. The FreKAQ-J was significantly correlated with pain in motion, disability, pain-related catastrophizing, fear of movement, and anxiety symptomatology. Conclusions We developed FreKAQ-J by modifying the FreBAQ-J. The FreKAQ-J fits the Rasch measurement model well and is suitable for use in people with knee OA. Altered body perception may be worth evaluating when managing people with knee OA.
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Affiliation(s)
- Tomohiko Nishigami
- Department of Nursing and Physical Therapy, Konan Woman’s University, Kobe, Hyogo, Japan
- * E-mail:
| | - Akira Mibu
- Department of Rehabilitation, Tanabe Orthopaedics, Osaka, Osaka, Japan
| | - Katsuyoshi Tanaka
- Department of Rehabilitation, Tanabe Orthopaedics, Osaka, Osaka, Japan
| | - Yuh Yamashita
- Department of Rehabilitation, Morinaga Orthopedic Clinic, Saga, Saga, Japan
| | - Eiji Yamada
- Joint Surgery Centre, Kaisei Hospital, Sakaide, Kagawa, Japan
| | - Benedict M. Wand
- The School of Physiotherapy, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Mark J. Catley
- Sansom Institute for Health Research, University of South Australia, SA, Australia
| | - Tasha R. Stanton
- Sansom Institute for Health Research, University of South Australia, SA, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - G. Lorimer Moseley
- Sansom Institute for Health Research, University of South Australia, SA, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
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Exercise-induced Hypoalgesia in People With Knee Osteoarthritis With Normal and Abnormal Conditioned Pain Modulation. Clin J Pain 2017; 33:395-404. [DOI: 10.1097/ajp.0000000000000418] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Dave AJ, Selzer F, Losina E, Usiskin I, Collins JE, Lee YC, Band P, Dalury DF, Iorio R, Kindsfater K, Katz JN. The association of pre-operative body pain diagram scores with pain outcomes following total knee arthroplasty. Osteoarthritis Cartilage 2017; 25:667-675. [PMID: 27986621 PMCID: PMC5403582 DOI: 10.1016/j.joca.2016.12.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/18/2016] [Accepted: 12/07/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Approximately 20% of total knee arthroplasty (TKA) recipients have suboptimal pain relief. We evaluated the association between pre-surgical widespread body pain and incomplete pain relief following TKA. METHOD This prospective analysis included 241 patients with knee osteoarthritis (OA) undergoing unilateral TKA who completed questionnaires preoperatively and up to 12 months post-operatively. Questionnaires included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scale and a body pain diagram. We derived the number of non-index painful body regions from the diagram. We used Poisson regression to determine the association between painful body regions identified preoperatively and both WOMAC pain at follow-up and improvement in pain as defined by the minimal clinically important difference (MCID). RESULTS Mean subject age was 66 years (SD 9), and 61% were females. Adjusting for age, sex, co-morbid conditions, baseline pain, pain catastrophizing, and mental health, we found that more widespread body pain was associated with a higher likelihood of reporting 12-month WOMAC pain score >15 (relative risk [RR] per painful body region 1.39, 95% CI 1.18-1.63) and a greater likelihood of failing to achieve the MCID (RR 1.47, 95% CI 1.16-1.86).). Pain catastrophizing was an independent predictor of persistent pain and failure to improve by the MCID (RR 3.57, 95% CI 1.73-7.31). CONCLUSIONS Pre-operative widespread pain was associated with greater pain at 12-months and failure to reach the MCID. Widespread pain as captured by the pain diagram, along with the pain catastrophizing score, may help identify persons with suboptimal TKA outcome.
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Affiliation(s)
- A J Dave
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - F Selzer
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - E Losina
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - I Usiskin
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - J E Collins
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Y C Lee
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - P Band
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - D F Dalury
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - R Iorio
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - K Kindsfater
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - J N Katz
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe), Department of Orthopedic Surgery and Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Carlesso LC, Niu J, Segal NA, Frey-Law LA, Lewis CE, Nevitt MC, Neogi T. The Effect of Widespread Pain on Knee Pain Worsening, Incident Knee Osteoarthritis (OA), and Incident Knee Pain: The Multicenter OA (MOST) Study. J Rheumatol 2017; 44:493-498. [PMID: 28250143 PMCID: PMC5468496 DOI: 10.3899/jrheum.160853] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2017] [Indexed: 01/25/2023]
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.
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Affiliation(s)
- Lisa C Carlesso
- 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.
