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Observational Study
. 2016 Apr 30:17:194.
doi: 10.1186/s12891-016-1049-0.

The clinical characteristics of older people with chronic multiple-site joint pains and their utilisation of therapeutic interventions: data from a prospective cohort study

Rafi Raja  1 , Bright Dube  1 , Elizabeth M A Hensor  1 , Sarah F Hogg  1 , Philip G Conaghan  2 , Sarah R Kingsbury  1
Affiliations
Observational Study

The clinical characteristics of older people with chronic multiple-site joint pains and their utilisation of therapeutic interventions: data from a prospective cohort study

Rafi Raja et al. BMC Musculoskelet Disord. .

Abstract

Background: Chronic multiple-site joint pain (MSJP) is common in older people and associated with poor outcomes, yet under-researched. Our aim was to detail the clinical characteristics of people with MSJP and their utilisation of therapies.

Methods: MSJP was defined as pain in at least one large joint and one other joint for >6 weeks in the last three months. A mixed community, primary and secondary care cohort of people >50 years old underwent detailed history and examination by a single clinician. Treatment utilisation was recorded comprehensively.

Results: 201 adults were recruited, 82% women, mean age 63, BMI 31 kg/m(2). Median number of painful joints per patient was 6 (IQR 4-9; range 2-17); most common painful sites were knee (84%), lower back (62%) and shoulder (47%). 194/201 (96%) had an osteoarthritis (OA) diagnosis, 155/194 (80%) also had soft tissue pathology and 72% had back problems. 85% had OA at multiple sites. Upper and lower limb weakness was common (90 and 77% respectively). Lower limb weakness was significantly associated with obesity. Only 26% had received written information about their joints. Though 79% had attended physiotherapy, the majority (93%) had muscle weakness. Only 36 % of overweight participants had accessed weight-loss support. Half of those with foot pain had seen a podiatrist or used appliances. Multiple concurrent pharmacological therapies were used by 47%.

Conclusion: MSJP represents a combination of OA, back pain and soft tissue disorders; muscle weakness is extremely common. Therapies appear underutilised in people with MJSP. Identifying the reasons for this should guide effective intervention research.

Keywords: Back pain; Joint pain; Multiple site; Osteoarthritis; Soft tissue disorders; Therapeutics.

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Figures

Fig. 1
Fig. 1
Association between painful joints. Clockwise shading represents positive correlation and anti-clockwise shading represents negative correlation
See this image and copyright information in PMC

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