Neuropathic Symptoms Worsen Quality of Life, Function in Hip, Knee Osteoarthritis
Participants completed the modified painDETECT questionnaire to identify possible neuropathic-like symptoms.
Neuropathic-like symptoms may affect pain-related quality of life ratings and function in patients with hip and knee osteoarthritis (OA), respectively, according to a study published in PLoS One.
The study included participants with hip (n=117) and knee (n=138) OA. Participants completed the modified painDETECT questionnaire (mPDQ) to identify possible neuropathic-like symptoms (indicated by a score >12). The researchers used the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) to assess function and the RAND 36-item Health Survey (RAND-36) to assess health-related quality of life. The results were adjusted for age, sex, body mass index, back disorder, painful body regions, comorbidities, previous surgery, pain intensity, and analgesic usage.
The mPDQ scores indicated that 37% of participants with hip OA and 46% of participants with knee OA had possible neuropathic phenotypes. Participants with neuropathic-like hip OA had lower scores on the pain-related aspects of health-related quality of life (difference on the RAND-36 bodily pain score: 6.8 points; P =.047) compared with participants without neuropathy. Among participants with knee OA, neuropathic symptoms were associated with diminished joint function (difference in WOMAC domains scores: 7.1-10.5 points; P <.05) and lower scores on the physical functioning aspect of health-related quality of life (difference in RAND-36 physical functioning score: 6.8 points; P =.016).
“As a substantial proportion of patients experienced neuropathic-like symptoms and none reported using analgesics to treat neuropathic-like symptoms specifically, patients [with OA] could benefit from pain phenotype screening and a more customized treatment for their underlying pain mechanism (eg centrally acting analgesics like antidepressants),” the researchers wrote.
Blikman T, Rienstra W, van Raay JJAM, et al. Neuropathic-like symptoms and the association with joint-specific function and quality of life in patients with hip and knee osteoarthritis. PLoS One. 2018 Jun 14;13(6):e0199165.