The seven dimensions of osteoarthritis pain
By Afsaneh Gray, medwireNews Reporter
02 December 2013
PLoS One 2013; 8: e79988

medwireNews: Analysis of interviews with osteoarthritis sufferers about their experience of pain has shown that osteoarthritis pain can be divided into seven dimensions.

The authors of the study intend to use their results to construct a specific questionnaire on osteoarthritis pain quality, which they hope will “facilitate the development of more accurate and effective pain management.”

The researchers also noticed that patients with osteoarthritis are reluctant to talk about their pain, and identified several reasons why this is the case.

Two focus groups were carried out in Paris, France, with 14 participants aged between 40 and 75 years, 10 of whom were women. The participants were chosen to reflect the different types of disease, with seven respondents having diffuse osteoarthritis, three isolated knee disease, two isolated hand, one from knee and hand, and one isolated hip osteoarthritis.

The format of the focus groups, which were conducted by a psychologist with no prior relationship with the participants, was semi-structured and used open-ended questions.

Lead author Serge Perrot (Université Paris Descartes) and colleagues found that it was difficult to get osteoarthritis sufferers to talk about their pain. From content analysis they identified several reasons for this, including a perception that nobody wanted to hear about it and that osteoarthritis is a natural and inevitable phenomenon. Participants also felt that there was a lack of accurate vocabulary to describe their pain.

Despite this initial reluctance, the researchers were able to identify seven dimensions to osteoarthritis pain from participants’ responses. These were: pain sensory description; osteoarthritis-related symptoms; pain variability profile; pain-triggering factors; pain and physical activity; mood and image; and general physical symptoms.

Perrot and colleagues give an example of a “mood and image” dimension from a patient transcript as “My pain makes me feel isolated and old.” An example of a pain-triggering factor is an increase of pain in cold and wet weather.

Writing in PLoS One, the authors say: “Although chronic pain is generally acknowledged to be complex and multidimensional, the assessment of [osteoarthritis] pain in clinical trials is mostly one-dimensional, restricted to pain intensity, and in some cases to functional impact or repercussions.”

They hope that their research will lead to effective subgrouping of osteoarthritis patients based on the quality of their pain and, ultimately, to better pain management.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

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