Knee Osteoarthritis Symptom Duration Is Associated with Conditioned Pain Modulation and Vibration Perception Threshold Impairment

Kharma C. Foucher¹, Samuel Chmell² and Carol Courtney³, ¹Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, ²Orthopedic Surgery, University of Illinois at Chicago, Chicago, IL, ³Physical Therapy, University of Illinois at Chicago, Chicago, IL

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Neuromuscular Mechanisms, osteoarthritis and pain

Session Information

Date: Monday, October 22, 2018

Title: Osteoarthritis – Clinical Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Impaired descending pain inhibition has been observed in people with knee OA and may be associated with development of chronic pain as well as poorer treatment outcomes. In addition, higher (worse) vibration perception threshold (VPT) has also been observed in people with OA and linked to radiographic OA severity. It is not known how duration of symptoms may influence these neurophysiological measures. Our purpose was to evaluate the relationship between reported duration of symptoms and conditioned pain modulation (CPM), a measure of descending pain inhibition, as well as VPT. A secondary purpose was to determine whether these relationships differed in men and women. Methods: We evaluated 18 men and 27 women with moderate to severe knee OA. All subjects satisfied ACR OA classification criteria. Subjects were asked how long they had had OA symptoms. We assessed CPM using a submaximal-effort tourniquet test: Pressure pain threshold (PPT) at the symptomatic knee was evaluated before and after a noxious stimulus. CPM impairment was indicated by a ratio of pre-to-post stimulus PPT ≥1. VPT was assessed using a biothesiometer at the medial femoral condyle. Pearson correlations were used to determine whether there were associations between symptom duration and CPM and VPT. Chi-square and t-tests were used to identify potential sex differences. Results: 72% of men and 44% of women exhibited CPM impairment (p = 0.062). VPT was also similar in men (29.5 ± 7.8) and women (28.2 ± 1.6, p = 0.667). Duration of symptoms (Figure 1) was associated with CPM impairment in women (R=0.566, p=0.003) but not men (R=0.366, p=0.135). Duration of symptoms was also associated with VPT in both men (R = 0.580, p = 0.012) and women (R = 0.406, p = 0.039).Conclusion: These results suggest that longer duration of knee OA may predict more severe pain sensitization and development of hypoesthesia. In addition, important sex differences may exist in descending pain inhibition in people with chronic knee OA that may affect disease and course of treatment in male and female patients. Figure 1. Association between duration of symptoms and CPM (L) and VPT (R). In left panel, values above dotted horizontal line indicate impaired CPM.

Disclosure: K. C. Foucher, None; S. Chmell, None; C. Courtney, None.

To cite this abstract in AMA style:

Foucher KC, Chmell S, Courtney C. Knee Osteoarthritis Symptom Duration Is Associated with Conditioned Pain Modulation and Vibration Perception Threshold Impairment [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/knee-osteoarthritis-symptom-duration-is-associated-with-conditioned-pain-modulation-and-vibration-perception-threshold-impairment/. Accessed .

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