The purpose of this study was to evaluate whether knee and hip pain are more prevalent with contralateral foot pain than with ipsilateral foot pain in a population-based sample of men and women.
Members of the Framingham Foot Study received a validated foot examination evaluating specific foot disorders, pain, pain location (including side of pain) and pain severity.
To assess pain at other sites, participants were given a diagram of the body with ten joint regions highlighted (shoulders, elbows, hips, wrists, knees, ankles, neck, upper back, middle back, and lower back) and asked questions.
From the information collected on foot, hip and knee pain, three four-category variables were created to indicate participants with no pain, bilateral pain, left-sided pain only or right-sided pain only for each pain location (foot, hip, and knee).
Age, height and weight were collected at the foot examination.
Descriptive statistics were generated for study variables using means and standard deviations or percentages where appropriate.
The multinomial logistic regression models allowed the authors to examine the association between contralateral pain (foot pain on the opposite side as the hip or knee pain) and ipsilateral pain (foot pain on the same side as the hip or knee pain).
The authors found that foot pain was associated with bilateral and ipsilateral knee pain in men and women.
Foot pain was also associated with ipsilateral hip pain in men, whereas in women bilateral foot pain was associated with ipsilateral, contralateral and bilateral hip pain.
A theory that may explain these results examines the correlated and compensatory postures and movements of an individual.
These findings advocate for a change in the paradigm of how patients with lower extremity pain should be evaluated clinically.
For clinicians who provide foot-related care, asking patients about hip or knee pain may provide further insights.
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