Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20200193
Brazilian Journal of Pain
Original Article

Pain, disability and catastrophizing in individuals with knee osteoarthritis

Dor, incapacidade e catastrofização em indivíduos com osteoartrite do joelho

Natália Cristina de Oliveira Vargas e Silva; Thiago da Silva Gusmão Cardoso; Elisabete Agrela de Andrade; Linamara Rizzo Battistella; Fábio Marcon Alfieri

http://dx.doi.org/10.5935/2595-0118.20200193 BrJP, vol.3, n4, p.322-327, 2020
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Abstract

BACKGROUND AND OBJECTIVES: Knee osteoarthritis is among the leading sources of chronic disability and may lead to depression, anxiety and pain catastrophizing, enhancing perceived pain. This study aimed at investigating the influence of pain catastrophizing on attitudes and perception of pain, and in the functionality of individuals with knee osteoarthritis.

METHODS: This observational study involved 18 patients, who were assessed for weight and height, and completed the Pain-related Catastrophizing Thoughts Scale (PCTS), Survey of Pain Attitudes (SPA), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the visual analog scale (VAS). Symptoms and disability were assessed by the Lequesne Index, functional mobility was evaluated by the Timed Up and Go (TUG) test. Pressure pain tolerance thresholds (PPT) were assessed by a digital algometer.

RESULTS: Mean body mass index of the sample was classified as obese (32,2±4,3). When split by the median of PCTS, differences were observed in most domains of SPA. Patients with more catastrophic thoughts took longer to perform TUG and presented more pain, joint stiffness and worse functionality (WOMAC). Despite the tendency to report more pain (VAS) in patients above the median score of PCTS, no differences were observed between groups with higher or lower catastrophizing regarding PPT. Positive and significant associations between the Rumination factor of PCTS and WOMAC outcomes were observed, as well as between the Hopelessness factor and TUG, Lequesne and WOMAC.

CONCLUSION: The higher the presence of catastrophic thoughts, the worse the attitudes towards pain and the physical functionality of knee osteoarthritis patients.

Keywords

Catastrophization, Knee, Osteoarthritis, Pain, Physical functional performance

Resumo

JUSTIFICATIVA E OBJETIVOS: A osteoartrite do joelho está entre as principais causas de incapacidade crônica e pode levar à depressão, ansiedade e catastrofização, intensificando a percepção da dor. Este estudo teve como objetivo investigar a influência da catastrofização da dor nas atitudes e na percepção da dor e a funcionalidade de indivíduos com osteoartrite do joelho.

MÉTODOS: Dezoito pacientes foram avaliados quanto ao peso e à estatura, e completaram a Escala de Pensamentos Catastróficos Sobre a Dor (EPCD), Inventário de Atitudes frente à Dor (IAD), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) e escala analógica visual (EAV). Os sintomas e a incapacidade foram avaliados pelo Índice de Lequesne, a mobilidade funcional foi avaliada pelo teste Timed Up and Go (TUG). Os limiares de tolerância à dor à pressão (LTDP) foram avaliados por um algômetro digital.

RESULTADOS: A média do índice de massa corporal da amostra foi classificado como obesa (32,2±4,3). Quando divididas pela mediana do EPCD, foram observadas diferenças na maioria dos domínios do IAD. Pacientes com pensamentos mais catastróficos demoraram mais para realizar o TUG e apresentaram mais dor, rigidez articular e pior funcionalidade (WOMAC). Apesar da tendência de relatar mais dor (EAV) em pacientes acima do escore mediano do EPCD, não foram observadas diferenças entre os grupos com maior ou menor catastrofização em relação aos LTDP. Foram observadas associações positivas e significantes entre o fator ruminação da EPCD e o WOMAC, bem como entre o fator Desesperança e TUG, Lequesne e WOMAC.

CONCLUSÃO: Quanto maior a presença de pensamentos catastróficos, piores as atitudes em relação à dor e funcionalidade física dos pacientes com osteoartrite do joelho.

Palavras-chave

Catastrofização, Desempenho físico funcional, Dor, Osteoartrite do joelho

References

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions. 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224-60.

