Movement-Evoked pain is differentially associated with physical and psychological functioning in non-Hispanic Blacks vs. non-Hispanic Whites

Abstract

Compared to Non-Hispanic Whites (NHWs), Non-Hispanics Blacks (NHBs) report greater pain intensity and worse physical functioning. It has been hypothesized that movement-evoked pain might be a better predictor of pain-related outcomes; yet, limited research exists regarding the extent to which movement-evoked pain (MEP) differs across racial and ethnic minorities with knee osteoarthritis and its relation to physical and psychological functioning. A sub-sample of 237 participants (NHBs=111 and NHWs=126) with and without knee OA from the Understanding Pain and Limitations in Osteoarthritis Disease (UPLOAD-2) study were included in this analysis. Questionnaires assessed physical functioning in the past 48 hours (WOMAC), pain interference in the past 6 months (GCPS), movement-evoked pain (SPPB), and current depressive symptoms (PROMIS-depression). Bivariate correlations were conducted to examine the association between study variables. Regression analyses were conducting to examine the moderating effect of race/ethnicity on the relationship between MEP with physical and psychological functioning. Our results revealed that the relationship between MEP and disability varied across race/ethnicity. After controlling for sociodemographic and clinical variables, higher levels of MEP were associated with greater impairments in WOMAC physical functioning and GCPS pain interference; however, these relationships were stronger among NHBs (b=1.20 p=.00; b=.45, p=.00) compared to NHWs (b=.82, p=.00; b=.25 p=.00), respectively. There was also a significant interaction between race/ethnicity and MEP with depressive symptoms. Specifically, higher MEP was associated with greater depressive symptoms, but only among NHBs (b=.79, p=.00). Our findings highlight the role that racial/ethnic differences have on MEP and physical and psychological functioning. In particular, our results suggest that MEP may have a greater influence on physical functioning and depressive symptoms among NHBs. Future research is warranted to examine the clinical utility of MEP and whether this provides a unique understanding of pain-related outcomes, particularly among NHBs. Ethnic Differences in Pain Response, R37 AG033906-11 (NIH/NIA) awarded to Dr. Roger Fillingim.