Elucidating factors contributing to disparities in pain-related experiences among adults with or at risk for knee osteoarthritis

Angela M Mickle; Lisa H Domenico; Jared J Tanner; Ellen L Terry; Josue Cardoso; Toni L Glover; Staja Booker; Adriana Addison; Cesar E Gonzalez; Cynthia S Garvan; David Redden; Roland Staud; Burel R Goodin; Roger B Fillingim; Kimberly T Sibille

doi:10.3389/fpain.2023.1058476

Elucidating factors contributing to disparities in pain-related experiences among adults with or at risk for knee osteoarthritis

Front Pain Res (Lausanne). 2023 Feb 22:4:1058476. doi: 10.3389/fpain.2023.1058476. eCollection 2023.

Authors

Angela M Mickle^{1

2}, Lisa H Domenico³, Jared J Tanner⁴, Ellen L Terry^{2

3}, Josue Cardoso², Toni L Glover⁵, Staja Booker^{2

3}, Adriana Addison⁶, Cesar E Gonzalez⁶, Cynthia S Garvan⁷, David Redden⁸, Roland Staud⁹, Burel R Goodin⁶, Roger B Fillingim², Kimberly T Sibille^{1

2

7}

Affiliations

¹ College of Medicine, Department of Physical Medicine and Rehabilitation, University of Florida, Gainesville, FL, United States.
² College of Dentistry, Pain Research and Intervention Center of Excellence (PRICE), University of Florida, Gainesville, FL, United States.
³ College of Nursing, Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL, United States.
⁴ College of Public Health and Health Professionals, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.
⁵ School of Nursing, Oakland University, Rochester, MI, United States.
⁶ Department of Psychology, College of Arts and Science, University of Birmingham Alabama, Birmingham, AL, United States.
⁷ College of Medicine, Department of Anesthesiology, University of Florida, Gainesville, FL, United States.
⁸ Department of Biostatistics, School of Public Health, University of Birmingham Alabama, Birmingham, AL, United States.
⁹ College of Medicine, Department of Rheumatology, University of Florida, Gainesville, FL, United States.

Abstract

Background and purpose: We and others have reported ethnic/race group differences in clinical pain, physical function, and experimental pain sensitivity. However, recent research indicates that with consideration for socioenvironmental factors, ethnicity/race differences become less or non-significant. Understanding of factors contributing to pain inequities are needed. Guided by the NIA and NIMHD Health Disparities Research Frameworks, we evaluate the contributions of environmental and behavioral factors on previously reported ethnic/race group differences in: (1) clinical pain, (2) physical function, and (3) experimental pain in individuals with knee pain.

Methods: Baseline data from Understanding of Pain and Limitations in Osteoarthritis Disease (UPLOAD) and UPLOAD-2 studies were analyzed. Participants were adults 45 to 85 years old who self-reported as non-Hispanic white (NHW) or black (NHB) with knee pain. A health assessment and quantitative sensory testing were completed. Sociodemographics, environmental, health, clinical and experimental pain, and physical functioning measures were included in nested regressions.

Results: Pooled data from 468 individuals, 57 ± 8 years of age, 63% women, and 53% NHB adults. As NHB adults were younger and reported greater socioenvironmental risk than the NHW adults, the term sociodemographic groups is used. With inclusion of recognized environmental and behavioral variables, sociodemographic groups remained a significant predictor accounting for <5% of the variance in clinical pain and physical function and <10% of variance in experimental pain.

Conclusion: The incorporation of environmental and behavioral factors reduced relationships between sociodemographic groups and pain-related outcomes. Pain sites, BMI, and income were significant predictors across multiple models. The current study adds to a body of research on the complex array of factors contributing to disparities in pain-related outcomes.

Keywords: clinical pain; experimental pain; health disparities; knee osteoarthritis; physical function; social determinants of health.

Abstract

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