Prevalence and Nature of Joint Pain among Arthritis Clients attending The Orthopaedic Opd at Bapuji Hospitals, Davanagere

 

Manjula BU1, Harsha KM2, Narmada.A3, Kirankumar H Bennur4

1II Year M. Sc Nursing Student, Bapuji College of Nursing, Davangere.

2Principal and HOD, Medical Surgical Nursing, Bapuji College of Nursing, Davanagere.

3Principal, Bapuji School of Nursing, Davanagere.

4Assistant Professor, Bapuji College of Nursing, Davanagere.

*Corresponding Author E-mail: manjutanu227@gmail.com

 

ABSTRACT:

Background: Arthritis is a common disease of aged population and one of the leading causes of disability. Incidence of arthritis is rising by increasing average age of general population. Age, weight, trauma to joint due to repeating movements in particular squatting and kneeling are common risk factors of arthritis. Objectives:

1.     To assess the prevalence of joint pain among arthritis patients. 2. To describe the nature of pain among arthritis patients. 3. To determine the association of severity of joint pain in arthritis patients with selected demographic variables. Methods: A descriptive design was adopted for the study. Samples were selected using non probability convenient sampling technique. Sample consists of 50 arthritis patients, out of which 41 are females and 9 were males attending outpatient department at Bapuji Hospital, Davangere. Data from the study participants was collected by structured questionnaires on prevalence and nature of joint pain. Data collected was analyzed using descriptive and inferential statistics. Results: The study findings revealed that the 82.0% of the study participants were females among them 68% were housewives. Around 68% of patients belong to age group of 50-70 years. The mean age and weight of study subject is 62.46 years and 74.04 kg respectively. It was found that the prevalence of joint pain in arthritis patients increased with increase in body mass index (BMI). Prevalence was found to be highest in people who are overweight and/ or obese. The pain was Prevalent in all the arthritis patients and it predominantly found in knee joint bilaterally. Analysis of level of pain reveals that 38% of the subjects had moderate pain with moderate trouble, 48% had severe pain with extreme difficulty and 14% had severe pain and impossible movements. About 56% of patients are having sever difficulty in movement of joint after prolonged rest period and .74% of patients have pain and stiffness after bed time, 62% of patients feels sever pain while walking and 20% of the them having impossible joint movements. Conclusion: From the study it is concluded that the samples suffer from moderate pain with moderate trouble. The ageing, female gender, over weight are some associated factors for joint pain. The study participant recommended on regular exercise, weight reduction and timely treatment to reduce the consequences of arthritis.

 

KEYWORDS: Prevalence, Nature of Joint Pain, Arthritis Clients, orthopedic OPD, Davangere.

 


INTRODUCTION:

Arthritis is derived from the Greek term “disease of the joints.” It is defined as an acute or chronic joint inflammation that often co-exists with pain and structural damage. More than 100 different types of arthritis have been described, the most common being is osteoarthritis which is non-inflammatory arthritis.1 There are several types of arthritis. Common ones include the following. Ankylosing spondylitis, Gout, Juvenile idiopathic arthritis, Osteoarthritis, Psoriatic arthritis, Reactive arthritis, Rheumatoid arthritis, lupus, fibromyalgia. Some of the symptoms of arthritis include pain, redness, heat, and swelling in joints. 2

 

The ethology of arthritis varies with the type of arthritis. In osteoarthritis, the major contributory factors include advancing age, female sex, joint trauma, and obesity and some genetic factors. 1 RA pain has a wide range of characteristics—constant or intermittent, localized or widespread—and is often associated with psychological distress and fatigue 2. The joint pain of OA is typically described as exacerbated by activity and relieved by rest. More advanced OA can cause rest and night pain leading to loss of sleep which further exacerbates pain. The cardinal symptoms of OA include pain which is often deep, aching and not well localized usually of insidious onset, reduced function, stiffness, joint instability, buckling, reduced movement, deformity, swelling, crepitus, and is increased with age. When pain persists pain-relate psychological distress.3

 

Inflammatory arthritis can also accompany other autoimmune connective tissue diseases such as systemic lupus erythematosus, Sjogren syndrome, scleroderma, myositis, inflammatory bowel disease, celiac disease, etc. 1

 

NEED FOR THE STUDY:

In 2020, an estimated 17·6 million people had rheumatoid arthritis worldwide. The age-standardized global prevalence rate was 208·8 cases per 100 000 population, representing a 14·1% increase since 1990. Prevalence was higher in females (age-standardized female-to-male prevalence ratio 2·45). We forecast that 31·7 million individuals will be living with rheumatoid arthritis worldwide by 2050.4

 

Overall, 9.36% of the Indian population aged 45 years or above had Arthritis The prevalence was 7.49% and 11.03% in males and females respectively. Females are more at risk for arthritis as compared to males with an odds ratio of 1.59.5

 

A community based cross sectional study estimated the prevalence of primary knee OA across five sites in India among 5000 subjects, overall prevalence of knee OA was found to be 28.7% and the associated factors were found to be female gender, obesity, age and sedentary work.6

 

OBJECTIVES:

1.     To assess the prevalence of joint pain among arthritis patients.

2.     To describe the nature of pain among arthritis patients.

3.     To determine the association of severity of joint pain in arthritis patients with selected demographic variables.

 

HYPOTHESIS:

H1: There is an association between severity of joint pain in arthritis patients with selected demographic variables.