- 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.
| | - Jingbo Niu
- 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
- 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
| | - Neil A Segal
- 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
- 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
| | - Laura A Frey-Law
- 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
- 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
| | - Cora E Lewis
- 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
- 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
| | - Michael C Nevitt
- 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
- 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
| | - Tuhina Neogi
- 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
- 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
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Abstract
Osteoarthritis (OA)-associated pain is a leading cause of disability. Central sensitization (CS), as a result of OA, is recognized as an important facet of human patients' chronic pain and has been measured in people using quantitative sensory testing (QST) testing. The spontaneous canine OA model has been suggested as a good translational model, but CS has not been explored in this model. In this study, QST was performed on dogs with and without spontaneous hip or stifle OA to determine whether OA is associated with CS in this model. Mechanical (von Frey and blunt pressure) and thermal (hot and cold) sensory thresholds obtained in dogs with chronic OA-associated pain (n = 31) were compared with those of normal dogs (n = 23). Dogs were phenotyped and joint-pain scored, and testing was performed at the OA-affected joint, cranial tibial muscle, and dorsal metatarsal region. QST summary data were evaluated using mixed-effect models to understand the influence of OA status and covariates, and dogs with OA and control dogs were compared. The presence of OA was strongly associated with hyperalgesia across all QST modalities at the index joint, cranial tibial muscle, and metatarsal site. Mechanical QST scores were significantly moderately negatively correlated with total joint-pain scores. The spontaneous canine OA model is associated with somatosensory sensitivity, likely indicative of CS. These data further validate the canine spontaneous OA model as an appropriate model of the human OA pain condition.
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274
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Abstract
The development of patient profiles to subgroup individuals on a variety of variables has gained attention as a potential means to better inform clinical decision making. Patterns of pain sensitivity response specific to quantitative sensory testing (QST) modality have been demonstrated in healthy subjects. It has not been determined whether these patterns persist in a knee osteoarthritis population. In a sample of 218 participants, 19 QST measures along with pain, psychological factors, self-reported function, and quality of life were assessed before total knee arthroplasty. Component analysis was used to identify commonalities across the 19 QST assessments to produce standardized pain sensitivity factors. Cluster analysis then grouped individuals who exhibited similar patterns of standardized pain sensitivity component scores. The QST resulted in 4 pain sensitivity components: heat, punctate, temporal summation, and pressure. Cluster analysis resulted in 5 pain sensitivity profiles: a "low pressure pain" group, an "average pain" group, and 3 "high pain" sensitivity groups who were sensitive to different modalities (punctate, heat, and temporal summation). Pain and function differed between pain sensitivity profiles, along with sex distribution; however, no differences in osteoarthritis grade, medication use, or psychological traits were found. Residualizing QST data by age and sex resulted in similar components and pain sensitivity profiles. Furthermore, these profiles are surprisingly similar to those reported in healthy populations, which suggests that individual differences in pain sensitivity are a robust finding even in an older population with significant disease.
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275
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Lindberg MF, Rustøen T, Miaskowski C, Rosseland LA, Lerdal A. The relationship between pain with walking and self-rated health 12 months following total knee arthroplasty: a longitudinal study. BMC Musculoskelet Disord 2017; 18:75. [PMID: 28183297 PMCID: PMC5301389 DOI: 10.1186/s12891-017-1430-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/24/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND A subgroup of patients continue to report pain with walking 12 months after total knee arthroplasty (TKA). The association between walking pain and self-rated health (SRH) after TKA is not known. This prospective longitudinal study aimed to investigate the association between a comprehensive list of preoperative factors, postoperative pain with walking, and SRH 12 months after TKA. METHODS Patients (N = 156) scheduled for TKA completed questionnaires that evaluated demographic and clinical characteristics, symptoms, psychological factors, and SRH. SRH was re-assessed 12 months after TKA. Clinical variables were retrieved from medical records. Pain with walking was assessed before surgery, at 6 weeks, 3, and 12 months after TKA. Subgroups with distinct trajectories of pain with walking over time were identified using growth mixture modeling. Multiple linear regression was used to investigate the relationships between pain with walking and other factors on SRH. RESULTS Higher body mass index, a higher number of painful sites at 12 months, recurrent pain with walking group membership, ketamine use, higher depression scores, and poorer preoperative self-rated health were associated with poorer SRH 12 months after TKA. The final model was statistically significant (p = 0.005) and explained 56.1% of the variance in SRH 12 months after surgery. SRH improved significantly over time. Higher C-reactive protein levels, higher number of painful sites before surgery, higher fatigue severity, and more illness concern was associated with poorer preoperative SRH. CONCLUSIONS In patients whose walking ability decreases over time, clinicians need to assess for unreleaved pain and decreases in SRH. Additional research is needed on interventions to improve walking ability and SRH.
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Affiliation(s)
- Maren Falch Lindberg
- Department of Surgery, Lovisenberg Diakonale Hospital, Pb 4970 Nydalen, 0440, Oslo, Norway.,Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Pb 1072 Blindern, 0316, Oslo, Norway
| | - Tone Rustøen
- Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Pb 1072 Blindern, 0316, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Pb 4956 Nydalen, 0424, Oslo, Norway
| | - Christine Miaskowski
- School of Nursing, University of California, San Francisco, UCSF, Box 0610, San Francisco, CA, 94143, USA
| | - Leiv Arne Rosseland
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Pb 4956 Nydalen, 0424, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Pb 1072 Blindern, 0316, Oslo, Norway
| | - Anners Lerdal
- Department of Surgery, Lovisenberg Diakonale Hospital, Pb 4970 Nydalen, 0440, Oslo, Norway. .,Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Pb 1072 Blindern, 0316, Oslo, Norway.
