Research Article
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Neuropathic pain adversely affects functional status, quality of life and depression in patients with knee osteoarthritis

Year 2019, Volume: 11 Issue: 1, 15 - 21, 31.03.2019
https://doi.org/10.21601/ortadogutipdergisi.435075

Abstract

Aim:
The aim of our study was to determine the existence of neuropathic pain (NP) in
knee OA and its association with risk factors, functional status, quality of
life, and depression.

Material
and Methods:
This was a descriptive study. A
total of 100 patients (90 female, 10
male) with knee OA were enrolled. Data including age, gender, educational
status, working status, body mass index, and symptom duration were obtained
from patients.
Patients
were divided into three groups according to the PainDETECT scores: likely NP,
possible NP, unlikely NP.
Patients'
pain severity was assessed using visual analogue scale (VAS). For the presence
of NP, PainDETECT scale was used. Functional status was evaluated by Western
Ontario and McMaster University Osteoarthritis Index (WOMAC). Quality of life
was assessed using Short Form-36 questionnaire (SF-36) and depression level was
evaluated using Hamilton Depression Scale (HAM-D). Kellgren-Lawrence grading
system was used to determine the radiologic severity.
Pain,
functional status, quality of life and depression were compared among the
groups.

Results: Of the total, 18 patients (18%) were
in the likely NP group; 23 patients (23%) were in the possible NP group and 59
(59%) patients were in the unlikely NP group.
No
significant differences were detected between the groups in sociodemographic
data (p > 0.05). Significant differences were detected in symptom duration, VAS,
WOMAC, SF-36 physical functioning subscale, physical role functioning subscale,
social role functioning subscale, vitality subscale, bodily pain subscale,
general health perceptions subscale and HAM-D scores among the groups (p <
0.05). PainDETECT scores were significantly correlated with VAS, WOMAC, SF-36
subscales, and HAM-D (p < 0.05).







Conclusion:
This study revealed that NP is associated with severe pain, reduced
functionality, impairment in quality of life, and higher depression scores in
patients with knee OA. 

