Prevalence of Knee OA and its Association with Low Back Pain
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Abstract
Background: Knee osteoarthritis (OA) is a prevalent musculoskeletal condition known to impact quality of life and daily functioning significantly. Previous studies have identified a potential association between knee OA and low back pain, but this relationship requires further exploration to understand its implications fully.
Objective: The objective of this study was to investigate the correlation between knee OA and low back pain, specifically examining the impact of knee pain on quality of life, daily functioning, and the severity of low back pain.
Methods: A cross-sectional study was conducted with 377 OA patients aged between 45 to 75 years, selected via non-probability convenient sampling from various hospitals in Sialkot. Exclusion criteria included a history of knee surgery or recent trauma, mental retardation, or diabetes. Data were collected using the Oswestry Low Back Disability Index and the KOOS Urdu version. Statistical analysis was performed using SPSS version 26, focusing on descriptive statistics, mean and standard deviation for quantitative data, and the chi-square test for associations, with a significance threshold set at a p-value greater than 0.05.
Results: The study found that the prevalence of knee OA varied by age group, with the highest prevalence (46.6%) in the 45-54 age group. Female participants predominated (75.9%). Severity levels of knee OA were classified as mild (32.6%), moderate (42.2%), and severe (21.8%). Significant correlations were observed between knee OA and low back pain, with correlation coefficients of 0.480 for pain effects on QOL, 0.441 for pain during SRF, 0.571 for pain during AODL, and 0.437 for the total score of pain.
Conclusion: The study confirms a significant correlation between knee OA and low back pain, highlighting the need for integrated management approaches for patients suffering from these conditions. Addressing both knee and back pain concurrently could lead to better patient outcomes and improved quality of life.
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References
Picavet HS, Hazes JM. Prevalence of self reported musculoskeletal diseases is high. Ann Rheum Dis. 2003;62(7):644-50.
Picavet H, Hazes JJAotrd. Prevalence of self reported musculoskeletal diseases is high. 2003;62(7):644.
Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019;393(10182):1745-59.
Johnson VL, Hunter DJ. The epidemiology of osteoarthritis. Best Pract Res Clin Rheumatol. 2014;28(1):5-15.
Long H, Liu Q, Yin H, Wang K, Diao N, Zhang Y, et al. Prevalence Trends of Site-Specific Osteoarthritis From 1990 to 2019: Findings From the Global Burden of Disease Study 2019. Arthritis Rheumatol. 2022;74(7):1172-83.
Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum. 2012;64(6):1697-707.
Goldring MB, Goldring SR. Articular cartilage and subchondral bone in the pathogenesis of osteoarthritis. Ann N Y Acad Sci. 2010;1192:230-7.
Costa RA, de Oliveira LM, Watanabe SH, Jones A, Natour J. Isokinetic assessment of the hip muscles in patients with osteoarthritis of the knee. Clinics. 2010;65(12):1253-9.
Alsufiany MB, Lohman EB, Daher NS, Gang GR, Shallan AI, Jaber HM. Non-specific chronic low back pain and physical activity: A comparison of postural control and hip muscle isometric strength: A cross-sectional study. Medicine. 2020;99(5).
Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum. 1987;30(8):914-8.
Jordan JM, Helmick CG, Renner JB, Luta G, Dragomir AD, Woodard J, et al. Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project. J Rheumatol. 2007;34(1):172-80.
Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. J Rheumatol. 2006;33(11):2271-9.
Dudley GA, Duvoisin MR, Adams GR, Meyer RA, Belew AH, Buchanan P. Adaptations to unilateral lower limb suspension in humans. Aviation, space, and environmental medicine. 1992;63(8):678-83.
Tsukada A, Uchida K, Aikawa J, Takano S, Iwase D, Mukai M, et al. Unilateral-dominant reduction in muscle volume in female knee osteoarthritis patients: computed tomography-based analysis of bilateral sides. Journal of Orthopaedic Surgery and Research. 2020;15(1):1-7.
