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Observational Study
. 2024 Aug;32(8):982-989.
doi: 10.1016/j.joca.2024.04.020. Epub 2024 May 18.

Associations of pain sensitivity and conditioned pain modulation with physical activity: findings from the Multicenter Osteoarthritis Study (MOST)

Soyoung Lee  1 , Tuhina Neogi  2 , Brooke McGinley  3 , Na Wang  4 , Laura Frey Law  5 , Kaveh A Torabian  6 , Kosaku Aoyagi  7 , Joshua J Stefanik  8 , Lisa C Carlesso  9 , Jeffrey M Hausdorff  10 , Eran Gazit  11 , Neil A Segal  12 , Cora E Lewis  13 , Michael C Nevitt  14 , Deepak Kumar  15
Affiliations
Observational Study

Associations of pain sensitivity and conditioned pain modulation with physical activity: findings from the Multicenter Osteoarthritis Study (MOST)

Soyoung Lee et al. Osteoarthritis Cartilage. 2024 Aug.

Abstract

Objective: Individuals with chronic pain due to knee osteoarthritis (OA) are insufficiently physically active, and alterations of facilitatory and inhibitory nociceptive signaling are common in this population. Our objective was to examine the association of these alterations in nociceptive signaling with objective accelerometer-based measures of physical activity in a large observational cohort.

Design: We used data from the Multicenter Osteoarthritis Study. Measures of peripheral and central pain sensitivity included pressure pain threshold at the knee and mechanical temporal summation at the wrist, respectively. The presence of descending pain inhibition was assessed by conditioned pain modulation (CPM). Physical activity was quantitatively assessed over 7 days using a lower back-worn activity monitor. Summary metrics included steps/day, activity intensity, and sedentary time. Linear regression analyses were used to evaluate the association of pain sensitivity and the presence of descending pain inhibition with physical activity measures.

Results: Data from 1873 participants was analyzed (55.9% female, age = 62.8 ± 10.0 years). People having greater peripheral and central sensitivity showed lower step counts. CPM was not significantly related to any of the physical activity measures, and none of the exposures were significantly related to sedentary time.

Conclusions: In this cohort, greater peripheral and central sensitivity were associated with reduced levels of objectively-assessed daily step counts. Further research may investigate ways to modify or treat heightened pain sensitivity as a means to increase physical activity in older adults with knee OA.

Keywords: Accelerometer; Central sensitization; Knee osteoarthritis; Pressure pain threshold; Sedentary time; Step count.

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Conflict of interest statement

Conflicts of interest

The authors have no professional relationships with companies or manufacturers who will benefit from the results of the present study. NAS reports personal fees from Pacira and Tenex Health, outside of the submitted work.

Figures

Figure 1.
Figure 1.
Participant flow diagram. *With following reasons: refused to use, cognitive impairment, no device available, physical/medical problems etc.
Figure 2.
Figure 2.
Adjusteda mean differences in step count (A), activity intensity (B) and sedentary time (C) across tertiles (Low: lowest tertile, Mid: middle tertile, High: highest tertile) of standardized PPT, temporal summation (TS), and dichotomized (Presence/Absence) conditioned pain modulation (CPM). Tertiles are modeled such that lower values reflect less pain sensitivity. a Adjusted for age, sex, race and site (as a single composite variable), BMI, education, and presence of radiographic knee OA.
See this image and copyright information in PMC

References

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