Gender Comparison of Severity of Pain, Stiffness, And Functional Limitation Among Second Stage Knee Osteoarthritis Patients with Diabetes

Gender Comparison of Osteoarthritis Patients with Diabetes


  • Haroon Raza Khan University of South Asia Cantt Campus Lahore, Pakistan
  • Safina Ruksar Department of Physiotherapy, University of South Asia Cantt Campus Lahore, Pakistan
  • Kiran Haq Rawal Institute of Health Sciences, Islamabad, Pakistan
  • Somiya Asif Margalla Institute of Health sciences, Rawalpindi, Pakistan
  • Priyanka Ratan Kumar National Institute of Physical Therapy and Rehabilitation Sciences, Pakistan
  • Zarqa Sharif Department of Physiotherapy, Superior University, Lahore, Pakistan
  • Muhammad Faizan Hamid University of South Asia Cantt Campus Lahore, Pakistan
  • Hafiz Rana Muhammad Arslan Department of Physiotherapy, NHS Dumfries and Galloway, Scotland



Gender Comparison of Osteoarthritis Patients with Diabetes


Osteoarthritis (OA) and diabetes mellitus (DM) are two medical conditions that frequently exist together and cause poor consequences. OA is described as joint pain and is one of the main reasons for impairment. Diabetes is high levels of glucose in blood because of disruption in insulin metabolism. Objective: To compare gender variations of severity of pain, stiffness and difficulty in functional performance among patients of second stage knee OA with diabetes. Methods: Data were collected from 360 individuals with mean age 52.32 ± 4.989 years for males and 50.73 ± 4.763 years for females. Individuals with definite osteophytes in knee joint and clinically diagnosed DM were included in the study. The severity of stiffness and functional limitation was calculated using WOMAC questionnaire. Results: The mean of pain score was 9.0833 ± 3.04322, stiffness score was 4.3389 ± 1.12446 and the mean of physical function score was 34.0944 ± 8.65135. Overall, 109 patients had less severe symptoms while 71 had more severe symptoms. Among 180 female participants, n=15 had mild, n=139 had moderate and n=26 had severe pain on NPRS. The mean of the pain score was 9.8778 ± 2.90762. The mean of stiffness score was 4.5167 ± 1.28365 and the mean of physical function score was 37.1611 ± 7.98963. Conclusion: Our findings concluded that the gender difference of severity of pain and physical function limitation was statistically significant, but no significant difference was found in severity of stiffness. Also, females with diabetes had more severe symptoms than males with diabetes


Taj S and Tayaba H. A comparison of health-related quality of life among knee osteoarthritis patients in two cities in Pakistan. Clinical Surgery Research Communications. 2019 Dec; 3(4): 20-5. doi: 10.31491/CSRC.2019.12.040.

Abd El Hamid M, El Sawy N, Abo Zeid A, Abdelmaksoud R. Prevalence of knee osteoarthritis among Egyptian diabetic type 2 patients. International Journal of Physiotherapy and Research. 2018 Apr; 6(2):2654-9. doi: 10.16965/ijpr.2018.101.

Sheikh NI, Tahir F, Zahoor A. Risk factors for osteoarthritis of knee joint among Pakistani population. Journal of HBS Medical and Dental College . 2021 Apr; 1(2): 66-8.

Nielen JT, Emans PJ, van den Bemt B, Dagnelie PC, Schram MT, Stehouwer CD, et al. Association of type 2 diabetes mellitus with self-reported knee pain and clinical knee osteoarthritis: the Maastricht study. Diabetes & Metabolism Journal. 2018 Feb; 44(3): 296-9. doi: 10.1016/j.diabet.2018.01.013.

Kim WB, Kim BR, Kim SR, Han EY, Nam KW, Lee SY, et al. Comorbidities in patients with end-stage knee OA: prevalence and effect on physical function. Archives of Physical Medicine and Rehabilitation. 2019 Nov; 100(11): 2063-70. doi: 10.1016/j.apmr.2019.04.005.

Alenazi AM, Alshehri MM, Alothman S, Alqahtani BA, Rucker J, Sharma NK et al. The association of diabetes with knee pain locations, pain while walking, and walking speed: data from the osteoarthritis initiative. Physical Therapy. 2020 Nov; 100(11): 1977-86. doi: 10.1093/ptj/pzaa144.

Pathak BG, Rahini S, Manapurath RM. The proportion of hand and knee osteoarthritis and its associated risk factors among an urban diabetic population. International Journal of Academic Medicine. 2022 Apr; 8(2):102-8. doi: 10.4103/ijam.ijam_115_21.

