The following is a summary of “Hand osteoarthritis phenotypes based on a biopsychosocial approach, and their associations with cross-sectional and longitudinal pain,” published in the April 2024 issue of Rheumatology by Mulrooney et al.
Hand osteoarthritis (OA) pain presents a complex and varied clinical picture, influenced by a range of factors only now fully explored. Design Using data from the Nor-Hand study’s baseline examination (2016–17), latent class analysis categorized participants with hand OA into distinct phenotypes based on a comprehensive biopsychosocial framework. Pain intensity in the hands and overall bodily pain (assessed via Numeric Rating Scale, 0–10) was evaluated at baseline and follow-up (2019–21). Linear regression models analyzed the associations between these phenotypes and pain outcomes, with the healthiest class as the reference group.
Five distinct phenotypic classes emerged, characterized by varying degrees of radiographic hand OA severity, ultrasound-detected OA in lower extremities, demographic profiles, psychosocial burden, and pain sensitization. Interestingly, individuals with milder hand OA but higher biopsychosocial burden reported the most intense hand pain (beta 3.65, 95% CI 2.53, 4.75). In contrast, those with severe hand OA but a lower biopsychosocial burden experienced less pain (beta 1.03, 95% CI 0.41, 1.65). Similar patterns were observed for overall bodily pain and persisted at follow-up. Although changes in pain were modest overall, a significant association between a specific phenotypic class characterized by elevated biopsychosocial burden and pain changes was noted.
The study identified five distinct hand OA phenotypes linked to pain intensity initially and over a 3.5-year follow-up period. Notably, individuals with less severe OA but higher biopsychosocial burden reported more pain compared to those with more severe OA, highlighting the complex interplay between structural severity and symptom experience in hand OA. These findings underscore the need for personalized approaches to managing hand OA pain that consider structural disease severity and psychosocial factors.
Source: sciencedirect.com/science/article/pii/S1063458424011683