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Arendt-Nielsen L, Jiang GL, DeGryse R, Turkel CC. Intra-articular onabotulinumtoxinA in osteoarthritis knee pain: effect on human mechanistic pain biomarkers and clinical pain. Scand J Rheumatol 2016; 46:303-316. [PMID: 27733091 DOI: 10.1080/03009742.2016.1203988] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES OnabotulinumtoxinA (onabotA) attenuates peripheral nociceptive transduction and consequently neuronal firing. The aim of this mechanistic study was to evaluate the effect of intra-articular (IA) onabotA in patients with painful knee osteoarthritis (OA). METHOD We conducted a double-blind, randomized, placebo-controlled, 12-week trial using a single ultrasound-guided IA injection of onabotA (200 U). Patients (N = 121) were randomized to receive onabotA (n = 61) or placebo (n = 60). Mechanistic pain biomarkers and clinical outcomes were used for profiling the effect. The biomarkers were pressure pain thresholds (PPTs) from the knee joint (localized sensitization) and extra-articular sites (widespread sensitization), and wind-up pain (central sensitization). Clinical assessments included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), average daily pain (ADP), patient global impression of change (GIC), and rescue medication. The painDETECT questionnaire (PD-Q) was used for subgrouping patients (nociceptive, neuropathic, and mixed/uncertain). RESULTS The nociceptive and non-nociceptive groups were identical with respect to all baseline data. No significant differences in clinical efficacy parameters were found between onabotA and placebo in the entire population. The nociceptive group showed significant improvement after IA onabotA at week 8 for all WOMAC outcomes, ADP at weeks 9 and 10, and patient GIC at week 12, and significant reduction in rescue medication counts within each 14-day period at weeks 9 and 10. After 4, 8, and 12 weeks, significant correlations were obtained in the onabotA group between ADP (both the entire group and the nociceptive group) and various sensitization parameters. The nociceptive group showed pronounced effects on widespread sensitization. CONCLUSIONS Intra-articular onabotA given to patients with nociceptive knee OA reduced pain sensitization together with improvement in pain and function.
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Affiliation(s)
| | - G-L Jiang
- b Sanofi Biosurgery DPU , Cambridge , MA , USA
| | - R DeGryse
- c Allergan, Inc. , Irvine , CA , USA
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279
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Kaukinen P, Podlipská J, Guermazi A, Niinimäki J, Lehenkari P, Roemer FW, Nieminen MT, Koski JM, Arokoski JPA, Saarakkala S. Associations between MRI-defined structural pathology and generalized and localized knee pain - the Oulu Knee Osteoarthritis study. Osteoarthritis Cartilage 2016; 24:1565-76. [PMID: 27174007 DOI: 10.1016/j.joca.2016.05.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 04/07/2016] [Accepted: 05/02/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the associations between multi-feature structural pathology assessed using magnetic resonance imaging (MRI) and the presence of knee pain, and to determine the associations between the locations of structural changes and different knee pain patterns. METHOD Eighty symptomatic subjects with knee pain and suspicion or diagnosis of knee OA and 63 asymptomatic subjects underwent knee MRI. Severity of structural changes was graded by MRI Osteoarthritis Knee Score (MOAKS) in separate knee locations. The associations between cartilage damage, bone marrow lesions (BMLs), osteophytes, Hoffa's synovitis, effusion-synovitis, meniscal damage and structural pathologies in ligaments, tendons and bursas and both the presence of pain and the knee pain patterns were assessed. RESULTS The presence of Hoffa's synovitis (adjusted RR 1.6, 95% CI 1.2-1.3) and osteophytes in any region (2.07, 1.19-3.60) was significantly associated with the presence of pain. Any Hoffa's synovitis was associated with patellar pain (adjusted RR 4.70, 95% CI 1.19-3.60) and moderate-to-severe Hoffa's synovitis with diffuse pain (2.25, 1.13-4.50). Medial knee pain was associated with cartilage loss in the medial tibia (adjusted RR 2.66, 95% CI 1.22-5.80), osteophytes in the medial tibia (2.66, 1.17-6.07) and medial femur (2.55, 1.07-6.09), medial meniscal maceration (2.20, 1.01-4.79) and anterior meniscal extrusions (2.78, 1.14-6.75). CONCLUSIONS Hoffa's synovitis and osteophytes were strongly associated with the presence of knee pain. Medial pain was associated most often with medially located structural pathologies.
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Affiliation(s)
- P Kaukinen
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland.
| | - J Podlipská
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.
| | - A Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
| | - J Niinimäki
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - P Lehenkari
- Department of Anatomy, University of Oulu, Oulu, Finland; Department of Surgery, Medical Research Center, Oulu University Hospital, Oulu, Finland.
| | - F W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - M T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Finland.
| | - J M Koski
- Department of Internal Medicine, Mikkeli Central Hospital, Mikkeli, Finland.
| | - J P A Arokoski
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland.
| | - S Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital and University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Finland.
