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Knee Pain Can Point to Other Pain

And pain in more than one joint ups risk of depression, researchers say

THURSDAY, July 28, 2005 (HealthDay News) -- The knee bone is connected to the thigh bone, and the thigh bone is connected to the hip bone, but could the knee bone be connected to the backbone?

The answer seems to be "yes," at least where pain and depression are concerned, claims a group of British researchers.

Their study examined how often knee pain was associated with pain in other parts of the body and the effect of multiple sites of pain on the quality of life for patients aged 50 and older. People in this age group frequently experience joint pain, especially in the knees, according to the report in the August issue of Arthritis & Rheumatism.

It turned out that the majority of people with knee pain also had pain in other parts of the body, including the neck, hips, ankles and lower back. And people who suffered from pain at more than one site were more likely to suffer depression and anxiety. In other words, widespread physical pain had a notable impact on the emotional quality of patients' lives.

The researchers, led by Dr. Peter Croft of Keele University in Keele, England, surveyed nearly 5,400 patients averaging 65 years of age. More than half -- 55 percent -- were women and nearly all -- 99.6 percent -- were white Europeans.

Each patient completed a questionnaire about where they had experienced pain in the past month. Researchers then grouped patients into one of three categories: those who experienced no pain; those with knee pain alone or knee pain in one to two other locations; and those without knee pain but pain in one to three different locations.

More than half (57 percent) of those with knee pain reported pain in at least two other joint areas. And pain at more than one site was associated with depression and anxiety, as well as a lower level of physical functioning.

Pain and disability were milder in those with knee pain alone, compared with those with several painful sites, regardless of the person's age, sex and weight, the study found.

The findings suggest that knee pain and disability are worse in the presence of pain elsewhere in the body and hint at new ways to treat joint pain in older adults, said study co-author Clare Jinks.

It is not known whether the majority of doctors who treat pain in older adults also investigate the presence and extent of pain elsewhere in the body, she said. But treatments that target general pain management might be as useful as local treatments such as physiotherapy, knee injections and knee operations.

"One important issue for the physician is to be wary of dealing with knee pain as a purely regional syndrome of pain," Jinks said.

For their part, patients who suffer from joint pain could take simple steps such as using analgesics and heat or ice, getting enough sleep, exercising and losing weight if necessary. "Obviously, none of this removes the need for seeking appropriate clinical advice and attention," Jinks added.

But according to Dr. Michael Gross, a rheumatologist in Fair Lawn, N.J, more research is needed.

"It's possible that other pain regions may increase pain in areas not connected," he said. Studies should now investigate whether treating pain elsewhere improves pain in the knee, said Gross. What's more, most pain medications treat the whole body, not a single area, he said.

More information

The Medical College of Wisconsin has more on arthritis of the knee.

SOURCES: Clare Jinks, Ph.D., Keele University, Keele, England; Michael Gross, M.D., rheumatologist, Fairlawn, N.J.; August 2005 Arthritis & Rheumatism
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