Descriptions of joint pain by American Indians: comparison of inflammatory and noninflammatory arthritis.

OBJECTIVE

To improve assessment of arthritis joint pain in American Indians by describing how symptoms are communicated.

METHODS

In-depth interviews were conducted with American Indians who experience chronic joint pain (n = 56), to elicit descriptions and self-reported ratings of pain, disability, and beliefs associated with the pain for affected joints (n = 326).

RESULTS

Discrete sets of specific verbal descriptions distinguished inflammatory arthritis (n = 20 terms) from noninflammatory arthritis (n = 22 terms), and indicated levels of pain intensity. An additional set of 14 vague but commonly used verbal descriptors did not distinguish the type of joint disease or pain intensity.

CONCLUSIONS

Subtle pain complaints and vague verbal descriptions, such as "ache," "hurt," and "discomfort," may reflect severe pain symptoms, disability, and more serious joint disease in American Indian patients. In addition, certain specific sensory descriptions used by American Indians suggest inflammatory arthritis and may warrant further evaluation.