The knee largest as well as one of the most complicated join in the body. It needs to be strong along with must be flexible enough to support our weight and allow bending and twisting movements. Gradual onset of knee pain, stiffness and swelling are typical symptoms of knee osteoarthritis

A study was performed to find out that whether there is any association between change in pain location and clinically-relevant improvements in walking pain severity and physical dysfunction in people suffering from medial tibiofemoral osteoarthritis (OA) and using footwear for self-management.

So analysis of a sub-set including 91 participants was done, which were taken from both arms of a 6-month randomized controlled trial of footwear for knee OA. The Photographic Knee Pain Map was self-administered to produce changes in the number of painful zones (‘unchanged’, ‘increased’, ‘decreased’) and anatomical patterns of pain (‘unchanged’, ‘no longer diffuse’, ‘becoming diffuse’, ‘other pattern changes’). Estimation of improvement on symptoms was done using minimum clinically important differences (MCIDs) in pain severity on a numeric rating scale, and function with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Fisher's exact tests was used to find the differences in symptom improvement among the categories of change and odds ratios (ORs, 95% CI) were calculated (adjusted for treatment allocation).

The result of study revealed change in location of pain in 74% (n = 67) of participants, and clinically-relevant improvements in pain and function was observed in 46–50% (n = 42–45) respectively. Fewer participants ‘becoming diffuse’ reported improved pain (n = 0, 0%) as compared to the other pattern change categories (P = 0.012). Participants with ‘no longer diffuse’ (OR (95% CI) = 0.3 (0.1–0.9) or ‘becoming diffuse’ (OR (95% CI) = 0.0 (0.0–0.4) pain patterns had significantly lower odds of improved function than those with ‘other pattern changes’.

The study concluded that participants either developing into, or changing from, diffuse pain patterns were less likely to get improvement in pain and/or function while self-managing with footwear.