A brief screening tool for knee pain in primary care (KNEST). 2. Results from a survey in the general population aged 50 and over

Rheumatology (Oxford). 2004 Jan;43(1):55-61. doi: 10.1093/rheumatology/keg438. Epub 2003 Aug 15.


Objective: To use a brief screening tool to identify knee pain (all knee pain, non-chronic and chronic knee pain) and associated health-care use in the general population aged 50 yr and over.

Methods: A cross-sectional survey was mailed to 8995 individuals registered with three general practices in North Staffordshire, UK. The questionnaire included a Knee Pain Screening Tool (KNEST), the Short Form 36 (SF36), demographic questions and, for those who reported knee pain, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).

Results: The survey achieved a 77% response. The 12-month period prevalence of all knee pain was 46.8% [95% confidence interval (CI) 45.6%, 48.0%]. Figures for non-chronic knee pain (pain of less than 3 months duration) and chronic knee pain (pain of more than 3 months duration) were 21.5% (95% CI 20.5%, 22.5%) and 25.3% (95% CI 24.3%, 26.4%) respectively. An estimated 6% of the older population had non-chronic but severe knee pain or disability. Thirty-three per cent of all knee pain sufferers had consulted their general practitioner (GP) about their symptom in the last year. This included 34% of those with non-chronic but severe knee pain or disability and 56% of those with chronic and severe knee pain or disability. The use of private treatments or services for knee pain was minimal. A third of those with chronic and severe knee pain or disability had not used any services (including GP) in the last year.

Conclusions: The KNEST is a simple tool for the identification of individuals with knee pain and their health-care use. Focusing only on chronic knee pain will underestimate the total need and demand for health-care in knee pain sufferers in the general older population, as non-chronic as well as chronic knee pain has a significant impact on people's lives and on their use of primary health-care. The KNEST, when combined with the WOMAC, identifies population groups who have potentially diverse health-care needs and who might benefit from effective health-care. These data can be used alongside evidence on effective treatments by service planners when considering needs for the care of older adults in primary care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chronic Disease
  • Cross-Sectional Studies
  • England
  • Female
  • Health Services Needs and Demand
  • Health Surveys
  • Humans
  • Knee Joint / pathology*
  • Male
  • Middle Aged
  • Pain / pathology*
  • Patient Acceptance of Health Care*
  • Prevalence
  • Primary Health Care*
  • Surveys and Questionnaires