(OARSI2014) A new study supports a role for psychological factors in the onset of knee osteoarthritis (OA) pain, and reveals coping mechanisms that reduce it.
A new study supports a role for psychological factors in the onset of knee osteoarthritis (OA) pain, and reveals coping mechanisms that reduce it.
Patients with knee OA are more likely to have flares later in the same week that they reported negative psychological affect, according to a Web-based study reported at the Osteoarthritis Research Society International meeting in Paris. In contrast, those who reported positive psychological affect, or active coping strategies, were less likely to have flares.
In the case-crossover study, 267 participants with a diagnosis of symptomatic knee OA were recruited and followed for three months at ten-day intervals (control periods). Subjects were instructed to log on to the study website if they experienced a knee pain exacerbation during the follow-up period (hazard periods).
Via the Internet, the investigators collected data on triggers occurring during the control periods (periods without pain exacerbation) and hazard periods (periods immediately preceding the pain exacerbation).
The Australian team, headed by rheumatologist David J. Hunter MD, collected data on potential triggers, including psychological factors, for the seven days preceding the date of pain exacerbation. Higher negative affects (mood items such as “distressed,” “irritable,” or “nervous”) and passive coping strategies (such as, “I restrict my social activities,” or “I focus on the location and intensity of pain”) showed a significant association with increased risk of flares in the following days.
In contrast, higher positive affect (mood items such as “excited.” “proud,” “inspired”) and active coping strategies (such as, “I stay busy or active,” or “I clear my mind of bothersome thoughts”) trended towards an association with a protective effect.
The authors note that psychosocial factors such as mood and coping are modifiable.