Variation of Pain Intensity with Smoking in Knee Osteoarthritis in Males

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Mahrukh Naseem
Muhammad Mahmood Alam
Muhammad Waseem Akhtar
Saadia Perwaiz
Muhammad Burhan
Shehroz Masood
Adan Nehal
Rabia Shahid


Background: Knee osteoarthritis is a significant cause of disability, affecting daily living activities predominantly in females but also impacting males. Various factors contribute to its development, including smoking, yet data on its effect on the male population is sparse.

Objective: To explore the relationship between smoking and pain intensity in males with moderate-stage knee osteoarthritis.

Methods: A cross-sectional study was conducted over six months, enrolling 71 male participants aged 30 to 75 years with grade 2 knee osteoarthritis, diagnosed according to the Kellgren and Lawrence scale. Participants were categorized into smokers and non-smokers. Data on smoking habits and pain severity, assessed using the numeric pain rating scale, were collected through questionnaires. The association between smoking and pain intensity was analyzed using the Pearson Chi-square test, with a significance level set at P<0.05.

Results: Out of 71 participants, 36 (50.7%) were smokers, and 35 (49.3%) were non-smokers. Severe pain was reported by 25 smokers, while 26 non-smokers experienced moderate pain. The analysis revealed a significant association between smoking and increased pain severity (P<0.05), with a direct correlation between the number of cigarettes smoked and pain intensity.

Conclusion: The study identified a significant association between smoking and higher pain intensity in male patients with knee osteoarthritis. These findings suggest that smoking cessation should be a key component of osteoarthritis management strategies to alleviate pain and improve quality of life in affected individuals.

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How to Cite
Naseem, M., Alam, M. M., Akhtar, M. W., Perwaiz, S., Burhan, M., Masood, S., Nehal, A., & Shahid, R. (2024). Variation of Pain Intensity with Smoking in Knee Osteoarthritis in Males. Journal of Health and Rehabilitation Research, 4(1), 389–393.


Roos EM, Arden NK. Strategies for the prevention of knee osteoarthritis. Nature Reviews Rheumatology. 2016;12(2):92-101.

Kellgren JH, Lawrence J. Radiological assessment of osteo-arthrosis. Annals of the rheumatic diseases. 1957;16(4):494.

Iqbal MN, Haidri FR, Motiani B, Mannan A. Frequency of factors associated with knee osteoarthritis. JPMA-Journal of the Pakistan Medical Association. 2011;61(8):786.

Prieto-Alhambra D, Judge A, Javaid MK, Cooper C, Diez-Perez A, Arden NK. Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints. Annals of the rheumatic diseases. 2014;73(9):1659-64.

Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G. A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthritis and cartilage. 2005;13(9):769-81.

Debi R, Mor A, Segal O, Segal G, Debbi E, Agar G, et al. Differences in gait patterns, pain, function and quality of life between males and females with knee osteoarthritis: a clinical trial. BMC musculoskeletal disorders. 2009;10:1-10.

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.

Amin S, Niu J, Guermazi A, Grigoryan M, Hunter DJ, Clancy M, et al. Cigarette smoking and the risk for cartilage loss and knee pain in men with knee osteoarthritis. Annals of the rheumatic diseases. 2007;66(1):18-22.

Cheon Y-H, Kim H-O, Suh YS, Kim MG, Yoo W-H, Kim RB, et al. Relationship between decreased lower extremity muscle mass and knee pain severity in both the general population and patients with knee osteoarthritis: Findings from the KNHANES V 1-2. PLoS One. 2017;12(3):e0173036.

Miranda H, Viikari-Juntura E, Martikainen R, Riihimäki H. A prospective study on knee pain and its risk factors. Osteoarthritis and cartilage. 2002;10(8):623-30.

Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman B, Aliabadi P, et al. Risk factors for incident radiographic knee osteoarthritis in the elderly. The Framingham Study. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1997;40(4):728-33.

Kong L, Wang L, Meng F, Cao J, Shen Y. Association between smoking and risk of knee osteoarthritis: a systematic review and meta-analysis. Osteoarthritis and cartilage. 2017;25(6):809-16.

Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian journal of internal medicine. 2011;2(2):205.

Kohn MD, Sassoon AA, Fernando ND. Classifications in Brief: Kellgren-Lawrence Classification of Osteoarthritis. Clinical Orthopaedics and Related Research®. 2016;474(8):1886-93.

Holzer N, Salvo D, Marijnissen A, Vincken K, Ahmad A, Serra E, et al. Radiographic evaluation of posttraumatic osteoarthritis of the ankle: the Kellgren–Lawrence scale is reliable and correlates with clinical symptoms. Osteoarthritis and cartilage. 2015;23(3):363-9.

Dai Y, Huang J, Hu Q, Huang L, Wu J, Hu J. Association of cigarette smoking with risk of chronic musculoskeletal pain: A meta-analysis. Pain Physician. 2021;24(8):495.

Hrvatin I, Puh U. Measurement properties of the numerical pain rating scale in patients with musculoskeletal impairments of the limbs–a systematic literature review. Sloven Med J. 2021;90:1-9.

Alghadir AH, Anwer S, Iqbal ZA. The psychometric properties of an Arabic numeric pain rating scale for measuring osteoarthritis knee pain. Disability and rehabilitation. 2016;38(24):2392-7.

Dubé CE, Liu S-H, Driban JB, McAlindon TE, Eaton CB, Lapane KL. The relationship between smoking and knee osteoarthritis in the Osteoarthritis Initiative. Osteoarthritis and cartilage. 2016;24(3):465-72.

Wilder F, Hall B, Barrett J. Smoking and osteoarthritis: is there an association? The Clearwater Osteoarthritis Study. Osteoarthritis and cartilage. 2003;11(1):29-35.

Al-Bashaireh AM, Haddad LG, Weaver M, Kelly DL, Chengguo X, Yoon S. The effect of tobacco smoking on musculoskeletal health: a systematic review. Journal of environmental and public health. 2018;2018.

Abate M, Vanni D, Pantalone A, Salini V. Cigarette smoking and musculoskeletal disorders. Muscles, ligaments and tendons journal. 2013;3(2):63-9.

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