Mediating Effect of Pain Sensitization on the Paradoxical Relation of Taking Opioids to Pain Severity in Knee Osteoarthritis: The Multicenter Osteoarthritis Study
Authors' conclusion
Pain sensitization had small mediating effects on the paradoxical phenomenon of OIH, suggesting that pain sensitization may not play a major role and/or that PPT is an inadequate tool to assess OIH.
Study context
- Population
- People with or at risk of knee osteoarthritis (OA) in a cohort study (Multicenter Osteoarthritis Study)
- Participants
- 296 vs 1,070
- Exposure
- Opioids vs nonopioid analgesics at baseline
- Opioidn = 296
- Nonopioid analgesicn = 1,070reference
- Outcome
- WOMAC pain, with mediation by pain sensitization (change in PPT at wrist and patella)
- Follow-up
- Two years
Methodological detailsmulticentre, causal mediation analysis
- Multicentre
- Causal mediation analysis
Main finding
As reported in the abstract
WOMAC pain: effect of opioids mediated by change in PPT
Mediated effect via wrist pressure pain threshold (PPT)
0.05 unit
95% CI 0.01–0.10
Opioid
Mediated effect via patellar PPT
0.08 unit
95% CI 0.02–0.14
Opioid
Observational data: associations, not effects.
Further findings
| Outcome | Estimate |
|---|---|
| Any worsening in WOMAC pain: higher odds mediated by change in PPT · two yearsOpioid vs Nonopioid analgesic | higher odds mediated via wrist PPT 2% (95% CI 0.99–1.04) |
| Any worsening in WOMAC pain: higher odds mediated by change in PPT · two yearsOpioid vs Nonopioid analgesic | higher odds mediated via patellar PPT 5% (95% CI 1.01–1.09) |
Original publication
Mediating Effect of Pain Sensitization on the Paradoxical Relation of Taking Opioids to Pain Severity in Knee Osteoarthritis: The Multicenter Osteoarthritis Study. Arthritis Care Res (Hoboken). Published 28 December 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →