Cited by 135Musculoskeletal pain and rehabilitationOsteoarthritis Treatment and MechanismsPediatric Pain Management Techniques

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Psychosocial factors and the pain experience of osteoarthritis patients: new findings and new directions

Somers, Tamara J, Keefe, Francis J, Godiwala, Neha, Hoyler, Georgia H·2009·Current Opinion in Rheumatology

DOI 10.1097/bor.0b013e32832ed704

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Abstract

PURPOSE OF REVIEW: The present paper reviews recent psychosocial research in the area of osteoarthritis pain. First, the review highlights studies of psychosocial factors that can influence osteoarthritis pain. Next, research testing the efficacy of psychosocial treatments for osteoarthritis pain is summarized. RECENT FINDINGS: Recent studies suggest that asking osteoarthritis patients to recall pain experiences may not be as accurate as having them keep daily pain records. New studies also support the notion that fatigue and increased weight are linked to higher osteoarthritis pain. Osteoarthritis patients who report higher levels of depression are more prone to report increased osteoarthritis pain. New studies also indicate that social factors such as ethnic background, ability to communicate pain to others, and participation in social activities can influence osteoarthritis pain and disability. Cognitions about pain (i.e. pain catastrophizing, acceptance, self-efficacy for pain) also have been found to relate to pain in patients with osteoarthritis. Recent, randomized controlled studies suggest that psychosocial interventions (i.e. self-management programs, exercise) can decrease osteoarthritis pain and disability. SUMMARY: Several psychosocial variables have been suggested as influencing osteoarthritis pain and disability. There is evidence that psychosocial interventions may decrease osteoarthritis pain and disability.

