Abstract
Abstract Background Non-Steroidal Anti-Inflammatory Drug (NSAID) treatment is recommended as the first step in the treatment of knee osteoarthritis (KOA). Due to the risk of side-effects of NSIADs and low responds rate, methods for selection of NSAID responders are highly warranted. Recent studies suggest that pain sensitization in KOA might be predictive for the effect of surgical treatment, why the purpose of the present study was to evaluated whether quantitative sensory testing (QST) could be predictive for the effect of NSAID treatment in KOA. Material and methods 100 patients were enrolled and assessed using temporal summation of pain (TSP), pressure pain thresholds (PPT) and pain intensity (visual analog scale, VAS; 0: no pain and 10: worst imaginable pain) before and 8 weeks after daily treatment of Ibuprofen 400 mg × 3, Paracetamol 1 g × 3 and Pantoprazole 20 mg × 1. TSP was assessed by the difference in pain scores to one PinPrick stimulus followed by 10 PinPrick stimuli. PPT was assessed at the extensor carpi radialis longus muscle. Responders were categorized as decrease in pain intensity of at least three VAS-points. Results 80 patients had complete data at follow-up. 28 patients were categorized as responders and 52 patients as non-responders. Pre-treatment pain intensity (responders: 7.5 (SD: 1.6) vs. nonresponders: 6.5 (SD: 2.3), P < 0.03) and TSP (responders: 1.9 (SD: 2.5) vs. non-responders: 1.0 (SD: 1.5), P < 0.05) were significantly higher in responders compared with non-responders. Pre-treatment PPT at the arm trended towards significantly lower in responders (293 kPa (SD: 85)) compared with no responders (339 kPa (SD: 124), P < 0.06). Conclusions This preliminary analysis indicate that KOA patients with high pain intensities, facilitated TSP and widespread pressure hyperalgesia respond to NSAIDs.
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