References

  • 1. Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum 2012; 64: 1697–707.
  • 2. Kawano MM, Araújo IL, Castro MC, Matos MA. Assessment of quality of life in patients with knee osteoarthritis. Acta Ortop Bras 2015; 23: 307-10.
  • 3. Felson DT. The sources of pain in knee osteoarthritis. Curr Opin Rheumatol 2005; 17: 624-8.
  • 4. Arendt-Nielsen L. Pain sensitisation in osteoarthritis. Clin Exp Rheumatol 2017; 107: 68-74.
  • 5. Martindale JC, Wilson AW, Reeve AJ, Chessell IP, Headley PM. Chronic secondary hypersensitivity of dorsal horn neurons following inflammation of the knee joint. Pain 2007; 133: 79-86.
  • 6. Suri S, Gill SE, Massena de Camin S, Wilson D, McWilliams DF, Walsh DA. Neurovascular invasion at the osteochondral junction and in osteophytes in osteoarthritis. Ann Rheum Dis 2007; 66: 1423-28.
  • 7. Mease PJ, Hanna S, Frakes EP, Altman RD. Pain mechanisms in osteoarthritis: understanding the role of central pain and current approaches to its treatment. J Rheumatol 2011; 38: 1546-51.
  • 8. Kidd B. Mechanisms of pain in osteoarthritis. HSS J 2012; 8: 26-28.
  • 9. Ohtori S, Inoue G, Orita S, et al. Efficacy of combination of meloxicam and pregabalin for pain in knee osteoarthritis. Yonsei Med J 2013; 54: 1253-8.
  • 10. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16: 494-502.
  • 11. McConnell S, Kolopack P, Davis AM. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): a review of its utility and measurement properties. Arthritis Rheum 2001; 45: 453-61.
  • 12. Tüzün EH, Eker L, Aytar A, Dağkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage 2005; 13: 28-33.
  • 13. Hochman JR, Davis AM, Elkayam J, Gagliese L, Hawker GA. Neuropathic pain symptoms on the modified painDETECT correlate with signs of central sensitization in knee osteoarthritis. Osteoarthritis Cartilage 2013; 21: 1236-42.
  • 14. Alkan H, Ardic F, Erdogan C, Sahin F, Sarsan A, Findikoglu G. Turkish version of the painDETECT questionnaire in the assessment of neuropathic pain: a validity and reliability study. Pain Med 2013; 14: 1933-43.
  • 15. Pınar R. Reliability and construct validity of the SF-36 in Turkish cancer patients. Qual Life Res 2005; 14: 259-64.
  • 16. Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473-83.
  • 17. Akdemir A, Türkçapar MH, Orsel SD, Demirergi N, Dag I, Ozbay MH. Reliability and validity of the Turkish version of the Hamilton Depression Rating Scale. Compr Psychiatry 2001; 42: 161-65.
  • 18. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 56–62.
  • 19. Soni A, Batra RN, Gwilym SE, et al. Neuropathic features of joint pain: a community-based study. Arthritis Rheum 2013; 65: 1942–9.
  • 20. Hochman JR, French MR, Bermingham SL, Hawker GA. The nerve of osteoarthritis pain. Arthritis Care Res (Hoboken) 2010; 62: 1019-23.
  • 21. Roubille C, Raynauld JP, Abram F, et al. The presence of meniscal lesions is a strong predictor of neuropathic pain in symptomatic knee osteoarthritis: a cross-sectional pilot study. Arthritis Res Ther 2014; 16: 507.
  • 22. French HP, Smart KM, Doyle F. Prevalence of neuropathic pain in knee or hip osteoarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum 2017; 47: 1-8.
  • 23. Yücel A, Çimen A. Neuropathic pain: Mechanisms, diagnosis and treatment. 2005; 17: 5-13.
  • 24. Lee YC, Lu B, Bathon JM, et al. Pain sensitivity and pain reactivity in osteoarthritis. Arthritis Care Res (Hoboken) 2011; 63: 320-7.
  • 25. Neogi T, Frey-Law L, Scholz J, et al. Sensitivity and sensitisation in relation to pain severity in knee osteoarthritis: trait or state? Ann Rheum Dis 2015; 74: 682-8.
  • 26. Gölge UH, Şen HM, Kuyucu E, et al. Investigation of knee pain in osteoarthritic and neuropathic pain awareness. Acta Orthop Belg 2015; 81: 639-46.
  • 27. Garip Y, Eser F, Kılıçarslan A, Bodur H. Prevalence of Neuropathic Pain in Rheumatic Disorders: Association with Disease Activity, Functional Status and Quality of Life. Arch Rheumatol 2015; 30: 231-7.
  • 28. Aşkın A, Özkan A, Tosun A, Demirdal ÜS, İsnaç F. Quality of life and functional capacity are adversely affected in osteoarthritis patients with neuropathic pain. Kaohsiung J Med Sci 2017; 33:152-8.
  • 29. Hochman JR, Gagliese L, Davis AM, Hawker GA. Neuropathic pain symptoms in a community knee OA cohort. Osteoarthritis Cartilage 2011; 19: 647–54.
  • 30. Mesci N, Mesci E, Külcü DG. Association of neuropathic pain with ultrasonographic measurements of femoral cartilage thickness and clinical parameters in patients with knee osteoarthritis. J Phys Ther Sci 2016; 28: 2190-5.
  • 31. Ohtori S, Orita S, Yamashita M, et al. Existence of a neuropathic pain component in patients with osteoarthritis of the knee. Yonsei Med J 2012; 53: 801-5.

Nöropatik ağrı diz osteoartritli hastalarda fonksiyonel durumu, yaşam kalitesini ve depresyonu olumsuz etkiler

Year 2019, Volume: 11 Issue: 1, 15 - 21, 31.03.2019
https://doi.org/10.21601/ortadogutipdergisi.435075

Abstract

Amaç:
Çalışmamızın amacı, diz OA'da nöropatik ağrı (NA) varlığını ve risk faktörleri,
fonksiyonel durum, yaşam kalitesi ve depresyon ile ilişkisini belirlemektir.