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“A decrease in patient functioning frequently leads to sedentariness and isolation, which can trigger depression and catastrophizing and thus negatively affect pain.(40,41) Based on the KOOS questionnaire, all the braces resulted in a significant improvement in function during sports and recreational activities allowin…”
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Factors Associated with Depressive Symptoms in Patients with Chronic Low Back Pain
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The Relationship of Pain and Cognitive Impairment with Social Vulnerability—An Analysis of the Canadian Study of Health and Aging
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Effects of Repeated Co-Injections of Corticosteroids and Hyaluronic Acid on Knee Osteoarthritis: A Prospective, Double-Blind Randomized Controlled Trial
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Associations between Health Assessment Questionnaire Disability Index and physical performance in rheumatoid arthritis and osteoarthritis
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Subjective and Objective Sleep Quality in Individuals with Osteoarthritis in Taiwan
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“Studies also show that mental health may worsen when the quality of sleep is poor (Somers et al., 2009; Veldhuijzen et al., 2008).”
Pain Catastrophizing Is Independently Associated with Quality of Life in Patients with Severe Hip Osteoarthritis
Hayashi, K., Morishima, T., Ikemoto, T., 宮川, 博., Okamoto, T., Ushida, T., & Deie, M. (2018) · Pain Medicine · doi:10.1093/pm/pny265 · Cited by 23
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“In addition, with the move away from the traditional biomedical model, which has been proven to be inadequate with poor concordance between pain, disability and pathology [9], towards a biopsychosocial model [10], there has been a greater recognition of the psychosocial factors in knee OA [11,12].”
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Hsieh, R., & Lee, W. (2016) · Medicine · doi:10.1097/md.0000000000003952 · Cited by 20
Is the Wedged Insole an Effective Treatment Option When Compared with a Flat (Placebo) Insole: A Systematic Review and Meta‐Analysis
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“For example, pain is influenced by a myriad of psychosocial factors that can vary between people as well as within people over time [52].”
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The effect of lateral wedge insoles in patients with medial compartment knee osteoarthritis: balancing biomechanics with pain neuroscience
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Rehabilitation for the management of knee osteoarthritis using comprehensive traditional Chinese medicine in community health centers: study protocol for a randomized controlled trial
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“What if it doesn't unlock?”: A qualitative study into the lived experiences of adults with persistent intra-articular temporomandibular disorders
Dinsdale, A., Forbes, R., Thomas, L. C., & Treleaven, J. M. (2021) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2021.102401 · Cited by 15
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The Discordance Between Pain and Imaging in Knee Osteoarthritis
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“…(pain catastrophizing, self-efficacy for pain, acceptance), psychological resources, ability to communicate pain to others and participation in social activities [11–13] Physical activity/inactivity are key elements for patients with OA due to its association with the physical function [14].”
Depressive Symptoms among Community-Dwelling Older Adults with Mild to Moderate Knee Osteoarthritis: Extent, Interrelationships, and Predictors
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“Emerging data also reveal the disease process may be influenced adversely by a variety of psychological factors such as depression [13-19] and/or the self-efficacy beliefs held by the affected individual [20,21], both mutable factors.”
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The burden of osteoarthritis:the societal and the patient perspective
Uhlig, T., Slatkowsky-Christensen, B., Moe, R. H., & Kvien, T. K. (2010) · Therapy · doi:10.2217/thy.10.70 · Cited by 13
Negative health consequences of pain catastrophizing among retired National Football League athletes.
Mannes, Z. L., Ferguson, E. G., Perlstein, W. M., Waxenberg, L. B., Cottler, L. B., & Ennis, N. (2020) · Health Psychology · doi:10.1037/hea0000847 · Cited by 17
“Furthermore, among patients with obesity and osteoarthritis, two conditions that have become a growing concern among retired NFL athletes, catastrophizing is correlated with poorer weight management, increased disability, and poorer weight related quality of life, all factors that can contribute to mood difficulties (…”
Background
Incorporating Complementary and Alternative Medicine (CAM) Therapies to Expand Psychological Services to Veterans Suffering From Chronic Pain
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Rationale and design of the Staying Positive with Arthritis (SPA) Study: A randomized controlled trial testing the impact of a positive psychology intervention on racial disparities in pain
Hausmann, L. R. M., Ibrahim, S. A., Kwoh, C. K., Youk, A. O., Obrosky, D. S., Weiner, D. K., Vina, E. R., Gallagher, R. M., Mauro, G. T., & Parks, A. C. (2017) · Contemporary Clinical Trials · doi:10.1016/j.cct.2017.09.001 · Cited by 12
“Numerous studies have demonstrated that pain-related cognitions are associated with pain severity and functional impairment in patients with OA, with the most-oft studied and robust predictors being self-efficacy and pain catastrophizing.(26,55,61-64) Positive traits such as optimism and overall psychological resilien…”
Central sensitization in osteoarthritic knee pain: A cross-sectional study
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“Psychosocial factors such as depression, pain catastrophizing, and sleep disturbances are known to be associated with pain experience in knee OA patients.[33] In our study, while both BDI and ISI scores were higher in the OA group than in the control group, this significance was found only in BDI in the RA group.”
Background
Association between widespread pain and psychosocial factors in people with knee osteoarthritis: a cross-sectional study of patients from primary care in Denmark
Pérez, J. P., Mortensen, S. R., Girbés, E. L., Grønne, D. T., Thorlund, J. B., Roos, E. M., & Skou, S. T. (2024) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2024.2372381 · Cited by 12
“…anxiety, or pain-related fear of movement, have been suggested as negatively influencing KOA-related pain and disability (Baert et al., 2016; Somers, Keefe, Godiwala, and Hoyler, 2009) and may also be related to chronic postoperative pain in patients receiving total knee arthroplasty…”
Sources of pain in osteoarthritis: implications for therapy
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What is the Profile of Individuals Joining the KNEEguru Online Health Community? A Cross-Sectional Mixed-Methods Study
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Effects of exergames on rehabilitation outcomes in patients with osteoarthritis. A systematic review
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“Therefore, from a comprehensive therapeutic perspective, it should be considered that this set of signs and symptoms not only negatively influences physical functional capacity but also the cognitive [9] and psychosocial dimensions of OA patients [10].”
Body mass index, but not blood pressure is related to the level of pain in persons with chronic pain
Wood, D., Goodnight, S. M., Haig, A. J., & Nasari, T. J. (2011) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-2011-0284 · Cited by 10
“As Somers [19, 20] has pointed out, the relationships are much more complex.”
Psychosoziale Faktoren in der Prävention von Schmerz
Andrejeva, N., Baumeister, D., Eich, W., & Tesarz, J. (2021) · Der Schmerz · doi:10.1007/s00482-020-00523-4 · Cited by 9
Exercise physiologists use of pain neuroscience education for treating knee osteoarthritis: A qualitative interview study
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How is the experience of pain measured in older, community-dwelling people with osteoarthritis? A systematic review of the literature
de Luca, K. E., Parkinson, L., Pollard, H. P., Byles, J., & Blyth, F. (2015) · Rheumatology International · doi:10.1007/s00296-015-3268-3 · Cited by 9
“Pain has multifaceted etiologies from within and outside of the joint [3, 4] and is influenced by psychosocial conditions [4, 5].”
Background
Knowledge expectations of recently diagnosed patients with knee osteoarthritis
Pellinen, T., Villberg, J. J., Raappana, M., Leino‐Kilpi, H., & Kettunen, T. (2016) · Journal of Advanced Nursing · doi:10.1111/jan.13053 · Cited by 8
Influencia de los factores psicosociales en la experiencia de dolor musculoesquelético: una revisión de la literatura
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Maladaptive Compensatory Neural Mechanisms Associated with Activity-Related Osteoarthritis Pain: Dissociation of Psychological and Activity-Related Neural Mechanisms of WOMAC Pain and VAS Pain
Imamura, M., Pacheco‐Barrios, K., de Melo, P. S., Marduy, A., Battistella, L. R., & Fregni, F. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14113633 · Cited by 7
Determining Brain Mechanisms that Underpin Analgesia Induced by the Use of Pain Coping Skills
Cole, L. J., Bennell, K. L., Ahamed, Y., Bryant, C., Keefe, F. J., Moseley, G. L., Hodges, P. W., & Farrell, M. J. (2017) · Pain Medicine · doi:10.1093/pm/pnx301 · Cited by 7
Self-citation