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280
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O'Leary H, Smart KM, Moloney NA, Doody CM. Nervous System Sensitization as a Predictor of Outcome in the Treatment of Peripheral Musculoskeletal Conditions: A Systematic Review. Pain Pract 2016; 17:249-266. [DOI: 10.1111/papr.12484] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/23/2016] [Accepted: 06/03/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Helen O'Leary
- School of Public Health, Physiotherapy and Sports Science; University College Dublin; Dublin Ireland
| | - Keith M. Smart
- Physiotherapy Department; St. Vincent's University Hospital; Dublin Ireland
| | - Niamh A. Moloney
- Faculty of Medicine and Health Sciences; Macquarie University; Sydney New South Wales Australia
| | - Catherine M. Doody
- School of Public Health, Physiotherapy and Sports Science; University College Dublin; Dublin Ireland
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281
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Wei J, Hettinghouse A, Liu C. The role of progranulin in arthritis. Ann N Y Acad Sci 2016; 1383:5-20. [PMID: 27505256 DOI: 10.1111/nyas.13191] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/28/2016] [Accepted: 07/07/2016] [Indexed: 12/11/2022]
Abstract
Progranulin (PGRN) is a growth factor with a unique beads-on-a-string structure that is involved in multiple pathophysiological processes, including anti-inflammation, tissue repair, wound healing, neurodegenerative diseases, and tumorigenesis. This review presents up-to-date information concerning recent studies on the role of PGRN in inflammatory arthritis and osteoarthritis, with a special focus on the involvement of the interactions and interplay between PGRN and tumor necrosis factor receptor (TNFR) family members in regulating such musculoskeletal diseases. In addition, this paper highlights the applications of atsttrin, an engineered protein comprising three TNFR-binding fragments of PGRN, as a promising intervention in treating arthritis.
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Affiliation(s)
- Jianlu Wei
- Department of Orthopaedic Surgery, New York University Medical Center, New York, New York.,Department of Orthopaedic Surgery, Medical School of Shandong University, Jinan, Shandong, China
| | - Aubryanna Hettinghouse
- Department of Orthopaedic Surgery, New York University Medical Center, New York, New York
| | - Chuanju Liu
- Department of Orthopaedic Surgery, New York University Medical Center, New York, New York.,Department of Cell Biology, New York University School of Medicine, New York, New York
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282
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Expanded Distribution of Pain as a Sign of Central Sensitization in Individuals With Symptomatic Knee Osteoarthritis. Phys Ther 2016; 96:1196-207. [PMID: 26939604 DOI: 10.2522/ptj.20150492] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 02/24/2016] [Indexed: 02/09/2023]
Abstract
BACKGROUND Expanded distribution of pain is considered a sign of central sensitization (CS). The relationship between recording of symptoms and CS in people with knee osteoarthritis (OA) has been poorly investigated. OBJECTIVE The aim of this study was to examine whether the area of pain assessed using pain drawings relates to CS and clinical symptoms in people with knee OA. DESIGN This was a cross-sectional study. METHODS Fifty-three people with knee OA scheduled to undergo primary total knee arthroplasty were studied. All participants completed pain drawings using a novel digital device, completed self-administration questionnaires, and were assessed by quantitative sensory testing. Pain frequency maps were generated separately for women and men. Spearman correlation coefficients were computed to reveal possible correlations between the area of pain and quantitative sensory testing and clinical symptoms. RESULTS Pain frequency maps revealed enlarged areas of pain, especially in women. Enlarged areas of pain were associated with higher knee pain severity (rs=.325, P<.05) and stiffness (rs=.341, P<.05), lower pressure pain thresholds at the knee (rs=-.306, P<.05) and epicondyle (rs=-.308, P<.05), and higher scores with the Central Sensitization Inventory (rs=.456, P<.01). No significant associations were observed between the area of pain and the remaining clinical symptoms and measures of CS. LIMITATIONS Firm conclusions about the predictive role of pain drawings cannot be drawn. Further evaluation of the reliability and validity of pain area extracted from pain drawings in people with knee OA is needed. CONCLUSION Expanded distribution of pain was correlated with some measures of CS in individuals with knee OA. Pain drawings may constitute an easy way for the early identification of CS in people with knee OA, but further research is needed.
