Early osteoarthritis symptoms 'manifest during weight-bearing activities'

People with early forms of osteoarthritis are most likely to first notice pain when performing activities that requires them to bear weight using their knees, according to a new study.

The University of Leeds research, published in the medical journal Arthritis Care & Research, aimed to investigate which patient-reported activities are first associated with knee pain, in order to improve early detection of osteoarthritis and thereby increase the chances of effective intervention.

For this study, the team used data on 4,673 patients from the Osteoarthritis Initiative, an observational cohort of people who have or are at high risk of osteoarthritis. Participants completed surveys for up to seven years in order to help the researchers track the emergence of pain during different activities over a long-term period.

A total of 491 people were ultimately selected for subset analysis, and it was revealed that the question pertaining to comfort levels when using stairs was the first in which overall pain scores among patients started to increase above zero.

This was followed by pain emerging during walking, standing, lying or sitting and then finally when resting in bed, with the ordering shown to be consistent over successive visits.

The researchers concluded: "Knee pain is most likely to first appear during weight-bearing activities involving bending of the knee, such as using stairs. First appearance of this symptom may identify a group suitable for early intervention strategies."

Osteoarthritis is the UK's most common form of joint disease and can lead to pain, stiffness, swelling and a gradual decline in functionality in the joints affected.

An Arthritis Research UK spokesperson commenting on this study said: "Knee osteoarthritis is the most common of all musculoskeletal conditions, affecting more than 4.5 million people in the UK. Age, obesity and alteration to the way that the joints are loaded, for example as a result of an earlier injury, are all known to contribute to development of this condition.

"There are currently no simple and reliable methods available to make an early diagnosis of osteoarthritis and predict how it will develop or respond to therapy. Usually by the time a definite diagnosis has been made using X-rays, the disease is in its advanced stages. There is a great need for new methods of diagnosing this condition at an early stage and therefore we welcome the results of this study.

"Arthritis Research UK is funding research investigating whether biological markers such as proteins, which can be detected using a simple blood test, can be used not only to diagnose the osteoarthritis at an earlier stage than is currently possible, but also to inform doctors which patients are likely to get worse over time, and who is likely to receive the most benefit from specific treatments."

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