 

METHODOLOGY:

Research Design: The research design selected for study was descriptive research design.

 

Sampling Technique:

Convenience sampling technique

 

Sample:

Sample size was 50 patients attending orthopedic OPD at Bapuji hospital, Davangere.

 

VARIABLES:

Research variable:

Prevalence and nature of joint pain among arthritis patients.

 

Demographic variables:

Age, gender, education, occupation, BMI, diet are some demographic variables in this study.

 

SETTING:

The study was conducted in orthopedic outpatient department at Bapuji hospital, Davanagere.

 

DATA COLLECTION TECHNIQUE:

SECTION- A: This section deals with socio demographic characteristics which includes Age, gender, education, occupation, BMI, food pattern and life style.

 

SECTION-B: Structured questionnaire was prepared to assess the prevalence and nature of joint pain among arthritis patients attending the orthopedic OPD at Bapuji hospital, Davanagere.

 

RESULTS:

Section 1: Selected personal variables of the arthritis patients.

Table 1: Frequency and percentage of some demographic variables of arthritis patients                                                           n = 50

Variable

Frequency

Percent

1.       Age

 

 

a.       40-50 years

6

12.0

b.       51-60 years

16

32.0

c.       61-70 years

18

36.0

d.       71-80 years

10

20.0

2.       Gender

 

 

a.       Male

9

18.0

b.       Female

41

82.0

3.       BMI

 

 

a.       Overweight

28

56.0

b.       Obesity Level 1

12

24.0

c.       Obesity Level 2

6

12.0

d.       Obesity level 3

4

8.0

4.       Weight

 

 

a.       65-75 kg

31

62.0

b.       76-85 kg

19

38.0

5.       Food pattern

 

 

a.       Vegetarian

27

54.0

b.       Mixed

23

46.0

6.       Education

 

 

a.       No formal education

39

78.0

b.       Primary education

8

16.0

c.       PUC and above

3

6.0

7.       Occupation

 

 

a.       Housewife

34

68.0

b.       Daily wages/Coolie

8

16.0

c.       Former

7

14.0

d.       Teacher

1

2.0

8.       Lifestyle

 

 

a.       Sedentary

3

6.0

b.       Heavy

47

94.0

 

Table 1 depicts that majority (68%) of the study subjects were in the age group of 50-70 years, 82.0% of them were females, All the subjects were having overweight and obese. Among the participants 78% had no formal education and 68% were housewives, Most (94%) were heavy workers.

 

Table 2: Mean and standard deviation Of Age and Weight of The Subjects

Mean

SD

Age of subjects

62.46

9.675

Weight of the subjects

74.04

6.064

Table 2 revealed that the mean age and weight of the study subjects is 62.46±9.675 years and 74.04±6.064kg respectively.

 

Section 2: Analysis of Nature and characteristics of pain among arthritis patients.

Table 3: Comprises of nature and severity pain in arthritis patients

1.      Do you feel pain in any part of your body

Frequency

Percent

a.      Yes

50

100.0

b.      No

0

0.0

2.      How would you describe your overall pain level

 

 

a.      moderate pain with moderate trouble

19

38.0

b.      sever pain and extreme difficulty

24

48.0

c.      sever pain and impossible movements

7

14.0

 

All study participants were having pain in their joints among them 48% of patients having sever pain and extreme difficulty, 14% having sever pain and impossible movements

 

Table: 4 Shows the risk factors contributing to arthritis

3.      Did you have any previous injury to your bones and joint

Frequency

Percent

a.      No Injury

42

84.0

b.      Mild injury

4

8.0

c.      Severe Injury

2

4.0

d.      Undergone with surgery after injury

2

4.0

4.      Do you have any diseases other than joint pain

 

 

a.      Yes

20

40.0

b.      No

30

60.0

Most of the arthritis patients having no history of injury and around 40% of them having diseases other than joint pain.

Table: 6 Commonly affecting sites

5.      Predominant pain site

Frequency

Percent

a.      Knee

42

84.0

b.      Ankles

2

4.0

c.      Knee and ankle

3

6.0

d.      Knee and Hips

3

6.0

6.      Any one or both side

 

 

a.      One side

1

2.0

b.      Both

49

98.0

 

Most of the subjects having pain in both sides and 84% of them having pain at knee as predominant site

 

Table: 7 Nature and severity of pain in arthritis

7.      Do you have any difficulty in movement of joint after prolonged rest

Frequency

Percent

a.       Moderate level

15

30.0

b.      Severe difficulty

28

56.0

c.       Impossible to move the joints

7

14.0

8.      Did you feel pain and stiffness in the morning

Frequency

Percent

a.       Moderate pain and no stiffness

5

10.0

b.      Pain and stiffness

37

74.0

c.       Severe pain and stiffness

8

16.0

 

