Comorbidities in people with hand OA and their associations with pain severity and sensitization: Data from the longitudinal Nor-Hand study

Elisabeth Mulrooney; Tuhina Neogi; Hanne Dagfinrud; Hilde Berner Hammer; Pernille Steen Pettersen; Marthe Gløersen; Tore K Kvien; Karin Magnusson; Ida K Haugen

doi:10.1016/j.ocarto.2023.100367

Comorbidities in people with hand OA and their associations with pain severity and sensitization: Data from the longitudinal Nor-Hand study

Osteoarthr Cartil Open. 2023 May 5;5(3):100367. doi: 10.1016/j.ocarto.2023.100367. eCollection 2023 Sep.

Authors

Elisabeth Mulrooney^{1

2}, Tuhina Neogi³, Hanne Dagfinrud^{1

2}, Hilde Berner Hammer^{1

2}, Pernille Steen Pettersen¹, Marthe Gløersen^{1

2}, Tore K Kvien^{1

2}, Karin Magnusson⁴, Ida K Haugen^{1

2}

Affiliations

¹ Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.
² Faculty of Medicine, University of Oslo, Oslo, Norway.
³ Section of Rheumatology, Boston University School of Medicine, Boston, MA, United States.
⁴ Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Lund, Sweden.

Abstract

Objective: To determine whether the comorbidity burden and co-existing comorbidities are cross-sectionally and/or longitudinally associated with pain and pain sensitization in a cohort study of people with hand OA.

Design: We examined whether comorbidity burden and individual comorbidities based on the self-administered Comorbidity Index (range: 0-42) at baseline were associated with pain outcomes at baseline and 3 years follow-up. Pain outcomes included hand and overall bodily pain (range: 0-10) as well as pressure pain thresholds at the tibialis anterior muscle (kg/cm²) and temporal summation (distal radioulnar joint) as measures of central pain sensitization. We performed linear regression analyses adjusted for age, sex, body mass index, physical exercise and education.

Results: We included 300 and 196 participants in cross-sectional and longitudinal analyses, respectively. Using baseline data, the burden of comorbidities was associated with greater pain in hands (beta = 0.61, 95% CI 0.37, 0.85) and overall body (beta = 0.60, 95% CI 0.37, 0.87). Similar strength of associations was found between comorbidity burden (baseline) and follow-up pain. Among the individual comorbidities, back pain and depression were associated with nearly one unit higher pain score in hands and overall body at both baseline and follow-up. Only back pain was related to lower pressure pain thresholds at follow up (beta = -0.24, 95% CI -0.50, -0.001).

Conclusion: People with hand OA and greater comorbidity burden, co-existing back pain or depression reported greater pain severity than their counterparts, also 3 years later. These results acknowledge the relevance of accounting for comorbidities in the pain experience in people with hand OA.

Keywords: Comorbidity; Hand osteoarthritis; Osteoarthritis; Pain; Pain sensitization.

Abstract

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