FRI0608-HPR SEVERITY AND PREDICTORS OF PAIN INTENSITY AND HAND DISABILITY IN PATIENTS WITH TRAPEZIOMETACARPAL OSTEOARTHRITIS
Authors: T. Hamasaki, P. Harris, N. Bureau, N. Gaudreault, N. Patenaude, M. Choinière
Journal: Annals of the Rheumatic Diseases (2020)

Background: Trapeziometacarpal osteoarthritis (TMO) is one of the most prevalent and painful forms of hand osteoarthritis. 1 It limits thumb mobility, 2 reduces hand functions, and manual activities. 1 Yet, no study has exhaustively documented the characteristics of this pathology using a biopsychosocial approach (e.g., pain, disability, psychological well-being, pain-related catastrophic thinking, quality of life). Furthermore, radiographic TMO severity and symptomatology are only weakly to moderately correlated. 3, 4 The extent to which biopsychosocial factors (e.g., pain duration, depression, education) contribute to interindividual variability in TMO pain and hand disability merits further investigation. Objectives: This study aimed at 1) describing the pain experience of patients with trapeziometacarpal osteoarthritis (TMO) from a biopsychosocial perspective, and 2) identifying predictors of their pain intensity and hand disability. Methods: A total of 227 TMO patients recruited from 16 healthcare institutions completed validated questionnaires assessing their biopsychosocial characteristics. The associations of pain severity and hand disability with various biopsychosocial characteristics were analyzed by linear regression. Results: The participants’ mean age was 62.6 ± 8.5 years and 78% were women. Their mean pain intensity on the average in the last seven days was 5.8 ± 2.1 while their hand disability scores averaged 45.4 ± 18.8 on the QuickDASH. In terms of health-related quality of life, the participants’ scores on the physical and mental summary scales of the SF-12v2 were 41.0 ± 9.4 and 48.7 ± 9.7 respectively. Results of the multivariable linear regression analyses revealed that age, living condition, pain frequency, pain-related catastrophic thinking, and depression levels accounted for 43.3% of the variance in pain intensity while age, sex, pain intensity, pain-related catastrophic thinking, depression, level of education, employment status and living condition accounted for 60.6% of the variance in hand function. Conclusion: This comprehensive study showed that patients with TMO experience pain of moderate to severe intensity which can affect various aspects of their daily living and their physical health-related quality of life. Greater tendency to catastrophize in the face of pain and higher depression levels were associated with more severe pain suggesting that psychological interventions aiming at reducing these factors could be beneficial for some patients with TMO. References: [1] Bijsterbosch J, Visser W, Kroon HM, Stamm T, Meulenbelt I, Huizinga TW, Kloppenburg M. Thumb base involvement in symptomatic hand osteoarthritis is associated with more pain and functional disability. Annals of the rheumatic diseases. 2010;69:585-587. [2] Gehrmann SV, Tang J, Li ZM, Goitz RJ, Windolf J, Kaufmann RA. Motion deficit of the thumb in CMC joint arthritis. Journal of hand surgery. 2010;35:1449-1453. [3] Botha-Scheepers S, Riyazi N, Watt I, Rosendaal FR, Slagboom E, Bellamy N, Breedveld FC, Kloppenburg M. Progression of hand osteoarthritis over 2 years: a clinical and radiological follow-up study. Annals of the rheumatic diseases. 2009;68:1260-1264. [4] Hwang RW, Ring D. Pain and disability related to osteoarthrosis of the trapeziometacarpal joint. J Hand Microsurg. 2011;3:63-65. Acknowledgments: This study was supported by a discretionary fund of the Centre de recherche du CHUM (CRCHUM) to Choinière and from the Multidisciplinary Council of the CHUM. Hamasaki was supported by a Doctoral training award of the Fonds de recherche du Québec—Santé, a doctoral scholarship from the CHUM Foundation to Harris (Hand Surgery Branch) and from Choinière’s internal funds of the CRCHUM. Disclosure of Interests: None declared