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Obese Seniors with Arthritis More Sensitive to Pain,
Study Finds
March 1, 2006 A study of older adults with
osteoarthritis of the knee, a disease that causes inflammation and
extreme pain, has found that obese seniors may be more sensitive to pain
than those who are not overweight.
Participants were given a mild electrical
stimulation on their left ankle to measure their pain reflex. The
stimulus was given before and after the participants took part in a
45-minute coping skills training session that included a progressive
muscle relaxation exercise.
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The obese patients showed a greater physical
response to the electrical stimulation than did the non-obese people,
both before and after the training session. This indicates they had a
lower tolerance for the painful stimulation despite reporting, in
questionnaires, that they felt no more pain than non-obese people.
The relaxation procedure helped both groups cope
with pain, said
Charles Emery, the study's lead author and a professor of
psychology at Ohio State University.
Additionally, our tests showed both groups had
higher physical pain thresholds after the relaxation session. But the
obese participants still had a lower threshold for tolerating the pain.
Emery and his colleagues will present their
findings on March 4 in Denver at the annual meeting of the
American Psychosomatic Society, which opens today.
The researchers wanted to see if coping skills
training, including progressive relaxation techniques would help people
with osteoarthritis to better cope with the pain that the disease can
cause. Also called degenerative joint disease, osteoarthritis affects
more than 20 million people in the United States.
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All participants, obese or not, reported that
they felt less pain after the relaxation session than they did
before. Yet results of the sural nerve stimulus test showed that
the obese participants did not tolerate the painful stimulus as
well as the non-obese individuals.
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But they were particularly interested in seeing how
the obese group responded to pain; according to Emery, a small number of
studies have looked at pain sensitivity in obese people, but many of
these studies report conflicting results.
Some studies say that obese people are more
tolerant of pain, while other studies say they are less tolerant, Emery
said.
About a third of the study's 62 participants were
obese. Researchers determined who was obese based on participants' body
mass index (BMI) scores, which relates height to weight. Obese patients
in this study had a BMI greater than 30 but less than 35. (Scores higher
than 35 are considered morbidly obese.)
Are you overweight?
- check our Body Mass Index
The participants underwent two rounds of electrical
stimulation once before, and once after a 45-minute training session
where they learned different ways of coping with pain, including
instruction in progressive muscle relaxation therapy.
The electrical stimulation came from an iPod-sized
device that delivered a slight electrical shock to a patient's sural
nerve, a nerve that extends along the ankle and into the calf. This kind
of electrical stimulation causes sensations of tingling and mild pain in
the lower leg.
The researchers determined the body's response to
sural nerve stimulation by measuring the reflex of the lower leg muscles
that surround the sural nerve. When the brain senses pain, it sends a
message to the body to contract and move the muscles in order to get
away from the source of the pain.
This kind of evaluation is in some ways a more
objective way of measuring the body's response to pain, as opposed to
simply asking someone if they feel pain, Emery said.
But the researchers did ask participants how much
pain they felt. Participants completed questionnaires about anxiety and
pain perception after each round of electrical stimulations. All
participants, obese or not, reported that they felt less pain after the
relaxation session than they did before.
Yet results of the sural nerve stimulus test showed
that the obese participants did not tolerate the painful stimulus as
well as the non-obese individuals.
Our findings show the importance of looking at
objective as well as subjective measurements of how the body responds to
pain stimuli, Emery said.
Emery conducted the study with colleagues from Ohio
State,
Ohio and
Duke universities.
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