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Prevalence and dose-response relationship of handgrip strength with hand pain in Americans: A cross-sectional study
Xuan Wu1, Hao Tang2, XiaoJia Zhan1
1Center of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China; School of Rehabilitation Sciences, Southern Medical University, Guangzhou, China.
Background:
Hand pain is a prevalent musculoskeletal disorder affecting up to 18.1% of the general population, with substantial impacts on daily function. Current rehabilitation lacks evidence-based handgrip strength targets and dose-response guidance, limiting optimized management.
Purpose:
To examine the association between handgrip strength and hand pain.
Study Design:
Cross-sectional study.
Methods:
This cross-sectional study analyzed 8293 adults from the 2011-2014 National Health and Nutrition Examination Survey. Multivariable logistic regression models progressively adjusted for demographic (age, sex, race, and BMI), behavioral (smoking, alcohol), and socioeconomic confounders (education, income, and handedness). Restricted cubic splines characterized nonlinear associations, with generalized variance inflation factors (GVIF(1/(2Df))) evaluating multicollinearity.
Results:
Higher handgrip strength significantly reduced hand pain risk after full adjustment (per unit increase: left hand OR = 0.98, 95% CI = 0.97-0.99; right hand OR = 0.98, 95% CI = 0.97-0.99), equating to 1.3-4.1% risk reduction per handgrip strength unit. Nonlinear associations were prominent in minimally adjusted models (Pnonlinear < 0.001) but trended toward linearity after full confounder adjustment (Pnonlinear = 0.136-0.170). Over 80% of hand pain was unrelated to arthritis or carpal tunnel syndrome. Multicollinearity was negligible (max GVIF(1/(2Df)) = 1.519).
Conclusions:
Quantified handgrip strength thresholds demonstrate an independent inverse association with hand pain. This association remains stable after accounting for multidimensional confounders. Importantly, the relationship may involve reverse causality, as hand pain can also lead to reduced grip strength. After adjusting for confounders, the dose-response relationship transitions from nonlinear to nearly linear. These findings indicate a significant association between grip strength and hand pain. However, the direction of causality requires further research for confirmation.