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283
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Krüger S, Weitz C, Runkel B, Hilberg T. Pain sensitivity in patients with haemophilia following moderate aerobic exercise intervention. Haemophilia 2016; 22:886-893. [DOI: 10.1111/hae.13016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2016] [Indexed: 12/29/2022]
Affiliation(s)
- S. Krüger
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - C. Weitz
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - B. Runkel
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
| | - T. Hilberg
- Department of Sports Medicine; University of Wuppertal; Wuppertal Germany
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284
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Ogawa S, Awaga Y, Takashima M, Hama A, Matsuda A, Takamatsu H. Knee osteoarthritis pain following medial meniscectomy in the nonhuman primate. Osteoarthritis Cartilage 2016; 24:1190-9. [PMID: 26944197 DOI: 10.1016/j.joca.2016.02.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 02/08/2016] [Accepted: 02/12/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE A number of promising compounds developed for osteoarthritic pain have failed to demonstrate clinical efficacy. To enhance preclinical translational research for osteoarthritis, a model of knee osteoarthritis pain was developed in Macaca fascicularis and the effects of two distinct pharmacological classes of drugs were tested on pain-related behavior. DESIGN Behavioral assessments were developed specifically for the macaque. Baseline knee pressure threshold and weight bearing were assessed prior to a unilateral medial meniscectomy (MMx). Fifteen days following MMx, macaques underwent a once daily exercise regimen for 36 days. Sixty-seven days following MMx, macaques were assigned to one of three treatment groups (n = 3/group), either non-steroidal anti-inflammatory drug (NSAID) diclofenac, NK1 receptor antagonist aprepitant or vehicle, and treated for 5 days. Animals were tested 3-4 h after p.o. dosing and testing was performed blinded. Treatment utilized a crossover design-each animal received all treatments-and a 9-day washout period was utilized between treatments. RESULTS Vehicle-treated macaques consistently demonstrated decreased ipsilateral pressure threshold ("hyperalgesia") and decreased weight bearing. While diclofenac increased weight bearing and pressure threshold, full attenuation of pain was not obtained. No significant improvement of either knee pressure or weight bearing was observed with aprepitant. CONCLUSIONS Unilateral MMx in the macaque evoked pain-related behaviors and knee joint pathology reminiscent of osteoarthritis. The behavioral endpoints were sensitive to NSAID treatment but not sensitive to NK1 receptor block, which parallel clinical findings. The current macaque osteoarthritis model could be used to test potential treatments for osteoarthritis pain.
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Affiliation(s)
- S Ogawa
- Hamamatsu Pharma Research, Inc., Hamamatsu, Japan
| | - Y Awaga
- Hamamatsu Pharma Research, Inc., Hamamatsu, Japan
| | - M Takashima
- Hamamatsu Pharma Research, Inc., Hamamatsu, Japan
| | - A Hama
- Hamamatsu Pharma Research, Inc., Hamamatsu, Japan.
| | - A Matsuda
- Hamamatsu Pharma Research, Inc., Hamamatsu, Japan
| | - H Takamatsu
- Hamamatsu Pharma Research, Inc., Hamamatsu, Japan
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285
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Madry H, Kon E, Condello V, Peretti GM, Steinwachs M, Seil R, Berruto M, Engebretsen L, Filardo G, Angele P. Early osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 2016; 24:1753-62. [PMID: 27000393 DOI: 10.1007/s00167-016-4068-3] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 02/23/2016] [Indexed: 12/28/2022]
Abstract
There is an increasing awareness on the importance in identifying early phases of the degenerative processes in knee osteoarthritis (OA), the crucial period of the disease when there might still be the possibility to initiate treatments preventing its progression. Early OA may show a diffuse and ill-defined involvement, but also originate in the cartilage surrounding a focal lesion, thus necessitating a separate assessment of these two entities. Early OA can be considered to include a maximal involvement of 50 % of the cartilage thickness based on the macroscopic ICRS classification, reflecting an OARSI grade 4. The purpose of this paper was to provide an updated review of the current status of the diagnosis and definition of early knee OA, including the clinical, radiographical, histological, MRI, and arthroscopic definitions and biomarkers. Based on current evidence, practical classification criteria are presented. As new insights and technologies become available, they will further evolve to better define and treat early knee OA.
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Affiliation(s)
- Henning Madry
- Center of Experimental Orthopaedics, Saarland University, Kirrberger Strasse 100, Building 37-38, 66421, Homburg/Saar, Germany.
- Department of Orthopaedic Surgery, Saarland University Medical Center, Kirrberger Strasse 100, Building 37-38, 66421, Homburg/Saar, Germany.