Betancourt MC, Morais CL, Lipay MV, Aragão J, Machado EG, Marchi E. Gender differences in the effect of diabetes mellitus and its treatment on osteoarthritic pain. BMJ Open Diabetes Research and Care. 2019 Nov; 7(1):e000736. doi: 10.1136/bmjdrc-2019-000736.

Hawker GA, Croxford R, Bierman AS, Harvey P, Ravi B, Kendzerska T, et al. Osteoarthritis-related difficulty walking and risk for diabetes complications. Osteoarthritis and Cartilage. 2017 Jan; 25(1): 67-75. doi: 10.1016/j.joca.2016.08.003.

Wen CY, Chen Y, Tang HL, Yan CH, Lu WW, Chiu KY. Bone loss at subchondral plate in knee osteoarthritis patients with hypertension and type 2 diabetes mellitus. Osteoarthritis and Cartilage. 2013 Nov; 21(11): 1716-23. doi: 10.1016/j.joca.2013.06.027.

Yasuda E, Nakamura R, Matsugi R, Goto S, Ikenaga Y, Kuroda K, et al. Association between the severity of symptomatic knee osteoarthritis and cumulative metabolic factors. Aging Clinical and Experimental Research. 2018 May; 30(5): 481-8. doi: 10.1007/s40520-017-0808-6.

Schett G, Kleyer A, Perricone C, Sahinbegovic E, Iagnocco A, Zwerina J, et al . Diabetes is an independent predictor for severe osteoarthritis: results from a longitudinal cohort study. Diabetes Care. 2013 Feb; 36(2): 403-9. doi: 10.2337/dc12-0924.

Eitner A, Pester J, Vogel F, Marintschev I, Lehmann T, Hofmann GO, et al. Pain sensation in human osteoarthritic knee joints is strongly enhanced by diabetes mellitus. Pain. 2017 Sep; 158(9): 1743-53. doi: 10.1097/j.pain.0000000000000972.

Magnusson K, Hagen KB, Østerås N, Nordsletten L, Natvig B, Haugen IK. Diabetes is associated with increased hand pain in erosive hand osteoarthritis: data from a population‐based study. Arthritis Care & Research. 2015 Feb; 67(2): 187-95. doi: 10.1002/acr.22460.

Atayde SA, Yoshinari NH, Nascimento DP, Catanozi S, Andrade PC, Velosa AP, et al. Experimental diabetes modulates collagen remodelling of joints in rats. Histology and Histopathology. 2012 Nov; 27(11): 1471-9.

Li L, Li Z, Li Y, Hu X, Zhang Y, Fan P. Profiling of inflammatory mediators in the synovial fluid related to pain in knee osteoarthritis. BMC Musculoskeletal disorders. 2020 Dec; 21(1): 1-0. doi: 10.1186/s12891-020-3120-0.

Alenazi AM, Obaidat SM, Alshehri MM, Alothman S, Gray C, Rucker J, et al. Type 2 diabetes affects joint pain severity in people with localized osteoarthritis: a retrospective study. Pain Medicine. 2020 May; 21(5): 1025-31. doi: 10.1093/pm/pnz299.

Frilander H, Viikari‐Juntura E, Heliövaara M, Mutanen P, Mattila VM, Solovieva S. Obesity in early adulthood predicts knee pain and walking difficulties among men: a life course study. European Journal of Pain. 2016 Sep; 20(8): 1278-87. doi: 10.1002/ejp.852.

Majjad A, Errahali Y, Toufik H, H Djossou J, Ghassem MA, Kasouati J, et al. Musculoskeletal disorders in patients with diabetes mellitus: a cross-sectional study. International Journal of Rheumatology. 2018 Jun; 2018: 1-6. doi: 10.1155/2018/3839872.

Chen S, Ruan G, Zeng M, Chen T, Cao P, Zhang Y, et al. Association between Metformin Use and Risk of Total Knee Arthroplasty and Degree of Knee Pain in Knee Osteoarthritis Patients with Diabetes and/or Obesity: A Retrospective Study. Journal of Clinical Medicine. 2022 Aug; 11(16): 4796. doi: 10.3390/jcm11164796.




How to Cite

Raza Khan, H. ., Ruksar, S. ., Haq, K. ., Asif, S. ., Ratan Kumar, P. ., Sharif, Z. ., Faizan Hamid, M. ., & Muhammad Arslan, H. R. . (2022). Gender Comparison of Severity of Pain, Stiffness, And Functional Limitation Among Second Stage Knee Osteoarthritis Patients with Diabetes: Gender Comparison of Osteoarthritis Patients with Diabetes. THE THERAPIST (Journal of Therapies &Amp; Rehabilitation Sciences), 3(02), 20–24.



Original Article