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Knee pain predicts subsequent shoulder pain and the association is mediated by leg weakness: Longitudinal observational data from the osteoarthritis initiative

Citation

Laslett, LL and Otahal, P and Hensor, EMA and Kingsbury, SR and Conaghan, PG, Knee pain predicts subsequent shoulder pain and the association is mediated by leg weakness: Longitudinal observational data from the osteoarthritis initiative, Journal of Rheumatology, 43, (11) pp. 2049-2055. ISSN 0315-162X (2016) [Refereed Article]

Copyright Statement

Copyright 2016 The Journal of Rheumatology

DOI: doi:10.3899/jrheum.160001

Abstract

OBJECTIVE: To assess whether the "spread" of joint pain is related to pain-associated muscle loss in 1 joint leading to increased loading and subsequent pain in other joints.

METHODS: Associations between persistent knee pain (pain in 1 or 2 knees over 0-3 years vs no persistent pain) and incident shoulder pain at Year 4 were examined in participants from the longitudinal National Institutes of Health Osteoarthritis Initiative. Associations were assessed using log multinomial modeling, adjusted for age, sex, body mass index, depression score, other lower limb pain, and baseline leg weakness (difficulty standing from a sitting position).

RESULTS: In older adults with clinically significant knee osteoarthritis (OA) or at risk of knee OA (n = 3486), the number of painful joints increased yearly, from 2.1 joints (95% CI 2.0-2.2) at baseline increasing by 5.2% (95% CI 2.2-8.3) at Year 4. Shoulders were the next most commonly affected joints after knees (28.5%). Persistent pain in 1 or 2 knees increased risk of bilateral shoulder pain at Year 4 [1 knee: relative risk (RR) 1.59, 95% CI 0.97-2.61; 2 knees: RR 2.02, 95% CI 1.17-3.49] after adjustment for confounders. Further adjustment for leg weakness attenuated effect sizes (1 knee: RR 1.13, 95% CI 0.60-2.11; 2 knees: RR 1.44, 95% CI 0.75-2.77), indicating mediation by functional leg weakness.

CONCLUSION: Spread of joint pain is not random. Persistently painful knees predict new bilateral shoulder pain, which is likely mediated by leg weakness, suggesting that biomechanical factors influence the spread of pain.

Item Details

Item Type:Refereed Article
Keywords:Biomechanics, knee, osteoarthritis, pain, shoulder disorders
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Rheumatology and Arthritis
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Skeletal System and Disorders (incl. Arthritis)
Author:Laslett, LL (Dr Laura Laslett)
Author:Otahal, P (Mr Petr Otahal)
ID Code:112864
Year Published:2016
Deposited By:Menzies Institute for Medical Research
Deposited On:2016-12-01
Last Modified:2017-05-24
Downloads:0

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