Factors associated with pain pressure threshold in both local and remote sites in knee osteoarthritis

Abstract

AbstractBackgroundKnee osteoarthritis (KOA) is a prevalent condition, and its most frequent symptom is pain that often leads to disability. Pain sensitization is a core feature of KOA, and it can be measured through quantitative sensory testing protocols such as pain pressure threshold (PPT). However, there is a lack of understanding about the factors that may influence changes in PPTs in the KOA population.ObjectiveTo explore the clinical and functional factors associated with PPTs in a sample of people with chronic KOA pain and to compare models of local (knees) and remote (thenar regions) sites.DesignCross‐sectional analysis of a prospective cohort.SettingPrimary care in public institution.Participants113 adults with KOA.InterventionN/A.Main Outcome MeasuresMultivariable regression analyses evaluating demographic, clinical, and functional variables that could be associated with local and remote PPTs (main outcomes) were performed.ResultsBoth thenar region (adjusted‐R2: 0.29) and knee (adjusted‐R2: 0.45) models had the same significant negative association with being a female, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain levels (thenar: β: −0.15, p = .002; knee: β: −0.2, p < .001), and the 10‐Meter Walking Test (thenar: β: −0.05, p = .038; knee: β: −0.08, p = .004). A small significant positive association with depressive symptoms was identified in both models, which acted as a confounder for WOMAC pain and was likely affected by unmeasured confounders.ConclusionsPPTs in KOA pain are associated with functional outcomes such as the 10‐Meter Walking Test and activity‐related pain intensity; thus more disability is associated with smaller pain thresholds. Similarity between models may suggest central sensitization.