Authors: Somers, T. J., Keefe, F. J., Godiwala, N., & Hoyler, G. H.
Affiliations: Duke Medical Center (US)
Duke University (US)
Corresponding author: Keefe, Francis J
ORCID: Somers, Tamara J
Keefe, Francis J
Venue: Current Opinion in Rheumatology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2009-09
Volume: 21
Issue: 5
Pages: 501-506
ISSN: 1040-8711 (ISSN-L)
DOI: 10.1097/bor.0b013e32832ed704
OpenAlex: W1996735164
Cited by: 135
References: 57
Citations by year: 2026: 4 · 2025: 3 · 2024: 6 · 2023: 2 · 2022: 5 · 2021: 10 · 2020: 7 · 2019: 3 · 2018: 13 · 2017: 11 · 2016: 9 · 2015: 9 · 2014: 12 · 2013: 12 · 2012: 10
FWCI: 0.96
Type: journal article
Language: en
Open access: closed
Locations: Current Opinion in Rheumatology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Arthritis and Musculoskeletal and Skin Diseases (P01-AR-50245, R01AR049059, P01AR050245, R01AR054626, R34AR056727)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords: osteoarthritis pain, psychosocial factors, pain catastrophizing, pain acceptance, depression, fatigue, body weight, pain recall, ethnicity, social participation (health and rehabilitation), pain communication, self-management program, exercise intervention, disability
MeSH terms: Cognition, Fatigue, Humans, Obesity, Osteoarthritis, Pain, Psychology, Stress, Psychological, Pain Management

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Psychosocial factors and the pain experience of osteoarthritis patients: new findings and new directions

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