Chronic joint pain consistent with osteoarthritis one of the most debilitating conditions of our time. Chronic joint pain is expected to affect more and more people due to ageing populations and escalating obesity levels. Although osteoarthritis can affect any joint, the knee and hip joints are commonly affected. Current treatment guidelines recommend education, exercise and weight management. However, these treatments are often disappointing and increasingly patients are relying on end-stage treatment (i.e. joint replacement) for satisfactory management.
New treatment targets are needed to reduce the escalating demand for joint replacements, which are expensive and burdensome. Identifying new treatment targets will drive innovative ways to manage chronic hip and/knee pain. Addressing poor sleep may be a missed opportunity to reduce chronic hip and/knee pain. Poor sleep is often described by people with chronic hip and/knee pain but is rarely targeted in the management for chronic hip and knee pain. Animal research goes beyond what most of us can relate to, that pain causes disrupted sleep – and suggests that disturbed sleep causes pain. Our aim with this work is to determine the link between sleep and joint replacement (the clinical-end point) to justify why treatment targeting sleep may be worthwhile to manage chronic hip and/or knee pain.
In contrast to sleep, body composition is often the target of our treatments to manage chronic hip/knee pain. Exercise is prescribed to maintain muscle health and weight management strategies aim to reduce weight if needed. However, our current approach is inadequate as evidence by the increasing number of people opting to undergo joint replacement. Refined exercise and weight loss programs may be required depending on body composition, such as (1) sarcopenia; (2) sarcopenic obesity; (3) obesity; (4) normal – without sarcopenia or obesity). Our aim with this work is to determine the link between body composition and joint replacement (the clinical-end point) to justify why refined treatments targeting body composition may be worthwhile to manage chronic hip and/or knee pain.