1.Existence of a Neuropathic Pain Component in Patients with Osteoarthritis of the Knee.
Seiji OHTORI ; Sumihisa ORITA ; Masaomi YAMASHITA ; Tetsuhiro ISHIKAWA ; Toshinori ITO ; Tomonori SHIGEMURA ; Hideki NISHIYAMA ; Shin KONNO ; Hideyuki OHTA ; Masashi TAKASO ; Gen INOUE ; Yawara EGUCHI ; Nobuyasu OCHIAI ; Shunji KISHIDA ; Kazuki KUNIYOSHI ; Yasuchika AOKI ; Gen ARAI ; Masayuki MIYAGI ; Hiroto KAMODA ; Miyako SUZKUKI ; Junichi NAKAMURA ; Takeo FURUYA ; Gou KUBOTA ; Yoshihiro SAKUMA ; Yasuhiro OIKAWA ; Masahiko SUZUKI ; Takahisa SASHO ; Koichi NAKAGAWA ; Tomoaki TOYONE ; Kazuhisa TAKAHASHI
Yonsei Medical Journal 2012;53(4):801-805
PURPOSE: Pain from osteoarthritis (OA) is generally classified as nociceptive (inflammatory). Animal models of knee OA have shown that sensory nerve fibers innervating the knee are significantly damaged with destruction of subchondral bone junction, and induce neuropathic pain (NP). Our objective was to examine NP in the knees of OA patients using painDETECT (an NP questionnaire) and to evaluate the relationship between NP, pain intensity, and stage of OA. MATERIALS AND METHODS: Ninety-two knee OA patients were evaluated in this study. Pain scores using Visual Analogue Scales (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), painDETECT, duration of symptoms, severity of OA using the Kellgren-Lawrence (KL) system, and amount of joint fluid were evaluated and compared using a Spearman's correlation coefficient by rank test. RESULTS: Our study identified at least 5.4% of our knee OA patients as likely to have NP and 15.2% as possibly having NP. The painDETECT score was significantly correlated with the VAS and WOMAC pain severity. Compared with the painDETECT score, there was a tendency for positive correlation with the KL grade, and tendency for negative correlation with the existence and amount of joint fluid, but these correlations were not significant. CONCLUSION: PainDETECT scores classified 5.4% of pain from knee OA as NP. NP tended to be seen in patients with less joint fluid and increased KL grade, both of which corresponded to late stages of OA. It is important to consider the existence of NP in the treatment of knee OA pain.
Aged
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Aged, 80 and over
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Female
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Humans
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Knee/pathology/physiopathology
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Male
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Middle Aged
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Neuralgia/*physiopathology
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Osteoarthritis, Knee/*physiopathology
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