The public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
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Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.
Digital Trial Lecture - time and place
Adjudication committee
- First opponent: Professor Nidhi Sofat, Unversity of London, United Kingdom
- Second opponent: Senior Researcher Anushka Soni, University of Oxford, United Kingdom
- Third member and chair of the evaluation committee: Professor II Lars Nordsletten, Institute of Clinical Medicine, University of Oslo
Chair of defence
Professor Bård Natvig, Institute of Health and Society, University of Oslo
Principal Supervisor
MD, PhD Ida K. Haugen, Diakonhjemmet sykehus, Oslo
Summary
Pain sensitization, i.e. increased pain sensitivity, is believed contribute to chronic pain in many diseases, including osteoarthritis (OA). Hand OA is a serious, painful, and disabling disease. This doctoral thesis aimed to examine the relevance of peripheral and central pain sensitization in persons with hand OA.
Pain sensitization by pressure pain algometry and temporal summation was tested cross-sectionally in a large cohort and their relationships with pain severity as well as structural and inflammatory OA changes were analysed. Almost 300 participants were included, making it the largest study on the subject so far.
The results showed that central sensitization was common, and that peripheral and central sensitization was associated with higher hand pain intensity, independent of psychosocial factors and radiographic OA. The degree of structural and inflammatory changes in a finger joint was associated with pressure pain threshold of the same finger joint as a measure of peripheral and possibly also central sensitization in multilevel analyses. These results were not statistically significant in nonpainful joints alone. The overall amount of hand joint pathologies in a person with hand OA was not related to central sensitization except for presence of erosive hand OA. Disease duration was not associated with central sensitization.
The cross-sectional study design limited the ability to draw conclusions about causality. Prospective studies are needed to better understand the risk factors for pain sensitization and the causal association between pain sensitization and hand pain. Further, reliability-testing of pain algometry and temporal summation showed variable results and efforts should be made to enhance the reliability of these tests in future studies.
The papers of this thesis confirm the clinical relevance of pain sensitization in hand OA. The results lay a groundwork for further exploration of how pain sensitization may be targeted to reduce chronic pain from hand OA.
Additional information
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