Abstract
BACKGROUND: Arthritis imposes serious health consequences, including substantial disability and increased risk of all-cause mortality. Prior studies have reported that pain was associated with decreased health-related quality of life (HRQoL) among individuals with arthritis, yet the association between joint pain severity and HRQoL remains unclear. METHODS: This study analyzed pooled data from 362,366 U.S. adults with arthritis in the 2015-2019 Behavioral Risk Factor Surveillance Survey, categorizing joint pain severity as no/mild (0-3), moderate (4-6), or severe (7-10) via the Numerical Rating Scale. HRQoL was assessed using four domains: self-rated health, physical/mental unhealthy days, and activity limitation. Multivariable logistic regression examined the association between joint pain severity and loss of HRQoL in overall and across demographic subgroups. RESULTS: Compared to no/mild pain, moderate pain was associated with higher odds of poor self-rated health (OR = 2.18, 95%CI = 2.08-2.27), physical unhealthiness (2.46, 2.35-2.58), mental unhealthiness (2.05, 1.93-2.17), and activity limitation (2.33, 2.20-2.47). Severe pain showed stronger associations (e.g., poor self-rated health: OR = 4.61, 4.40-4.83; physical unhealthiness: 6.74, 6.41-7.09). Subgroup analyses revealed stronger associations in women, Non-Hispanic Whites, and adults aged 45-64 years. Joint pain severity was associated with worse HRQoL, with heterogeneous effects by demographic subgroups. CONCLUSIONS: Moderate-to-severe joint pain is associated with poorer HRQoL across all domains, with severity-correlated HRQoL decline and subgroup variations. Targeted pain management strategies, particularly for severe pain and vulnerable populations, are critical to improving outcomes in arthritis.