| | - Elizaveta Kon
- NABI Laboratory, Rizzoli Orthopaedic Institute, Via Di Barbiano, 1/10, 40136, Bologna, Italy
| | - Vincenzo Condello
- Dipartimento di Ortopedia, Responsabile di Struttura Semplice di Traumatologia dello, Sport Knee Surgery and Sports Traumatology, Ospedale Sacro Cuore - Don Calabria, Via Don, Sempreboni, 5, 37024, Negrar, Verona, Italy
| | - Giuseppe M Peretti
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Matthias Steinwachs
- SportClinic Zürich, Klinik Hirslanden, Witellikerstrasse 40, 8032, Zurich, Switzerland
| | - Romain Seil
- Service de Chirurgie Orthopédique, Centre de L'Appareil Locomoteur, de Médecine du Sport et de Prévention, Centre Hospitalier de Luxembourg-Clinique d'Eich and Sports Medicine Research Laboratory, Luxembourg Institute of Health, 78, rue d'Eich, 1460, Luxembourg, Luxembourg
| | - Massimo Berruto
- Centro di Eccellenza per L'attività Ortopedica, Reumatologica e Riabilitativa, L'Istituto Ortopedico Gaetano Pini è un'Azienda Ospedaliera di rilievo nazionale, P.zza A. Ferrari, 1, 20122, Milan, Italy
| | - Lars Engebretsen
- Department of Orthopedic Surgery, Oslo University Hospital and Oslo Sports Trauma Research Center, 0407, Oslo, Norway
| | - Giuseppe Filardo
- Biomechanics Laboratory, II Orthopaedics and Traumatology Clinic, Rizzoli Orthopaedic Institute, Via Di Barbiano, 1/10, 40136, Bologna, Italy
| | - Peter Angele
- Department of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany
- Sporthopaedicum Regensburg, Hildegard von Bingen Strasse 1, 93053, Regensburg, Germany
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286
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Pazzinatto MF, de Oliveira Silva D, Barton C, Rathleff MS, Briani RV, de Azevedo FM. Female Adults with Patellofemoral Pain Are Characterized by Widespread Hyperalgesia, Which Is Not Affected Immediately by Patellofemoral Joint Loading. PAIN MEDICINE 2016; 17:1953-1961. [DOI: 10.1093/pm/pnw068] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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287
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Rasheed N, Alghasham A, Rasheed Z. Lactoferrin from Camelus dromedarius Inhibits Nuclear Transcription Factor-kappa B Activation, Cyclooxygenase-2 Expression and Prostaglandin E2 Production in Stimulated Human Chondrocytes. Pharmacognosy Res 2016; 8:135-41. [PMID: 27034605 PMCID: PMC4780140 DOI: 10.4103/0974-8490.175612] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Background: Osteoarthritis (OA) is a progressive joint disorder, which remains the leading cause of chronic disability in aged people. Nuclear factor-kappa B (NF)-κB is a major cellular event in OA and its activation by interleukin-1β (IL-1β) plays a critical role in cartilage breakdown in these patients. Objective: In this study, we examined the effect of lactoferrin on NF-κB activation, cyclooxygenase-2 (COX-2) expression and prostaglandin E2 (PGE2) production in stimulated human articular chondrocytes. Materials and Methods: Human chondrocytes were derived from OA articular cartilage and treated with camel lactoferrin and then stimulated with IL-1β. Gene expression was determined by TaqMan assays and protein expression was studied by Western immunoblotting. NF-κB activity and PGE2 levels were determined by ELISA based assays. NF-κB activity was also determined by treatment of chondrocytes with NF-κB specific inhibitor Bay 11–7082. Results: Lactoferrin inhibited IL-1β-induced activation and nuclear translocation of NF-κB p65 in human OA chondrocytes. Lactoferrin also inhibited mRNA/protein expression of COX-2 and production of PGE2. Moreover, Bay 11–7082 also inhibited IL-1β-induced expression of COX-2 and production of PGE2. The inhibitory effect of lactoferrin on the IL-1β induced expression of COX-2 or production of PGE2 was mediated at least in part via suppression of NF-κB activation. Conclusions: Our data determine camel lactoferrin as a novel inhibitor of IL-1β-induced activation of NF-κB signaling events and production of cartilage-degrading molecule PGE2 via inhibition of COX-2 expressions. These results may have important implications for the development of novel therapeutic strategies for the prevention/treatment of OA and other degenerative/inflammatory diseases. SUMMARY Lactoferrin shows anti-arthritic activity in IL-1β stimulated primary human chondrocytes. Lactoferrin inhibits IL-1β-induced NF-κB activation. Lactoferrin inhibits production of cartilage degrading PGE2 via inhibition of COX-2 expression.
Abbreviations Used: OA: Osteoarthritis IL-1β: Interleukin-1 beta NF-κB: Nuclear factor-kappa B COX-2: cyclooxygenase-2 PGE2: prostaglandin E2
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Affiliation(s)
- Naila Rasheed
- Department of Medical Biochemistry, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Abdullah Alghasham
- Department of Pharmacology and Therapeutics, College of Medicine, Qassim University, Buraidah, KSA
| | - Zafar Rasheed
- Department of Medical Biochemistry, College of Medicine, Qassim University, Buraidah, Saudi Arabia
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288
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Evidence for a central mode of action for etoricoxib (COX-2 inhibitor) in patients with painful knee osteoarthritis. Pain 2016; 157:1634-1644. [DOI: 10.1097/j.pain.0000000000000562] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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289
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Soriano-Maldonado A, Klokker L, Bartholdy C, Bandak E, Ellegaard K, Bliddal H, Henriksen M. Intra-Articular Corticosteroids in Addition to Exercise for Reducing Pain Sensitivity in Knee Osteoarthritis: Exploratory Outcome from a Randomized Controlled Trial. PLoS One 2016; 11:e0149168. [PMID: 26871954 PMCID: PMC4752217 DOI: 10.1371/journal.pone.0149168] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 01/28/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess the effects of one intra-articular corticosteroid injection two weeks prior to an exercise-based intervention program for reducing pain sensitivity in patients with knee osteoarthritis (OA). DESIGN Randomized, masked, parallel, placebo-controlled trial involving 100 participants with clinical and radiographic knee OA that were randomized to one intra-articular injection on the knee with either 1 ml of 40 mg/ml methylprednisolone (corticosteroid) dissolved in 4 ml lidocaine (10 mg/ml) or 1 ml isotonic saline (placebo) mixed with 4 ml lidocaine (10 mg/ml). Two weeks after the injections all participants undertook a 12-week supervised exercise program. Main outcomes were changes from baseline in pressure-pain sensitivity (pressure-pain threshold [PPT] and temporal summation [TS]) assessed using cuff pressure algometry on the calf. These were exploratory outcomes from a randomized controlled trial. RESULTS A total of 100 patients were randomized to receive either corticosteroid (n = 50) or placebo (n = 50); 45 and 44, respectively, completed the trial. Four participants had missing values for PPT and one for TS at baseline; thus modified intention-to-treat populations were analyzed. The mean group difference in changes from baseline at week 14 was 0.6 kPa (95% CI: -1.7 to 2.8; P = 0.626) for PPT and 384 mm×sec (95% CI: -2980 to 3750; P = 0.821) for TS. CONCLUSIONS These results suggest that adding intra-articular corticosteroid injection 2 weeks prior to an exercise program does not provide additional benefits compared to placebo in reducing pain sensitivity in patients with knee OA. TRIAL REGISTRATION EU clinical trials (EudraCT): 2012-002607-18.
