Murphy Susan L, Lyden Angela K, Kratz Anna L, Fritz Heather, Williams David A, Clauw Daniel J, Gammaitoni Arnold R, Phillips Kristine
University of Michigan, Ann Arbor.
Wayne State University, Detroit, Michigan.
Arthritis Care Res (Hoboken). 2015 Aug;67(8):1103-11. doi: 10.1002/acr.22545.
Although pain in knee osteoarthritis (OA) commonly affects activity engagement, the daily pain experience has not been fully characterized. Specifically, the nature and impact of pain flares is not well understood. This study characterized pain flares as defined by participants with knee OA. Pain flare occurrence and experience were measured over 7 days.
This was a multiple methods study; qualitative methods were dominant. Data were collected during the baseline portion of a randomized controlled trial. Participants met criteria for knee OA and had moderate to severe pain. They completed questionnaires and a 7-day home monitoring period that captured momentary symptom reports simultaneously with physical activity via accelerometry (n = 45). Participants also provided individual definitions of pain flare that were used throughout the home monitoring period to indicate whether a pain flare occurred.
Pain flares were described most often by quality (often sharp), followed by timing (seconds, minutes) and by antecedents and consequences. When asked if their definition of a flare agreed with a supplied definition, 49% of the sample reported only "somewhat," "a little," or "not at all." Using individual definitions, 78% experienced at least 1 daily pain flare over the home monitoring period; 24% had a flare on more than 50% of the monitored days.
Pain flares were common, fleeting, and often experienced in the context of activity engagement. Participants' views on what constitutes a pain flare differ from commonly accepted definitions. Pain flares are an understudied aspect of the knee OA pain experience and require further characterization.
尽管膝关节骨关节炎（OA）疼痛通常会影响活动参与度，但日常疼痛体验尚未得到充分描述。具体而言，疼痛发作的性质和影响尚不明确。本研究对膝关节OA患者定义的疼痛发作进行了特征描述。在7天内对疼痛发作的发生情况和体验进行了测量。
这是一项多种方法的研究；定性方法为主。数据收集于一项随机对照试验的基线阶段。参与者符合膝关节OA标准且有中度至重度疼痛。他们完成了问卷调查和为期7天的家庭监测期，通过加速度计在进行身体活动的同时获取即时症状报告（n = 45）。参与者还提供了疼痛发作的个人定义，在整个家庭监测期内用于表明是否发生了疼痛发作。
疼痛发作最常根据性质（通常为剧痛）来描述，其次是发作时间（数秒、数分钟）以及发作的前因和后果。当被问及他们对发作的定义是否与提供的定义一致时，49%的样本表示只是“有点”“有一点”或“完全不”一致。根据个人定义，78%的参与者在家庭监测期内每天至少经历1次疼痛发作；24%的参与者在超过50%的监测天数有发作。
疼痛发作很常见，持续时间短暂，且常在活动参与过程中出现。参与者对疼痛发作的构成看法与普遍接受的定义不同。疼痛发作是膝关节OA疼痛体验中一个研究不足的方面，需要进一步进行特征描述。