Majority 74% of the patient having pain and stiffness after bed time and even 56% of patient have sever difficulty after prolonged rest

 

Table 8: Consequences of arthritis

9.      Do you have pain while walking

Frequency

Percent

a.      Moderate pain after short distance

9

18.0

b.      Severe pain while walking

31

62.0

c.      Impossible to move

10

20.0

10.   How long you can walk

Frequency

Percent

a.      More than 40 Minutes

1

2.0

b.      For 20 minutes

11

22.0

c.      just for 10 minutes

30

60.0

d.      can't walk at all

8

16.0

11.   Since how long have you been in pain

Frequency

Percent

a.      From last 4 months

2

4.0

b.      From last 12 months

16

32.0

c.      From last year

15

30.0

d.      More than 2 years

17

34.0

 

Most (62%) of the patients have severe pain, 42% of the them always limp while walking and can walk just for 10 minutes and 62% of the them have pain in their knee joint since more than one year

 

Table: 9 Issues with Quality of life

12.    Does the pain in your knee will cause you to limp while walking

Frequency

Percent

a.       Rarely or never

8

16.0

b.      Occasionally

7

14.0

c.       Frequently

14

28.0

13.    Have you had any trouble while getting in and out of car or using public transportation

Frequency

Percent

a.       No trouble

5

10.0

b.      Very little

13

26.0

c.       Moderate

17

34.0

d.      Extreme or impossible

15

30.0

14.    Does pain in your joints interferes with sleep

Frequency

Percent

a.       Never

7

14.0

b.      Once a while

16

32.0

c.       Some nights

18

36.0

d.      Most of the times

9

18.0

 

Most of the patients have extreme difficulty in using all kind of public transports because of severe pain 36% of the patients feels disturbance in sleep at night.

 

Section 3: Association between severity of pain in arthritis patients with their selected personal variables:

The study findings revealed that there is a statistically significant association of age and weight of subjects with the severity of pain perception among arthritis patients at 0.05 level.

 

CONCLUSION:

The study concludes that most of the arthritis patients were having pain in their both knees and they feels severe difficulty in movement of joints after prolonged rest period and have pain and stiffness in the morning. Most of the times pain is felt while doing house hold works and around most of the patients have severe pain while walking, disturbed sleep at night and extreme difficulty in using public transports. Ageing and female gender were the important associated factor for joint pain. The study recommends that weight reduction, regular exercise, rehabilitation, treatment and prevention of complications of arthritis.

 

RECOMMENDATIONS:

The following recommendations were made based on the results of the study.

1.     A similar study can be replicated on a larger sample with similar demographical characters.

2.     A study can be conducted to assess the effect of aromatherapy in reducing the pain among arthritis patients.

3.     A study can be conducted to assess the quality of life among arthritis patients.

 

REFERENCES:

1.      Senthelal S, Li J, Ardeshirzadeh S, et al. Arthritis. [Updated 2023 Jun 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan; Available from: https://www.ncbi.nlm.nih.gov/books/NBK518992/

2.      Walsh, D., McWilliams, D. Mechanisms, impact and management of pain in rheumatoid arthritis. Nat Rev Rheumatol. 2014; 10: 581–592. Available from: https://doi.org/10.1038/nrrheum.2014.64

3.      Hunter DJ, McDougall JJ, Keefe FJ. The symptoms of osteoarthritis and the genesis of pain. Rheum Dis Clin North Am. 2008 Aug; 34(3): 623-43. doi: 10.1016/j.rdc.2008.05.004. PMID: 18687276; PMCID: PMC2597216. Available from: https://doi.org/10.1016/j.rdc.2008.05.004

4.      GBD 2021 Rheumatoid Arthritis Collaborators. Global, regional, and national burden of rheumatoid arthritis, 1990-2020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023;5(10):e594-e610. Published 2023 Sep 25. doi:10.1016/S2665-9913(23)00211-4. Available from: https://doi.org/10.1016/S2665-9913(23)00211-4

5.      Sabat, S. K., Panda, S., Merli, P. K., and Bhuyan, S. K.  Prevalence and correlates of arthritis in Indian older adults: Findings from the longitudinal aging study of India. International Journal of Health Sciences. 2022; 6(S5): 10062–10072. https://doi.org/10.53730/ijhs.v6nS5.11119

6.      Pal, C. P., Singh, P., Chaturvedi, S., Pruthi, K. K., and Vij, A. Epidemiology of knee osteoarthritis in India and related factors. Indian journal of orthopaedics. 2016; 50(5): 518–522. https://doi.org/10.4103/0019-5413.189608

 

 

 

 

Received on 17.04.2024         Revised on 05.08.2024

Accepted on 02.10.2024         Published on 28.11.2024

Available online on December 31, 2024

A and V Pub J. of Nursing and Medical Res. 2024;3(4):121-124.

DOI: 10.52711/jnmr.2024.28

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