Impact of pain sensitisation on the quality of life of patients with knee osteoarthritis

Abstract

Objectives We aim to evaluate the effect on different ways of classifying pain sensitisation on impact and quality of life (QoL) in knee osteoarthritis (KOA). Methods We used baseline data from a cohort of consecutive patients with KOA listed for arthroplasty. We collected demographics and number of painful body sites. We measured pressure pain thresholds at the right forearm (PPT arm). Pain sensitisation was classified using: (1) widespread pain, (2) lowest 10th percentile of PPT arm and (3) PainDETECT questionnaire ≥13/38. Impact and QoL were assessed using Western Ontario and McMaster Universities Osteoarthritis Index and Short Form-36. Impact and QoL scores in patients with or without pain sensitisation were compared. We evaluated the association of pain sensitisation measures with QoL scores using multivariable regression. Results 233 patients (80% female, mean age 66 years) included in the analysis; 7.3%, 11.6% and 4.7% were classified as having pain sensitisation by widespread pain, low PPT arm and PainDETECT criteria, respectively. There was minimal overlap of patients as classified as pain sensitisation phenotype by different measures. Patients with pain sensitisation had poorer QoL compared with those without. Low PPT arm identified patients with poorer general health, while widespread pain and PainDETECT identified poorer QoL in more psychological domains. There was weak correlation between number of painful body sites and PainDETECT (rho=0.23, p<0.01), but no significant correlation with PPT arm. Conclusion Patients with KOA with pain sensitisation have poorer QoL compared with those without, regardless of classification method. Different criteria defined patients with different pattern of QoL impact.