Abstract
This retrospective
study explored the correlation between joint osteophyte severity and joint pain
and evaluated pain-targeted nursing interventions in 30 patients with joint
osteophytes. Patients were divided into intervention group (n=15) and control
group (n=15). The control group received routine nursing care, while the
intervention group received additional pain-targeted nursing interventions
including multimodal pain management, pain education and activity modification
based on pain levels. Primary outcomes included the correlation between
osteophyte severity (Larsen grade) and pain intensity (VAS score) and the
change in VAS score at 3 months. Secondary outcomes included Lequesne Index,
pain interference with daily activities (PI-ADL) and patient satisfaction.
Results showed a significant positive correlation between Larsen grade and
initial VAS score (r=0.68, p<0.01). At 3 months, the intervention group had
a significantly greater reduction in VAS score compared to the control group (4.8±1.3
vs 2.3±1.1, p<0.01). The intervention group also showed better improvement
in Lequesne Index, PI-ADL score and higher patient satisfaction (p<0.05 for
all). Pain-targeted nursing interventions effectively alleviate joint pain
associated with osteophytes and improve patient outcomes.
Keywords: Osteoarthrosis; Larsen grade; Kellgren-lawrence grade;
Lequesne index
Introduction
Joint osteophytes are
closely associated with joint pain, which is the main symptom leading to
reduced quality of life in patients1. However, the correlation between osteophyte severity
and pain intensity is not absolute and effective pain management is crucial for
nursing care2. This study aims to explore the correlation between
joint osteophytes and joint pain and evaluate the effect of pain-targeted
nursing interventions, providing evidence for clinical nursing practice3.
Methods
Study design and
participants
A retrospective analysis was conducted on 30
patients with joint osteophytes confirmed by radiography (knee joint in 22
cases, hip joint in 8 cases) admitted to our hospital. Inclusion criteria: age
45-75 years; osteophyte severity evaluated by Larsen grade (I-IV); joint pain
lasting for more than 1 month. Exclusion criteria: inflammatory arthritis,
joint infection, neurological diseases causing pain.
Grouping & interventions
Control subgroups: Routine nursing care,
including pain assessment, medication guidance and general health education.
Intervention subgroups:
On the basis of routine
nursing, pain-targeted nursing interventions were added:
• Multimodal pain management: combining physical therapy (hot/cold compress, transcutaneous electrical nerve stimulation), psychological intervention (relaxation training, cognitive behavioural therapy) and activity adjustment according to pain level.
• Pain education: explaining the relationship between osteophytes and pain, teaching pain self-assessment and coping skills.
• Individualized exercise program: formulating low-impact exercise plans based on pain tolerance, such as swimming, cycling and muscle strength training.
Outcome measures
• Primary: Correlation between Larsen grade and initial VAS score; change in VAS score (0-10, higher score indicates more severe pain) at 3 months.
• Secondary: Lequesne Index (evaluating joint function, 0-24, higher score indicates worse function); PI-ADL score (0-40, higher score indicates more severe pain interference); patient satisfaction (0-100, higher score indicates higher satisfaction).
Statistical analysis
SPSS 26.0 software was
used for statistical analysis. Pearson correlation analysis was used to explore
the correlation between Larsen grade and VAS score. Measurement data were
expressed as mean ± standard deviation (x̄±s) and independent sample t-test was
used for comparison between groups. P<0.05 was considered statistically
significant.
Results
Correlation between osteophyte severity and pain
There was a significant
positive correlation between Larsen grade and initial VAS score (r=0.68,
p<0.01) (Figure 1).
Baseline characteristics
There were no
significant differences in age, gender, affected joint, Larsen grade, initial
VAS score, Lequesne Index or PI-ADL score between the two groups (p>0.05),
which were comparable (Table 1).
Table 1: Comparison of baseline
characteristics between the two groups
|
Characteristics |
Intervention Group (n=15) |
Control Group (n=15) |
p-value |
|
Age (years, x̄±s) |
58.6±8.2 |
59.3±7.8 |
0.803 |
|
Gender (male/female, n) |
8/7 |
7/8 |
0.735 |
|
Affected joint (knee/hip, n) |
11/4 |
11/4 |
1.000 |
|
Larsen grade
(I/II/III/IV, n) |
2/8/4/1 |
3/7/4/1 |
0.917 |
|
Initial VAS score (x̄±s) |
7.2±1.3 |
7.0±1.2 |
0.652 |
|
Initial Lequesne Index (x̄±s) |
16.8±3.5 |
17.2±3.2 |
0.756 |
|
Initial PI-ADL score (x̄±s) |
22.5±4.1 |
23.1±3.8 |
0.689 |
Primary outcome
At 3 months, the VAS
score in the intervention group was significantly lower than that in the
control group and the reduction amplitude was significantly larger (p<0.01) (Table
2).
Table 2: Comparison of VAS
scores between the two groups at different time points (x̄±s, points)
|
Group |
n |
Baseline |
1 month |
3 months |
Reduction at 3 months |
|
Intervention Group |
15 |
7.2±1.3 |
4.5±1.1 |
2.4±0.9 |
4.8±1.3 |
|
Control Group |
15 |
7.0±1.2 |
5.8±1.0 |
4.7±1.0 |
2.3±1.1 |
|
p-value |
- |
0.652 |
<0.001 |
<0.001 |
<0.001 |
Secondary outcomes
At 3 months, the
Lequesne Index and PI-ADL score in the intervention group were significantly
lower than those in the control group and the patient satisfaction was
significantly higher (p<0.05) (Table 3).
Table 3: Comparison of
secondary outcomes between the two groups at 3 months (x̄±s)
|
Outcome Indicators |
Intervention Group (n=15) |
Control Group (n=15) |
p-value |
|
Lequesne Index (points) |
8.2±2.1 |
12.5±2.8 |
<0.001 |
|
PI-ADL score (points) |
10.3±3.2 |
16.8±3.5 |
<0.001 |
|
Patient satisfaction (points) |
85.6±6.3 |
68.2±7.5 |
<0.001 |
Discussion
This study found a
significant positive correlation between joint osteophyte severity (Larsen
grade) and joint pain (VAS score), which is consistent with previous studies4. However, it should
be noted that pain is not only related to osteophyte itself but also affected
by factors such as inflammation, muscle spasm and psychological state5. Therefore, pain
management should not only focus on osteophyte but also take a comprehensive
approach.
The pain-targeted
nursing interventions in this study achieved good results. Multimodal pain
management combines physical therapy and psychological intervention, which can
exert synergistic effects. Physical therapy can relieve local inflammation and
muscle tension, while psychological intervention can reduce pain perception by
alleviating anxiety and improving coping ability6. Individualized
exercise programs can enhance muscle strength around the joint, improve joint
stability and reduce pain, which is supported by relevant research7.
Pain education helps
patients correctly understand the relationship between osteophytes and pain,
reduces unnecessary fear and improves compliance with treatment and nursing8. The improvement of
Lequesne Index and PI-ADL score in the intervention group indicates that
relieving pain can effectively improve joint function and reduce pain
interference with daily activities.
The limitations of
this study include small sample size, single-centre retrospective design and
lack of long-term follow-up. Future studies with larger samples and longer
follow-up periods are needed to further verify the effectiveness of
pain-targeted nursing interventions.
Conclusion
There is a significant positive
correlation between joint osteophytes and joint pain. Pain-targeted nursing
interventions can effectively reduce joint pain, improve joint function, reduce
pain interference with daily activities and improve patient satisfaction. It is
worthy of clinical promotion and application.
References