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Neuropathic-like knee pain and associated risk factors: a cross-sectional study in a UK community sample

Fernandes, Gwen Sascha; Valdes, Ana Marie; Walsh, David Andrew; Zhang, Weiya; Doherty, Michael


Gwen Sascha Fernandes

Professor of Rheumatology

Michael Doherty



Neuropathic-like knee pain (NKP) is often reported in individuals with knee pain (KP), but the contribution of specific central and peripheral risk factors to NKP has not been studied previously. The aims of the present study were to determine the prevalence of NKP in a community-derived sample with KP and to identify risk factors associated with NKP.


A cross-sectional study was undertaken (n = 9506) in the East Midlands community among responders (aged 40+ years) to a postal questionnaire. Questions included KP severity (numerical rating scale) and type (neuropathic versus nociceptive) using the modified painDETECT questionnaire, as well as age, body mass index (BMI), significant knee injury, widespread pain, pain catastrophising and fatigue. Multinomial regression analysis was used to determine ORs and 95% CIs. Risk factors were categorised into central and peripheral, and proportional risk contribution (PRC) and 95% CI were estimated using ROC.


KP was reported in 28.2% of responders, of whom 13.65% had NKP (i.e., 3.9% of the total population). Women reported more NKP. After adjustment for age, gender, BMI and pain severity, definite NKP showed associations (aOR, 95% CI) with fibromyalgia (4.07, 2.49–6.66), widespread pain (1.93, 1.46–2.53), nodal osteoarthritis (1.80, 1.28–2.53), injury (1.50, 1.12–2.00), pain catastrophising (5.37, 2.93–9.84) and fatigue (5.37, 3.08–9.35) compared with non-NKP participants. Although only central risk factors contributed to NKP (PRC 8%, 95% CI 2.5–12.5 for central vs. PRC 3%, 95% CI −0.25 to 7.5 for peripheral), both central and peripheral risk factors contributed equally to non-NKP (PRC 10%, 95% CI 5–20 for both).


NKP appears to be driven largely by central risk factors and may require different prevention/treatment strategies.


Fernandes, G. S., Valdes, A. M., Walsh, D. A., Zhang, W., & Doherty, M. (2018). Neuropathic-like knee pain and associated risk factors: a cross-sectional study in a UK community sample. Arthritis Research and Therapy, 20(1), Article 215.

Journal Article Type Article
Acceptance Date Sep 6, 2018
Online Publication Date Sep 27, 2018
Publication Date Dec 1, 2018
Deposit Date Nov 14, 2018
Publicly Available Date Nov 14, 2018
Journal Arthritis Research & Therapy
Print ISSN 1478-6354
Electronic ISSN 1478-6362
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 20
Issue 1
Article Number 215
Keywords Neuropathic pain; Osteoarthritis; Risk factors; Pain catastrophizing; Anxiety; Depression
Public URL
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