Background Previous studies have shown various results with regard to whether structural and inflammatory osteoarthritis (OA) features cause OA pain. Pain in hand OA could possibly also be influenced by socio-economic status, lifestyle, mental health and comorbidity, but these associations have not yet been investigated.
Objectives To explore what factors are related to pain in hand OA.
Methods Persons living in Ullensaker community, Norway, who had self-reported OA and were diagnosed with clinical hand OA (American College of Rheumatology criteria) at a clinical examination in 2010 were included in this cross sectional study (n=319). The Australian-Canadian Hand pain subscale (AUSCAN, 0-20 scale) and number of tender finger joints upon palpation (0-30 scale) were used as outcome variables in separate multivariate linear regression analyses. Possible explanatory variables were education status, having family members with OA, mental health (Short Form 36 mental component score, 0-100 scale), smoking, alcohol drinking, physical activity level, Body Mass Index, self-reported diabetes, measured hypertension, additional OA in hips/knees, number of pain sites the last week (0-2 vs. ≥3 on the Standardized Nordic Questionnaire), Kellgren-Lawrence sum scores in the thirty finger joints [0-120], and ultrasonographic synovitis sum scores [0-90].
Results Mean (SD) age was 63.4 (8.6) years and 247 (77.4%) were women. We found that lower age, low education status, diabetes, higher number of pain sites, radiographic and inflammatory features were significantly associated with AUSCAN hand pain independent of each other (adjusted for age and sex), while lower age, poor mental health, diabetes, radiographic and inflammatory features were significantly associated with the number of tender joints (Table). The two models explained 17.8% and 12.6% of the variance in AUSCAN hand pain and number of tender joints, respectively.
Conclusions In persons with clinical hand OA, being at lower age, having diabetes and having more radiographic and inflammatory features were related both to patient-reported and joint-specific pain outcomes. Having low education level and a high number of pain sites were related to patient-reported pain only. Although our study included a broad range of possible predictors of pain, only a small part of the variation in hand OA pain can be explained.
Disclosure of Interest None declared