Fisher NM, White S, Yack H, Smolinski R, Pendergast D. Muscle function and gait in patients with knee osteoarthritis before and after muscle rehabilitation. Disability and Rehabilitation. 1997;19(2):47-55.
Al-Khlaifat L, Herrington LC, Hammond A, Tyson SF, Jones RK. The effectiveness of an exercise programme on knee loading, muscle co-contraction, and pain in patients with medial knee osteoarthritis: A pilot study. The Knee. 2016;23(1):63-9.
Wolfe F. Determinants of WOMAC function, pain and stiffness scores: evidence for the role of low back pain, symptom counts, fatigue and depression in osteoarthritis, rheumatoid arthritis and fibromyalgia. Rheumatology (Oxford, England). 1999;38(4):355-61.
Hawker G, Gignac M, Badley E, Davis A, French M, Gordon A, et al. The impact of concominant persistent back problems in people living with hip and knee osteoarthritis. Osteoarthritis Cartilage. 2006;14:S125.
Molton IR, Terrill AL. Overview of persistent pain in older adults. American Psychologist. 2014;69(2):197.
Hirano K, Imagama S, Hasegawa Y, Ito Z, Muramoto A, Ishiguro N. Impact of low back pain, knee pain, and timed up-and-go test on quality of life in community-living people. Journal of Orthopaedic Science. 2014;19:164-71.
Muraki S, Akune T, Oka H, En-Yo Y, Yoshida M, Saika A, et al. Health-related quality of life in subjects with low back pain and knee pain in a population-based cohort study of Japanese men: the Research on Osteoarthritis Against Disability study. Spine. 2011;36(16):1312-9.
Iizuka Y, Iizuka H, Mieda T, Tsunoda D, Sasaki T, Tajika T, et al. Prevalence of chronic nonspecific low back pain and its associated factors among middle-aged and elderly people: an analysis based on data from a musculoskeletal examination in Japan. Asian spine journal. 2017;11(6):989.
Muraki S, Akune T, Nagata K, Ishimoto Y, Yoshida M, Tokimura F, et al. Association of knee osteoarthritis with onset and resolution of pain and physical functional disability: the ROAD study. Mod Rheumatol. 2014;24(6):966-73.
Sharma L, Cahue S, Song J, Hayes K, Pai YC, Dunlop D. Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors. Arthritis Rheum. 2003;48(12):3359-70.
Althomali OW, Amin J, Acar T, Shahanawaz S, Talal Abdulrahman A, Alnagar DK, et al., editors. Prevalence of Symptomatic Knee Osteoarthritis in Saudi Arabia and Associated Modifiable and Non-Modifiable Risk Factors: A Population-Based Cross-Sectional Study. Healthcare; 2023: MDPI.
Meunier MJCiSM. Lateral epicondylitis/extensor tendon injury. 2020;39(3):657-60.
Tang X, Wang S, Zhan S, Niu J, Tao K, Zhang Y, et al. The prevalence of symptomatic knee osteoarthritis in China: results from the China health and retirement longitudinal study. Arthritis & rheumatology. 2016;68(3):648-53.
Murase K, Tabara Y, Ito H, Kobayashi M, Takahashi Y, Setoh K, et al. Knee pain and low back pain additively disturb sleep in the general population: a cross-sectional analysis of the Nagahama study. PloS one. 2015;10(10):e0140058.
Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. The Journal of rheumatology. 2006;33(11):2271-9.
Norvell DC, Czerniecki JM, Reiber GE, Maynard C, Pecoraro JA, Weiss NS. The prevalence of knee pain and symptomatic knee osteoarthritis among veteran traumatic amputees and nonamputees. Archives of physical medicine and rehabilitation. 2005;86(3):487-93.
Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1987;30(8):914-8.
Quintana JM, Arostegui I, Escobar A, Azkarate J, Goenaga JI, Lafuente I. Prevalence of knee and hip osteoarthritis and the appropriateness of joint replacement in an older population. Archives of internal medicine. 2008;168(14):1576-84.