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Affiliation(s)
- Alberto Soriano-Maldonado
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Louise Klokker
- The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | - Cecilie Bartholdy
- The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark
- Department of Physical and Occupational Therapy, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | - Elisabeth Bandak
- The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | - Karen Ellegaard
- The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | - Henning Bliddal
- The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | - Marius Henriksen
- The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark
- Department of Physical and Occupational Therapy, Copenhagen University Hospital Bispebjerg and Frederiksberg, Frederiksberg, Denmark
- * E-mail:
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290
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Moss P, Knight E, Wright A. Subjects with Knee Osteoarthritis Exhibit Widespread Hyperalgesia to Pressure and Cold. PLoS One 2016; 11:e0147526. [PMID: 26809009 PMCID: PMC4726459 DOI: 10.1371/journal.pone.0147526] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 01/05/2016] [Indexed: 12/22/2022] Open
Abstract
Hyperalgesia to mechanical and thermal stimuli are characteristics of a range of disorders such as tennis elbow, whiplash and fibromyalgia. This study evaluated the presence of local and widespread mechanical and thermal hyperalgesia in individuals with knee osteoarthritis, compared to healthy control subjects. Twenty-three subjects with knee osteoarthritis and 23 healthy controls, matched for age, gender and body mass index, were recruited for the study. Volunteers with any additional chronic pain conditions were excluded. Pain thresholds to pressure, cold and heat were tested at the knee, ipsilateral heel and ipsilateral elbow, in randomized order, using standardised methodology. Significant between-groups differences for pressure pain and cold pain thresholds were found with osteoarthritic subjects demonstrating significantly increased sensitivity to both pressure (p = .018) and cold (p = .003) stimuli, compared with controls. A similar pattern of results extended to the pain-free ipsilateral ankle and elbow indicating widespread pressure and cold hyperalgesia. No significant differences were found between groups for heat pain threshold, although correlations showed that subjects with greater sensitivity to pressure pain were also likely to be more sensitive to both cold pain and heat pain. This study found widespread elevated pain thresholds in subjects with painful knee osteoarthritis, suggesting that altered nociceptive system processing may play a role in ongoing arthritic pain for some patients.
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Affiliation(s)
- Penny Moss
- School of Physiotherapy and Exercise Science, Curtin University of Technology, Perth, Western Australia, Australia
- * E-mail:
| | - Emma Knight
- School of Physiotherapy and Exercise Science, Curtin University of Technology, Perth, Western Australia, Australia
| | - Anthony Wright
- School of Physiotherapy and Exercise Science, Curtin University of Technology, Perth, Western Australia, Australia
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Evidence of Nervous System Sensitization in Commonly Presenting and Persistent Painful Tendinopathies: A Systematic Review. J Orthop Sports Phys Ther 2015; 45:864-75. [PMID: 26390275 DOI: 10.2519/jospt.2015.5895] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Systematic review. Objectives To elucidate if there is sensitization of the nervous system in those with persistent rotator cuff (shoulder), lateral elbow, patellar, and Achilles tendinopathies. Background Tendinopathy can be difficult to treat, and persistent intractable pain and dysfunction are frequent. It is hypothesized that induction or maintenance of persistent pain in tendinopathy may be, at least in part, based on changes in the nervous system. Methods The PRISMA guidelines were followed. Relevant articles were identified through a computerized search in Embase, PubMed, and Web of Science, followed by a manual search of reference lists of retained articles. To be eligible, studies had to include quantitative sensory testing and evaluate individuals diagnosed with a persistent tendinopathy of the rotator cuff (shoulder), lateral elbow, patella, or Achilles tendon. Methodological quality assessment was evaluated with the Newcastle-Ottawa Scale. Results In total, 16 full-text articles met the criteria for inclusion, of which the majority were case-control studies with heterogeneous methodological quality. No studies on Achilles tendinopathy were found. Mechanical algometry was the predominant quantitative sensory testing used. Lowered pressure pain threshold was observed across different tendinopathies at the site of tendinopathy, as well as at other sites, the latter being suggestive of central sensitization. Conclusion Although more research on sensory abnormalities is warranted, it appears likely that there is an association between persistent tendon pain and sensitization of the nervous system. This evidence is primarily from studies of upper-limb tendinopathy, and caution should be exercised with inference to lower-limb tendinopathy. J Orthop Sports Phys Ther 2015;45(11):864-875. Epub 21 Sep 2015. doi:10.2519/jospt.2015.5895.
