Duration of symptoms is associated with conditioned pain modulation and somatosensory measures in knee osteoarthritis

Abstract Objectives To assess the immediate and three days postintervention effect of one dry needling session compared to one sham needling session on pain, central pain processing, muscle co-contraction and spatiotemporal parameters during gait in knee osteoarthritis patients. Methods A double-blind randomized controlled trial was conducted. Sixty-one knee osteoarthritis patients were randomly assigned to the dry needling or sham needling group. Primary outcomes were pain and central pain processing. Secondary outcomes included muscle co-contraction and spatiotemporal parameters during gait. Patients were assessed at baseline and 15 min after the intervention, and pain also three days after the intervention. Linear mixed models were used to examine between- and within-group differences. Results No significant between-group differences for pain were found, but within-group scores showed a significant decrease 15 min after sham needling and three days after dry needling. The mean conditioned pain modulation effect measured at the m. Trapezius worsened significantly 15 min after sham needling compared to after dry needling (between-group difference). However, individual conditioned pain modulation percentage scores remained stable over time. Various significant within-group differences were found 15 min after sham needling: a decrease of conditioned pain modulation measured at m. Quadriceps and m. Trapezius and stride- and step-time scores, and an increase in step length and widespread pain pressure threshold. A significant decrease in muscle co-contraction index of the m. Vastus Medialis and Semitendinosus was found as within-group difference 15 min after dry needling. Conclusions Dry needling has no larger effect on pain, central pain processing, muscle co-contraction and gait pattern 15 min and three days postintervention compared to sham needling. Mean conditioned pain modulation scores worsened after sham needling compared to after dry needling. Further research remains necessary.

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(294) The association of psychological resilience and conditioned pain modulation is moderated by optimism in adults with symptomatic knee osteoarthritis

Journal of Pain ◽

10.1016/j.jpain.2017.02.187 ◽

2017 ◽

Vol 18 (4) ◽

pp. S49

Author(s):

K. Thompson ◽

H. Bulls ◽

K. Sibille ◽

E. Bartley ◽

L. Bradley ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Pain Modulation ◽

Conditioned Pain Modulation ◽

Psychological Resilience ◽

Symptomatic Knee Osteoarthritis ◽

Symptomatic Knee

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The Association of Pain Sensitization and Conditioned Pain Modulation to Pain Patterns in Knee Osteoarthritis

Arthritis Care & Research ◽

10.1002/acr.24437 ◽

2020 ◽

Author(s):

Lisa C. Carlesso ◽

Laura Frey Law ◽

Na Wang ◽

Michael Nevitt ◽

Cora E. Lewis ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Pain Modulation ◽

Conditioned Pain Modulation ◽

Pain Sensitization

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POS1281 HOW DOES OBESITY INFLUENCE THE FEATURES OF KNEE OSTEOARTHRITIS?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3602 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 923.4-924

Author(s):

H. Hachfi ◽

D. Khalifa ◽

M. Brahem ◽

N. Ben Chekaya ◽

M. Younes

Keyword(s):

Knee Osteoarthritis ◽

Functional Impairment ◽

Statistical Significance ◽

Obese Group ◽

University Hospital ◽

Obese Patients ◽

Cross Sectional ◽

Duration Of Symptoms ◽

Lequesne Index ◽

The Mean

Background:Knee osteoarthritis and obesity are both major health problems. It is now admitted that the prevalence of knee osteoarthritis gets higher with obesity and that weight loss helps knee function and allows patients to avoid surgery.Objectives:The aim of this study was to study the influence of obesity on knee osteoarthritis features.Methods:A cross-sectional study was conducted in the university hospital Taher Sfar of Tunisia over a period of 6 months. Patients who had knee osteoarthritis confirmed by radiographs were included. Sociodemographic, clinical, radiological and therapeutic data were collected from medical records and visits. Obesity was defined by a body mass index (BMI) ≥30. Functional impairment was assessed by the Womac index and Lequesne index.Results:The study included 186 patients. There were 31 males and 155 femmes. The mean age was 60±10 years. The percentage of obese patients was 53,8%. The mean age was similar in both groups obese and non obese. There were more women in the obese group compared to the non obese group (p=0.0001), more patients who had diabetes mellitus and dyslipidemia (p=0.002). Non-obese patients had a shorter duration of symptoms with no statistical significance (p=0.151). Obese patients had more involvement of both knees (p<0.0001). Obesity did not have an impact on pain severity. Severity of radiological images (p=0,0001) were more frequent in obese patients. Functional impairment was similar in both groups. However, the percentage of patients having a very important functional impairment with Lequesne index was higher in obese patients (p<0.029). Obese patients also needed more physical therapy sessions (p=0.035).Conclusion:Knee osteoarthritis in obese patients is characterized with the femlae gender predominance, bilateral knee involvement, and a more severe images on radiographs. Thus the need for better control of weight and the importance of physical activity.References:[1]Coggon D, Reading I, Croft P, et al. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord J Int Assoc Study Obes 2001; 25: 622–627.Disclosure of Interests:None declared

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Pain perception in chronic knee osteoarthritis with varying levels of pain inhibitory control: an exploratory study

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0016 ◽

2020 ◽

Vol 20 (4) ◽

pp. 651-661

Author(s):

Paulo E. P. Teixeira ◽

Hanan I. Zehry ◽

Swapnali Chaudhari ◽

Laura Dipietro ◽

Felipe Fregni

Keyword(s):

Knee Osteoarthritis ◽

Pain Intensity ◽

Pain Perception ◽

Small Sample Size ◽

Linear Regression Analysis ◽

Small Sample ◽

Pain Modulation ◽

Clinical Variables ◽

Pain Scores ◽

Intensity Perception

AbstractBackground and aimsPain is a disabling symptom in knee osteoarthritis (KOA) and its underlying mechanism remains poorly understood. Dysfunction of descending pain modulatory pathways and reduced pain inhibition enhance pain facilitation in many chronic pain syndromes but do not fully explain pain levels in chronic musculoskeletal conditions. The objective of this study is to explore the association of clinical variables with pain intensity perception in KOA individuals with varying levels of Conditioned Pain Modulation (CPM) response.MethodsThis is a cross-sectional, exploratory analysis using baseline data of a randomized clinical trial investigating the effects of a non-invasive brain stimulation treatment on the perception of pain and functional limitations due to KOA. Sixty-three subjects with KOA were included in this study. Data on pain perception, mood perception, self-reported depression, physical function, quality of life, and quantitative sensory testing was collected. Multiple linear regression analysis was performed to explore the association between the clinical variables with pain perception for individuals with different levels of CPM response.ResultsFor KOA patients with limited CPM response, perception of limitations at work/other activities due to emotional problems and stress scores were statistically significantly associated with pain scores, F(2, 37) = 7.02, p < 0.01. R-squared = 0.275. For KOA patients with normal CPM response, general health perception scores were statistically significantly associated with pain scores, F(1, 21) = 5.60, p < 0.05. R-squared = 0.2104. Limitations of this study include methodology details, small sample size and study design characteristics.ConclusionsPain intensity perception is associated differently with clinical variables according to the individual CPM response. Mechanistic models to explain pain perception in these two subgroups of KOA subjects are discussed.

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