The following is a summary of “Weekly pain trajectories among people with knee or hip osteoarthritis participating in a digitally delivered first-line exercise and education treatment,” published in the December 2023 issue of Pain by Kiadaliri et al.

Researchers conducted a retrospective study analyzing weekly pain patterns over a year in knee or hip osteoarthritis (OA) patients using a digital self-management program.

They enrolled 16,274 individuals (January 2019 to September 2021) who participated for at least 4 weeks and up to 52 weeks in the program (n = 16,274). Pain was assessed using the Numeric Rating Scale (NRS 0–10), and latent class growth analysis was applied to identify groups with similar pain trajectories. Multinomial logistic regression and dominance analysis explored associations between baseline characteristics and trajectory classes.

The results showed four pain trajectory classes, “mild-largely improved” (30%), “low moderate-largely improved” (34%), “upper moderate-improved” (24%), and “severe-persistent” (12%). For classes with decreasing pain, the most reduction occurred in the first 20 weeks and remained stable afterward. Factors such as male sex, older age, lower BMI, better physical function, lower activity impairment, less anxiety/depression, higher education, knee OA, no walking difficulties, no wish for surgery, and higher physical activity at enrollment were associated with higher chances of belonging to the “mild-largely improved” class. Per dominance analysis, activity impairment, desire for surgery, and walking issues were the top predictors of trajectory class membership.

Investigators concluded that early intervention with digital self-management programs may be crucial for OA patients before pain worsens and surgical desires arise.

Source: academic.oup.com/painmedicine/advance-article-abstract/doi/10.1093/pm/pnad167/7486570