Article

The presence of widespread pain is easily determined and is known to
increase the risk for persistent symptoms. The study hypothesis was
that people with no or minimal knee osteoarthritis (OA) and high Western Ontario
and McMaster Universities (WOMAC) Pain Scale scores would be more likely than
other subgroups to report widespread pain. DESIGN: A cross-sectional design was
used. METHODS: Data were obtained from the Multicenter Osteoarthritis Study,
which includes people with or at high risk for knee OA. The inclusion criteria
were met by 755 people with unilateral knee pain and 851 people with bilateral
knee pain. Widespread pain was assessed with body diagrams, and radiographic
Kellgren-Lawrence grades were recorded for each knee. Knee pain during daily
tasks was quantified with WOMAC Pain Scale scores. RESULTS: Compared with people
who had high levels of pain and knee OA, people with a low level of pain and a
high level of knee OA, and people with low levels of pain and knee OA, a higher
proportion of people with a high level of knee pain and a low level of knee OA
had widespread pain. This result was particularly true for people with bilateral
knee pain, for whom relative risk estimates ranged from 1.7 (95% confidence
interval=1.2-2.4) to 2.3 (95% confidence interval=1.6-3.3). LIMITATIONS: The
cross-sectional design was a limitation. CONCLUSIONS: People with either no or
minimal knee OA and a high level of knee pain during daily tasks are particularly
likely to report widespread pain. This subgroup is likely to be at risk for not
responding to knee OA treatment that focuses only on physical impairments.
Assessment of widespread pain along with knee pain intensity and OA status may
assist physical therapists in identifying people who may require additional
treatment.

Langue : ANGLAIS