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Intermittent and constant pain and physical function or performance in men and women with knee osteoarthritis: data from the osteoarthritis initiative

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Abstract

Severe constant and intermittent knee pain are associated with “unacceptable” symptoms in older adults with osteoarthritis (OA) [22]. We hypothesized that constant and intermittent pain would be independently related to physical function, with intermittent knee pain being a better predictor of future declines in physical function in early symptomatic knee OA. This study included men (n = 189) and women (n = 133) with radiographic, unilateral knee OA, observed using data from the Osteoarthritis Initiative (OAI). Pain types were measured using the Intermittent and Constant Osteoarthritis Pain (ICOAP) scale. Physical function was measured using the Western Ontario and McMaster Universities Arthritis Index (WOMAC-PF) and Knee Injury and Osteoarthritis Outcome Score (KOOS-FSR) and physical performance tests. High baseline intermittent (B = 0.277; p = 0.001) and constant (B = 0.252; p = 0.001) knee pain were related to poor WOMAC-PF. Increased constant (B = 0.484; p = 0.001) and intermittent (B = 0.104; p = 0.040) pain were related to 2-year decreased WOMAC-PF. High baseline intermittent knee pain predicted poor KOOS-FSR at year 2 (B = −0.357; p = 0.016). Increased constant pain was related to decreased chair stand test performance over 2 years in women (B = 0.077; p = 0.001). High baseline intermittent pain was related to poor performance on repeated chair stands (B = 0.035; p = 0.021), while baseline constant pain was related to poor 400-m walk performance in women (B = 0.636; p = 0.047). Intermittent and constant knee pain were independent factors in self-perceived physical function and were important predictors of future limitations in physical function. Identifying intermittent and constant pain in early symptomatic OA may allow patients to adopt strategies to prevent worsening pain and future declines in physical function.

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Acknowledgments

This article was prepared using an Osteoarthritis Initiative public use data set and does not necessarily reflect the opinions or views of the Osteoarthritis Initiative investigators, the NIH, or the private funding partners. The Osteoarthritis Initiative is a public-private partnership comprised of five contracts (N01-AR-2-2258, N01-AR-2-2259, N01-AR-2-2260, N01-AR-2-2261, and N01-AR-2-2262) funded by the NIH, a branch of the Department of Health and Human Services, and conducted by the Osteoarthritis Initiative Study Investigators. Private funding partners include Merck Research Laboratories, Novartis Pharmaceuticals Corporation, GlaxoSmithKline, and Pfizer. Private sector funding for the Osteoarthritis Initiative is managed by the Foundation for the NIH. Michael J. Davison’s Master of Science education research is supported by McMaster University Department of Medicine’s Graduate Research Initiative.

Ethical standards

The study was approved by the participating hospital’s ethics boards and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its amendments. All participating individuals gave their informed consent prior to their inclusion in the study.

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Authors and Affiliations

  1. Department of Medical Science, McMaster University, 25 Charlton Ave. E., Suite 501, Hamilton, ON, L8N 1Y2, Canada

    Michael J. Davison

  2. Department of Medicine, McMaster University, 25 Charlton Ave. E., Suite 501, Hamilton, ON, L8N 1Y2, Canada

    George Ioannidis, Jonathan D. Adachi & Karen A. Beattie

  3. School of Rehabilitation Science, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada

    Monica R. Maly

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  1. Michael J. Davison
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Correspondence to Karen A. Beattie.

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Davison, M.J., Ioannidis, G., Maly, M.R. et al. Intermittent and constant pain and physical function or performance in men and women with knee osteoarthritis: data from the osteoarthritis initiative. Clin Rheumatol 35, 371–379 (2016). https://doi.org/10.1007/s10067-014-2810-0

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