Gereç
ve Yöntemler:
Bu tanımlayıcı bir çalışmadır. Diz
OA’i tanılı toplam 100 hasta (90 kadın, 10 erkek) çalışmaya alındı. Hastalardan
yaş, cinsiyet, eğitim durumu, çalışma durumu, vücut kütle indeksi ve semptom
süresini içeren veriler elde edildi. PainDETECT skorlarına göre hastalar üç
gruba ayrıldı: pozitif NA, muhtemel NA, negatif NA. Hastaların ağrı şiddeti görsel
analog skala (GAS) ile değerlendirildi. NA varlığı için PainDETECT ölçeği
kullanıldı. Fonksiyonel durum  Western
Ontario ve McMaster Üniversitesi Osteoartrit İndeksi (WOMAC) ile
değerlendirildi. Yaşam kalitesi Kısa Form-36 anketi (KF-36), depresyon düzeyi
Hamilton Depresyon Skalası (HAM-D) kullanılarak değerlendirildi. Radyolojik
değerlendirme için Kellgren-Lawrence evreleme sistemi kullanıldı. Gruplar
arasında ağrı, fonksiyonel durum, yaşam kalitesi ve depresyon karşılaştırıldı.

Bulgular:
Toplam 18 hasta (%18) pozitif NA grubunda, 23 hasta (%23) muhtemel NA grubunda,
59 hasta negatif NA grubundaydı. Sosyodemografik verilerde gruplar arasında
anlamlı fark saptanmadı (p > 0.05). Semptom süresi, GAS, WOMAC, KF-36
fiziksel fonksiyon alt ölçeği, fiziksel rol işleyişi alt ölçeği, sosyal
fonksiyon alt ölçeği, canlılık alt ölçeği, ağrı alt ölçeği, genel sağlık durumu
alt ölçeği ve HAM-D skorları arasında gruplar arasında anlamlı fark bulundu (p <
0.05). PainDETECT skorları GAS, WOMAC, KF-36 alt ölçekleri ve HAM-D ile anlamlı
olarak koreleydi (p < 0.05).







Sonuç:
Bu çalışma diz OA hastalarında NA'nın şiddetli ağrı, azalmış işlevsellik, yaşam
kalitesinde bozulma ve daha yüksek depresyon skorları ile ilişkili olduğunu
ortaya koymuştur. 