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292
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Miller RE, Tran PB, Sondoqah A, Raghu P, Ishihara S, Miller RJ, Malfait AM. The Role of Peripheral Nociceptive Neurons in the Pathophysiology of Osteoarthritis Pain. Curr Osteoporos Rep 2015; 13:318-26. [PMID: 26233284 PMCID: PMC4596062 DOI: 10.1007/s11914-015-0280-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Knee osteoarthritis is characterized by progressive damage and remodeling of all tissues in the knee joint. Pain is the main symptom associated with knee osteoarthritis. Recent clinical and pre-clinical studies have provided novel insights into the mechanisms that drive the pain associated with joint destruction. In this narrative review, we describe current knowledge regarding the changes in the peripheral and central nervous systems that occur during the progression of osteoarthritis and discuss how therapeutic interventions may provide pain relief.
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Affiliation(s)
- Rachel E. Miller
- Department of Internal Medicine, Division of Rheumatology, Rush University Medical Center, 1611 W. Harrison St, Suite 510, Chicago, IL 60612
- Department of Biochemistry, Rush University Medical Center, 1611 W. Harrison St, Suite 510, Chicago, IL 60612
| | - Phuong B. Tran
- Department of Internal Medicine, Division of Rheumatology, Rush University Medical Center, 1611 W. Harrison St, Suite 510, Chicago, IL 60612
| | - Alia Sondoqah
- Department of Biochemistry, Rush University Medical Center, 1611 W. Harrison St, Suite 510, Chicago, IL 60612
| | - Padmanabhan Raghu
- Department of Internal Medicine, Division of Rheumatology, Rush University Medical Center, 1611 W. Harrison St, Suite 510, Chicago, IL 60612
| | - Shingo Ishihara
- Department of Internal Medicine, Division of Rheumatology, Rush University Medical Center, 1611 W. Harrison St, Suite 510, Chicago, IL 60612
| | - Richard J. Miller
- Department of Pharmacology, Northwestern University, Lurie 8-125, 303 E. Superior St, Chicago, IL 60611
| | - Anne-Marie Malfait
- Department of Internal Medicine, Division of Rheumatology, Rush University Medical Center, 1611 W. Harrison St, Suite 510, Chicago, IL 60612
- Department of Biochemistry, Rush University Medical Center, 1611 W. Harrison St, Suite 510, Chicago, IL 60612
- Corresponding author Anne-Marie Malfait, MD, PhD, Associate Professor of Medicine, , T: 312-563-2925, F: 312-563-2267
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293
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Glover TL, Horgas AL, Fillingim RB, Goodin BR. Vitamin D status and pain sensitization in knee osteoarthritis: a critical review of the literature. Pain Manag 2015; 5:447-53. [PMID: 26399462 DOI: 10.2217/pmt.15.43] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Diagnostic imaging of disease severity has been found thus far to be a relatively modest predictor of knee osteoarthritis (OA) pain and disability, suggesting that other factors likely contribute to clinical symptoms in this condition. Recent evidence suggests that sensitization of the peripheral and central pathways that process nociceptive information (i.e., pain sensitization) is an important contributor to knee OA clinical symptoms. Furthermore, low levels of vitamin D have been found to be associated with the presence of pain sensitization, as well as the overall experience of clinical pain severity in knee OA. African-Americans with knee OA may be at increased risk for poor clinical outcomes given evidence of lower vitamin D levels as well as greater pain sensitization compared with non-Hispanic whites. Whether vitamin D supplementation is effective for alleviating knee OA clinical symptoms is an important topic to be addressed in future research with racially diverse samples that include sufficient numbers of African-Americans.
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Affiliation(s)
- Toni L Glover
- University of Florida, College of Nursing, Biobehavioral Nursing Science, Gainesville, FL 32610, USA.,University of Florida, Pain Research & Intervention Center of Excellence (PRICE), Gainesville, FL 32610, USA
| | - Ann L Horgas
- University of Florida, College of Nursing, Biobehavioral Nursing Science, Gainesville, FL 32610, USA
| | - Roger B Fillingim
- University of Florida, Pain Research & Intervention Center of Excellence (PRICE), Gainesville, FL 32610, USA.,University of Florida, College of Dentistry, Department of Community Dentistry & Behavioral Science, Gainesville, FL 32610, USA
| | - Burel R Goodin
- University of Alabama at Birmingham, Departments of Psychology & Anesthesiology & Perioperative Medicine, Birmingham, AL 35294, USA
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