![]() With international guidelines now recommending clinicians identify and address different clinical OA phenotypes ( 21), a greater understanding of the clinical presentation of people with concurrent knee OA and foot pain, and their cumulative effects upon knee-OA symptoms and functional status, is needed. ![]() For instance, whilst increased foot pronation, a well- recognized biomechanical risk factor for many painful foot conditions ( 15- 18), has been reported in people with medial knee OA compared to those without, studies have only explored associations between the foot and knee of the same limb ( 19, 20). This information is important as it may provide insight into common clinical knee OA phenotypes, and has the potential to increase our knowledge of pain presentations at these two common sites. No study has explored the relationship between foot pain and knee OA-specific symptoms or function. For instance, one study suggested the most common multi-joint pain presentation was foot and knee pain but did not report prevalence ( 13), whereas another reported prevalence rates (16.6%) but used a strict definition of isolated foot pain (i.e. Whilst it is recognized that multiple joint symptoms are both common and disabling in people with knee OA ( 10- 12), concurrent foot and knee pain is rarely described and its prevalence is unclear. Concurrent foot pain in people with knee OA therefore has the potential to further exacerbate disability and symptom severity than if knee OA occurred in isolation. Compared to those without foot pain, people with foot pain perform significantly worse during daily activities and basic functional tasks such as walking and balance activities ( 7, 8), and are also at a greater risk of falling ( 9). Like knee OA, foot pain also reduces quality of life ( 7) and is a major cause of disability. Foot pain, often defined as pain in the foot and/or ankle ( 4), is also very common amongst older people, with epidemiological studies reporting that approximately 40% of those over 50 years experience pain in their feet on most days in the last month ( 5) or year ( 6). ![]() The primary symptom of knee OA is pain, and painful knee OA significantly reduces physical function ( 2) and quality of life ( 3). Knee osteoarthritis (OA) is a highly prevalent disease affecting approximately 30% of people aged over 65 years ( 1). ![]()
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