References

  • 1. Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum 2012; 64: 1697–707.
  • 2. Kawano MM, Araújo IL, Castro MC, Matos MA. Assessment of quality of life in patients with knee osteoarthritis. Acta Ortop Bras 2015; 23: 307-10.
  • 3. Felson DT. The sources of pain in knee osteoarthritis. Curr Opin Rheumatol 2005; 17: 624-8.
  • 4. Arendt-Nielsen L. Pain sensitisation in osteoarthritis. Clin Exp Rheumatol 2017; 107: 68-74.
  • 5. Martindale JC, Wilson AW, Reeve AJ, Chessell IP, Headley PM. Chronic secondary hypersensitivity of dorsal horn neurons following inflammation of the knee joint. Pain 2007; 133: 79-86.
  • 6. Suri S, Gill SE, Massena de Camin S, Wilson D, McWilliams DF, Walsh DA. Neurovascular invasion at the osteochondral junction and in osteophytes in osteoarthritis. Ann Rheum Dis 2007; 66: 1423-28.
  • 7. Mease PJ, Hanna S, Frakes EP, Altman RD. Pain mechanisms in osteoarthritis: understanding the role of central pain and current approaches to its treatment. J Rheumatol 2011; 38: 1546-51.
  • 8. Kidd B. Mechanisms of pain in osteoarthritis. HSS J 2012; 8: 26-28.
  • 9. Ohtori S, Inoue G, Orita S, et al. Efficacy of combination of meloxicam and pregabalin for pain in knee osteoarthritis. Yonsei Med J 2013; 54: 1253-8.
  • 10. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16: 494-502.
  • 11. McConnell S, Kolopack P, Davis AM. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): a review of its utility and measurement properties. Arthritis Rheum 2001; 45: 453-61.
  • 12. Tüzün EH, Eker L, Aytar A, Dağkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage 2005; 13: 28-33.
  • 13. Hochman JR, Davis AM, Elkayam J, Gagliese L, Hawker GA. Neuropathic pain symptoms on the modified painDETECT correlate with signs of central sensitization in knee osteoarthritis. Osteoarthritis Cartilage 2013; 21: 1236-42.
  • 14. Alkan H, Ardic F, Erdogan C, Sahin F, Sarsan A, Findikoglu G. Turkish version of the painDETECT questionnaire in the assessment of neuropathic pain: a validity and reliability study. Pain Med 2013; 14: 1933-43.
  • 15. Pınar R. Reliability and construct validity of the SF-36 in Turkish cancer patients. Qual Life Res 2005; 14: 259-64.
  • 16. Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473-83.
  • 17. Akdemir A, Türkçapar MH, Orsel SD, Demirergi N, Dag I, Ozbay MH. Reliability and validity of the Turkish version of the Hamilton Depression Rating Scale. Compr Psychiatry 2001; 42: 161-65.
  • 18. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 56–62.
  • 19. Soni A, Batra RN, Gwilym SE, et al. Neuropathic features of joint pain: a community-based study. Arthritis Rheum 2013; 65: 1942–9.
  • 20. Hochman JR, French MR, Bermingham SL, Hawker GA. The nerve of osteoarthritis pain. Arthritis Care Res (Hoboken) 2010; 62: 1019-23.
  • 21. Roubille C, Raynauld JP, Abram F, et al. The presence of meniscal lesions is a strong predictor of neuropathic pain in symptomatic knee osteoarthritis: a cross-sectional pilot study. Arthritis Res Ther 2014; 16: 507.
  • 22. French HP, Smart KM, Doyle F. Prevalence of neuropathic pain in knee or hip osteoarthritis: A systematic review and meta-analysis. Semin Arthritis Rheum 2017; 47: 1-8.
  • 23. Yücel A, Çimen A. Neuropathic pain: Mechanisms, diagnosis and treatment. 2005; 17: 5-13.
  • 24. Lee YC, Lu B, Bathon JM, et al. Pain sensitivity and pain reactivity in osteoarthritis. Arthritis Care Res (Hoboken) 2011; 63: 320-7.
  • 25. Neogi T, Frey-Law L, Scholz J, et al. Sensitivity and sensitisation in relation to pain severity in knee osteoarthritis: trait or state? Ann Rheum Dis 2015; 74: 682-8.
  • 26. Gölge UH, Şen HM, Kuyucu E, et al. Investigation of knee pain in osteoarthritic and neuropathic pain awareness. Acta Orthop Belg 2015; 81: 639-46.
  • 27. Garip Y, Eser F, Kılıçarslan A, Bodur H. Prevalence of Neuropathic Pain in Rheumatic Disorders: Association with Disease Activity, Functional Status and Quality of Life. Arch Rheumatol 2015; 30: 231-7.
  • 28. Aşkın A, Özkan A, Tosun A, Demirdal ÜS, İsnaç F. Quality of life and functional capacity are adversely affected in osteoarthritis patients with neuropathic pain. Kaohsiung J Med Sci 2017; 33:152-8.
  • 29. Hochman JR, Gagliese L, Davis AM, Hawker GA. Neuropathic pain symptoms in a community knee OA cohort. Osteoarthritis Cartilage 2011; 19: 647–54.
  • 30. Mesci N, Mesci E, Külcü DG. Association of neuropathic pain with ultrasonographic measurements of femoral cartilage thickness and clinical parameters in patients with knee osteoarthritis. J Phys Ther Sci 2016; 28: 2190-5.
  • 31. Ohtori S, Orita S, Yamashita M, et al. Existence of a neuropathic pain component in patients with osteoarthritis of the knee. Yonsei Med J 2012; 53: 801-5.
There are 31 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original article
Authors

Burhan Fatih Koçyiğit 0000-0002-6065-8002

Tuba Tülay Koca 0000-0002-4596-858X

Publication Date March 31, 2019
Published in Issue Year 2019 Volume: 11 Issue: 1

Cite

Vancouver Koçyiğit BF, Koca TT. Neuropathic pain adversely affects functional status, quality of life and depression in patients with knee osteoarthritis. otd. 2019;11(1):15-21.

e-ISSN: 2548-0251

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