Psychosocial and demographic factors influencing pain scores of patients with knee osteoarthritis

• Published in: PloS one Vol. 13; no. 4; p. e0195075
• Main Authors: Eberly, Lauren, Richter, Dustin, Comerci, George, Ocksrider, Justin, Mercer, Deana, Mlady, Gary, Wascher, Daniel, Schenck, Robert
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 09.04.2018; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Aged, 80 and over; Alcohol; Alcoholic beverages; Analysis; Arthritis; Behavior modification; Biocompatibility; Biology and Life Sciences; Body mass; Body mass index; Body size; Care and treatment; Cohort Studies; Correlation analysis; Demographic variables; Demographics; Diabetes mellitus; DNA methylation; Drug abuse; Ethnicity; Family medical history; Female; Fibromyalgia; Health aspects; Health sciences; Humans; Knee; Male; Medical records; Medical treatment; Medicine and Health Sciences; Mental depression; Mercer, Gary; Middle Aged; Minority & ethnic groups; Multivariate analysis; Narcotics; Opioids; Osteoarthritis; Osteoarthritis, Knee - complications; Pain; Pain - etiology; Pain - physiopathology; Pain - psychology; Pain Measurement; Patients; People and places; Psychological aspects; Questionnaires; Rehabilitation; Rheumatic diseases; Risk factors; Severity of Illness Index; Smoking; Studies; Substance abuse treatment; Surgery; Young Adult; United States > US; New Mexico
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0195075

Pain levels in patients with osteoarthritis (OA) of the knee are commonly assessed by using a numeric scoring system, but results may be influenced by factors other than the patient's actual physical discomfort or disease severity, including psychosocial and demographic variables. We examined the possible relation between knee-pain scores and several psychosocial, sociodemographic, disease, and treatment variables in 355 patients with knee OA. The pain-evaluation instrument was a 0- to 10-point rating scale. Data obtained retrospectively from the patients' medical records were demographic characteristics, body mass index (BMI), concomitant disorders, illicit and prescription drug use, alcohol use, smoking, knee OA treatment, and severity of knee OA indicated by Kellgren-Lawrence (KL) radiographic grade. Univariate and multivariate analyses were performed to determine whether these variables correlated with reported pain scores. On univariate analysis, higher pain scores were significantly associated with Native American or Hispanic ethnicity; a higher BMI; current prescription for an opioid, antidepressant, or gabapentinoid medication; depression; diabetes mellitus; fibromyalgia; illicit drug use; lack of health insurance; smoking; previous knee injection; and recommendation by the clinician that the patient undergo knee surgery. Neither the patient's sex nor the KL grade showed a correlation. On multivariate analysis, depression, current opioid prescription, and Native American or Hispanic ethnicity retained a significant association with higher pain scores. Our results in a large, ethnically diverse group of patients with knee OA suggest that psychosocial and sociodemographic factors may be important determinants of pain levels reported by patients with knee OA.