Arthritis

Updated 17 November 2015

Joint pain in seniors reduces quality of life

A study indicates that most older people with knee pain also have pain at other sites and tend to have more limited physical function and suffer more from depression and anxiety.

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Joint pain, especially in the knees, is a common complaint in older patients and can impact quality of life.

Pain at other sites


A team of researchers recently set out to examine how often knee pain is accompanied by pain elsewhere in the body and whether the presence of multiple joint pain affects older patients' general health and psychological status.

Their findings, published in the August 2005 issue of Arthritis & Rheumatism (http://www.interscience.wiley.com/journal/arthritis), indicate that most people with knee pain also have pain at other sites and these patients tend to have more limited physical function and suffer more from depression and anxiety.

Led by Peter Croft of Keele University in Keele, UK, the authors surveyed a total of 5,364 patients aged 50 years or older who were registered with 3 general practices in North Staffordshire, UK. Each participant completed a questionnaire that included a body mannequin on which they shaded any areas where they had experienced pain for one or more days during the last month.

Read: Sugar injections ease knee arthritis pain

Pain was categorized into regions, which included: knee, neck, hand, lower back, hip, and foot and ankle. Based on where the pain occurred, participants were then grouped into (i) those with no pain at all, (ii) those with knee pain, either alone or with pain in 1 or 2 or more locations elsewhere, (iii) those with no knee pain but with pain in 1, 2 or 3 or more locations other than the knee.

Standard health survey


A standard health survey used to determine the influence of pain elsewhere on general health was also completed, as well as an index to measure pain and disability specifically related to the knee. Obesity, anxiety and depression, all of which are linked to widespread pain, were also measured using various scales.

Of those surveyed, slightly more than one-third (1,909) ended up in the no pain group, 41% (2,210) in the knee pain group, and 23% (1,245) in the pain elsewhere group. Decreased physical function increased with the number of pains in the body, both in the knee and elsewhere.

In those with at least 3 pain regions, the subgroup that included knee pain had worse physical function. This group was also more likely to be depressed than either those with no pain at all or those who had pain in a location other than the knee, even if it was in 3 or more regions.

Poorer general and psychological health


The results indicate that knee pain does not tend to occur by itself, and that when it occurs with pain in other regions, it is associated with poorer general and psychological health. In addition, the results suggest a link between the extent of pain in the body and the impact of pain in a particular region.

"We have shown that knee-specific pain and disability are actually worse in the presence of pains elsewhere than the knee, even after accounting for poorer psychological health," the authors state.

"The practical importance of our findings is that the presence and extent of pain in other sites may be an important determinant of outcome in patients who present with knee pain, just as it appears to be in those who present with back pain [as shown in previous studies]," the authors conclude.

In addition, they note that managing pain in one region such as the knee (with local treatments such as physiotherapy or total knee replacement) might have beneficial effects on the general perception of pain and on the frequency and impact of pains elsewhere in the body.

Read more:

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Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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