July 29, 2005
Old Age Aches And Pains Come In Clusters

Knee pain usually does not occur by itself.

Joint pain, especially in the knees, is a common complaint in older patients and can impact quality of life. A team of researchers recently set out to examine how often knee pain is accompanied by pain elsewhere in the body and whether the presence of multiple joint pain affects older patients' general health and psychological status. Their findings, published in the August 2005 issue of Arthritis & Rheumatism, indicate that most people with knee pain also have pain at other sites and these patients tend to have more limited physical function and suffer more from depression and anxiety.

Led by Peter Croft of Keele University in Keele, UK, the authors surveyed a total of 5,364 patients aged 50 years or older who were registered with 3 general practices in North Staffordshire, UK. Each participant completed a questionnaire that included a body manikin on which they shaded any areas where they had experienced pain for one or more days during the last month. Pain was categorized into regions, which included: knee, neck, hand, lower back, hip, and foot and ankle. Based on where the pain occurred, participants were then grouped into (i) those with no pain at all, (ii) those with knee pain, either alone or with pain in 1 or 2 or more locations elsewhere, (iii) those with no knee pain but with pain in 1, 2 or 3 or more locations other than the knee.

A standard health survey used to determine the influence of pain elsewhere on general health was also completed, as well as an index to measure pain and disability specifically related to the knee. Obesity, anxiety and depression, all of which are linked to widespread pain, were also measured using various scales.

Of those surveyed, slightly more than one-third (1,909) ended up in the no pain group, 41% (2,210) in the knee pain group, and 23% (1,245) in the pain elsewhere group. Decreased physical function increased with the number of pains in the body, both in the knee and elsewhere. In those with at least 3 pain regions, the subgroup that included knee pain had worse physical function. This group was also more likely to be depressed than either those with no pain at all or those who had pain in a location other than the knee, even if it was in 3 or more regions.

Knee pain occurs in pain clusters with involvement of other regions of the body.

The results indicate that knee pain does not tend to occur by itself, and that when it occurs with pain in other regions, it is associated with poorer general and psychological health. In addition, the results suggest a link between the extent of pain in the body and the impact of pain in a particular region. "We have shown that knee-specific pain and disability are actually worse in the presence of pains elsewhere than the knee, even after accounting for poorer psychological health," the authors state.

"The practical importance of our findings is that the presence and extent of pain in other sites may be an important determinant of outcome in patients who present with knee pain, just as it appears to be in those who present with back pain [as shown in previous studies]," the authors conclude. In addition, they note that managing pain in one region such as the knee (with local treatments such as physiotherapy or total knee replacement) might have beneficial effects on the general perception of pain and on the frequency and impact of pains elsewhere in the body.

Do the various pains have a common cause? Does chronic pain indicate a generally faster rate of aging?

I'd like to see a follow-up of this study with people over the age of 50 where stem cells get extracted from knees and other regions of pain and also from the blood. The goal would be to measure telomere lengths and compare them between people with and without pain to see if people with more pain are biologically older than age equivalent people who suffer less pain. Telomeres are caps on the ends of chromosomes and their lengths provide an indication of how many times a cell has divded. The more times a cell divides the shorter the telomeres get. I bet that the people with more chronic pains have shorter telomere lengths. Also, I bet that people with shorter telomere lengths will have lower life expectancies on average.

A study that looks for correlations between stem cell age and extent of aches and pains would provide evidence for whether development of stem cell treatments should gain priority in treatment of arthritis and other diseases that cause pain with age. Advocates for Strategies for Engineered Negligible Senescence (SENS) such as Aubrey de Grey argue that it would be more productive to develop rejuvenation therapies than to try to develop treatments for every disease of old age. If aches and pains are the result of cellular aging and of a lack of young stem cells to supply replacements for repair then more rapid development of rejuvenating stem cell therapies would provide better solutions for the pains of old age than surgery, anti-inflammatory drugs, anti-pain medication, and other current approaches.

For why I expect the people with more pains to have shorter telomeres and older stem cells see my previous posts "Telomere Length Indicates Mortality Risk", "Chronic Stress Accelerates Aging As Measured By Telomere Length", and "Aubrey de Grey On Stem Cell Reseeding For Aging".

Share |      Randall Parker, 2005 July 29 10:27 AM  Aging Studies

Brett Bellmore said at July 30, 2005 6:27 AM:

At this point, let me put in a plug for SAMe. (S-adenosylmethionine) A few years after breaking my leg just above the ankle, I developed traumatic arthritis, and it looked like I was going to spend the rest of my life taking anti-inflamatories, and even be slated for joint replacement in a decade or so. After taking Naproxen for a few months, I read about the SAMe, and gave it a try. I found it to be fabulously effective, and my doctor is pretty impressed with the results, too.

I wouldn't say the results are perfect, as I still have to pop an Ibeprofen occasionally, but unlike the pain killers, the effect is cumulative; It's actually causing my cartilege to gradually rebuild, in addition to relieving the joint pain.

The fact that it's also an anti-depressant, (Do NOT take it if you're bipolar!) was quite the bonus.

Eric McErlain said at August 1, 2005 8:43 AM:

I spent five years at the Arthritis Foundation in PR and fundraising, and was always struck by how folks would never hesitate to look for a drug or some other treatment for relief when old-fashioned exercise could do the trick as well.

The cycle we'd see in patients was always the same -- patient loses function due to arthritis; loss of function leads to decreased physical activity; decreased physical activity leads to depression; depression leads to further diminishment of physical activity, which can lead to or exacerbate diabetes and/or heart disease. Further deterioration of physical condition leads to even deeper depression and so on . . .

Tragic to say the least. Glad to see it getting more attention.

sheril said at February 6, 2006 12:25 PM:

hi, i have a problme. my leg started achin 11 years ago, i tried many things but it didnt work. at this moment, it's achin terribily,more than before. i tried many things but it still aches, can you please reply back and tell me the solution towards it?? thankyou very much for your time and cooperation.


aliasghar said at January 25, 2009 12:27 AM:

I am 34Year Male and i have problem with, When i am climing on steps or sit and want to stand up i could not stand up quickly and could not step up on stairs quickly because its paining/aching in my both knee. kindly let me know by return why its happening.

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