Association between widespread pain and psychosocial factors in people with knee osteoarthritis: a cross-sectional study of patients from primary care in Denmark.
Javier Peral Pérez, Sofie Rath Mortensen, Enrique Lluch Girbés and 4 others
PMID 38946473WHAT IT FOUND
In people with knee osteoarthritis, marking more body sites as painful on a chart was linked to lower confidence in managing symptoms and more anxiety or depression.
However, widespread pain was not linked to higher fear of movement, and in some groups was linked to less.
Key findings
01Participants with widespread pain (two or more body sites) had significantly lower scores for self-efficacy in managing pain and other symptoms compared to those with no widespread pain, with the effect strengthening as the number of pain sites increased.
02Having widespread pain was associated with higher odds of experiencing anxiety or depression, particularly in those with three or more pain sites, after adjusting for factors like age, sex, and pain intensity.
03Contrary to expectations, widespread pain was associated with lower odds of kinesiophobia (fear of movement) in some groups, though the authors suggest this may be a chance finding or reflect selection bias in those willing to exercise.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study is cross-sectional, so it cannot determine whether widespread pain causes psychosocial issues or vice versa. Kinesiophobia was assessed with a single yes/no question, which may lack sensitivity compared to validated scales. Anxiety and depression were assessed with a single item from the EQ-5D-5L, which may not capture the full construct. The pain mannequin assessed pain in the last 24 hours, which may not reflect chronic widespread pain status. Broad eligibility criteria may have included patients without confirmed knee osteoarthritis, although diagnosis was made by trained physiotherapists.
Declared interests
The GLA:D start-up phase was partly funded by the Danish Physiotherapist Association, the Danish Rheumatism Association, and the Physiotherapy Practice Foundation. One author (STS) received unrelated grants from Region Zealand and the European Union. The funders had no role in the study design or analysis.
The easy way to misread this
Do not interpret the lower odds of kinesiophobia in some widespread pain groups as evidence that widespread pain reduces fear of movement. The authors state this finding lacks a logical causal explanation and may be due to chance or selection bias among participants willing to join an exercise program.