Neuropathic Pain Commonly Found in End-Stage Lower Extremity Osteoarthritis

Patients with end-stage knee or hip osteoarthritis (OA) often experience possible neuropathic pain — particularly pain at rest vs on activity, and especially in men, according to a retrospective analysis published in Osteoarthritis Cartilage.

Individuals with knee or hip OA who were scheduled to undergo total joint arthroplasty (n=843; mean age, 65.1; 57.1% women) were included in this study.

Before surgery, patients filled out questionnaires that gathered sociodemographic data as well as information on medication use, health status, depression, pain catastrophizing, and pain at rest and on activity and neuropathic pain. Questionnaires were evaluated using painDETECT.

In this cohort, neuropathic pain was found to be higher in women vs men (painDETECT scores: 11.2±6.6 vs 9.3±7.0, respectively; P ≤.001). The percentage of patients meeting cut-offs for potential or likely neuropathic pain were 35.6% for women and 27.7% for men. In addition, women with knee OA vs women with hip OA reported greater neuropathic pain scores (12.1±38 vs 10.1±38, respectively; P =.003).

The variance in neuropathic pain scores was not accounted for by the combination of age, education, body mass index, surgical joint, number of comorbidities, and neuropathic comorbidities in a regression analysis. The addition of “pain at rest” raised the correlation in both men and women (by 23.4 and 13.9 percentage points, respectively).

The findings from this study may be limited to only those with end-stage OA.

Overall, the findings from this study support “the presence of neuropathic pain features in some individuals with knee, as well as hip OA, and suggest that greater pain at rest, specifically, may be a useful clinical marker for identification of patients who may be affected.”

Reference

Power JD, Perruccio AV, Gandhi R, et al. Neuropathic pain in end-stage hip and knee osteoarthritis: differential associations with patient-reported pain at rest and pain on activity [published online January 8, 2018]. Osteoarthritis Cartilage. doi: 10.1016/j.joca.2018.01.002

This article originally appeared on Clinical Pain Advisor