Associations between quantitative sensory tests and measures of pain and function in persons over 45 with meniscal tear

Objective: Symptomatic meniscal tear and knee osteoarthritis (OA) are commonly accompanied by pain, which may arise from nociceptive mechanisms and from processes, referred to as sensitization, that alter and amplify pain perception. Sensitization may be assessed objectively with quantitative sensory testing (QST). There is a paucity of data on the magnitude of associations between QST measures and subjective and objective outcome measures. Design: We assessed cross-sectional associations between QST measures and pain, muscle strength, and performance measures in participants in the TeMPO trial of nonoperative therapies for meniscal tear and OA. QST measures included pain pressure thresholds (PPT), temporal summation (TS) and conditioned pain modulation (CPM). We derived standardized mean differences in each outcome between the lowest vs. highest tercile of each QST measure using linear regression, adjusted for age, body mass index (BMI), and Kellgren-Lawrence (KL) radiographic grade. Results: The sample included 317 participants with mean age 59.1 years, 58% female. Correlations between QST measures and pain, catastrophizing, widespread pain, strength (gluteus medius, quadriceps, hamstring), 40-meter timed walk, 30-second sit to stand, and timed single-leg stand were generally < 0.20. The adjusted standardized mean difference in each outcome between the lowest vs. highest tercile of each QST measure generally differed by <0.30 standard deviations. Conclusions: In this cross-sectional assessment of individuals with meniscal tear and OA, associations between QST measures and measures of pain, strength and performance were generally weak, suggesting pain sensitization makes minor contributions to these objective and subjective outcomes.