These factors (not the ones you think of) are associated with worse arthritis

When people think of arthritis, they think joint and cartilage damage. It’s the wear and tear of the joint lining that’s the main cause of pain intensity and limitations the person has. Well this study in the Journal of Orthopedics found the opposite. The authors state in their conclusion: “This study confirms that limitations and pain from osteoarthritis of the hip and knee are more closely related to personal and psychological factors, less effective cognitive coping strategies such as catastrophic thinking and kinesiophobia in particular, than to pathological and anatomical factors such as location and severity of arthritis.”

Arthritis is a good condition to look at because we can see real joint changes on imaging scans. Even in the light of these changes, this study showed the brain (psychological) not the body (physical) played a significant role in pain intensity and limitations. It’s powerful information since the general population and many medical providers likely believe and treat arthritis as solely a physical structurally-related condition. We need to look at and assess all pain and physical symptoms from a biopsychsocial model, not just a biological one.

The authors in the introduction talk about some of the psychological factors that I look to assess and address when we were are dealing with chronic pain and neuroplastic symptoms. They say: “Mounting evidence documents that mental and social health account for much of the variation in symptoms and limitations. Less effective cognitive coping strategies such as fear of movement (kinesiophobia) and worst-case (or catastrophic) thinking are important. Symptoms of anxiety and depression (psychological distress) also contribute. Mindset and circumstances can contribute to a cycle of disuse and further avoidance of movement, leading to greater limitations and more intense pain.”