Neuropathic-like pain in knee osteoarthritis: exploring differences in knee loading and inflammation. A cross-sectional study.
Paolo Dainese, Sophie DE Mits, Ruth Wittoek and 5 others
PMID 37934188WHAT IT FOUND
Patients with knee osteoarthritis and signs of neuropathic-like pain walked with higher dynamic load on the inner knee.
They also reported worse pain and function. These are cross-sectional associations, so it is unknown if the load causes the pain or the pain changes the walking.
Key findings
01Patients with an indication of neuropathic-like pain had a significantly higher knee adduction moment impulse than those unlikely to have it, suggesting greater dynamic medial joint loading.
02This same group reported worse scores for pain, stiffness and physical function on the WOMAC questionnaire compared to both other pain groups.
03Markers of inflammation on MRI, such as effusion-synovitis and bone marrow lesions, did not differ significantly between the three neuropathic-like pain groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was cross-sectional, so it cannot determine whether neuropathic-like pain causes higher knee loading or if higher loading leads to neuropathic-like pain. MRI data were missing for 11 participants, and those missing data had different knee osteoarthritis severity, which may bias the inflammation results. The difference in knee loading between the pain groups was very small, close to the limit of what the measurement tools can reliably detect. The study used a questionnaire to identify neuropathic-like pain rather than an objective test for nerve damage.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Research Foundation Flanders, which supported the parent randomized controlled trial.
The easy way to misread this
Do not assume that neuropathic-like pain is caused by inflammation. The study found no significant differences in MRI inflammation markers between pain groups, despite the higher knee loading and worse symptoms in the neuropathic-like pain group.