Poor mental health can increase the pain of arthritis

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According to new research carried out by scientists at the Davis School of Medicine, University of California, people who are not in good mental health may experience worse arthritic pain than those who have better emotional wellbeing.

The research involved 266 arthritic patients each of whom had agreed to take part in the Longitudinal Examination of Arthritis Pain Study. This study was designed to investigate the relationship between pain, fluctuations in pain, and health outcomes.

Over a 12 week period the participants, all of whom had hip or knee pain, engaged in weekly telephone interviews where their pain levels were assessed using the Western Ontario and McMaster University Osteoarthritis Index of 0 – 10, and mental health scores were identified using the Mental Health Index-5 in which scores of between 5 and 30 were given. A higher score on the Mental Health index would indicate better mental health.

What the researchers found was that those who had better mental health reported less pain and those with poor mental health reported more pain.

“We found that increased levels of pain were associated with worse mental health at baseline” said lead study author Dr Barton Wise.

“And further, pain flares were associated with poorer mental health during the week prior to the pain flare.”

The results of the study showed that a mental health score of between 28 and 30 was associated with a low pain score. Those that fell in a lower range of mental health scores of between 13 and 22 had double the risk of pain than those who had higher mental health scores.
The study, “Psychological Factors and Their Relation to Osteoarthritis Pain” is published in the journal Osteoarthritis and Cartilage.
Pain is a subjective experience and is therefore very difficult to study and it could be argued that although many studies might identify a link between poor mental health and higher pain, perhaps the higher pain is actually causing the poor mental health.

However, this study was different in that it was able to gauge different people’s perception of their pain at different times and under different circumstances.

Dr Barton Wise did note that a person’s experience of pain is likely to be influenced by a “large group different factors” rather than a single physiological factor.

The authors concluded that mental health may offer a “new therapeutic target” for osteoarthritis related pain.

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