Rice D, McNair P, Huysmans E, Letzen J, Finan P. Best evidence rehabilitation for chronic pain part 5: osteoarthritis. J Clin Med. 2019;8(11).

Witvrouw E, Pattyn E, Almqvist KF, Crombez G, Accoe C, Cambier D. Catastrophic thinking about pain as a predictor of length of hospital stay after total knee arthroplasty: a prospective study. Knee Surg Sports Traumatol Arthrosc. 2009;17(10):1189-94.

Hirschmann MT, Testa E, Amsler F, Friederich NF. The unhappy knee arthroplasty (TKA) patient: higher WOMAC and lower KSS in depressed patients prior and after TKA. Knee Surg Sports Traumatol. Arthrosc. 2013;21(10):2405-11.

Gibson E, Sabo MT. Can pain catastrophizing be changed in surgical patients? A scoping review. Can J Surg. 2018;61(5):311-8.

Jones DA, Rollman GB, White KP, Hill ML, Brooke RI. The relationship between cognitive appraisal, affect, and catastrophizing in patients with chronic pain. J Pain. 2003;4(5):267-77.

Wong WS, Lam HM, Chen PP, Chow YF, Wong S, Lim HS. The fear-avoidance model of chronic pain: Assessing the role of neuroticism and negative affect in pain catastrophizing using structural equation modeling. Int J Behav Med. 2015;22(1):118-31.

Sullivan M. The communal coping model of pain catastrophizing: clinical and research implications. Can Psychol. 2012;53(1):32-41.

Pinto PR, McIntyre T, Almeida A, Araújo-Soares V. The mediating role of pain catastrophizing in the relationship between presurgical anxiety and acute postsurgical pain after hysterectomy. Pain. 2012;153(1):218-26.

Edwards RR, Cahalan C, Mensing G, Smith M, Haythornthwaite JA. Pain, catastrophizing, and depression in the rheumatic diseases. Nat Rev Rheumatol. 2011;7(4):216-24.

Suso-Ribera C, García-Palacios A, Botella C, Ribera-Canudas MV. Pain catastrophizing and its relationship with health outcomes: does pain intensity matter?. Pain Res Manag. 2017;2017:9762864.

Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17(1):52-64.

Sullivan MJL, Tripp DA, Santor D. Gender differences in pain and pain behavior: the role of catastrophizing. Cognitive Therapy and Research. 2000;24(3):121-34.

Mankovsky T, Lynch M, Clark A, Sawynok J, Sullivan MJ. Pain catastrophizing predicts poor response to topical analgesics in patients with neuropathic pain. Pain Res Manag. 2012;17(1):10-4.

Sullivan MJ, Lynch ME, Clark AJ, Mankovsky T, Sawynok J. Catastrophizing and treatment outcome: differential impact on response to placebo and active treatment outcome. Contemp Hypn. 2008;25(3-4):129-40.

Scott EL, Kroenke K, Wu J, Yu Z. Beneficial effects of improvement in depression. pain catastrophizing. and anxiety on pain outcomes: a 12-month longitudinal analysis. J Pain. 2016;17(2):215-22.

Sardá Júnior J, Nicholas MK, Pereira IA, Pimenta CAM, Asghari A, Cruz RM. Validação da escala de pensamentos catastróficos sobre a dor. Acta Fisiátrica. 2008;15(1):31-6.

Pimenta CAM, Kurita GP, Silva EM, Cruz DALM. Validade e confiabilidade do inventário de atitudes frente à dor crônica (IAD-28 itens) em língua portuguesa. Rev Esc Enferm USP. 2009;43(Esp):1071-9.

Garcia DM, Pimenta CAM, Cruz DALM. Validação do inventário de atitudes frente à dor crônica - profissionais. Rev Esc Enferm USP. 2007;41(4):636-44.

Bellamy N, Buchanan WW, Goldsmith CH, Campbell , Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15(12):1833-40.

Marx FC, Oliveira LM, Bellini CG, Ribeiro MCC. Tradução e validação cultural do Questionário Algofuncional de Lequesne para osteoartrite de joelhos e quadris para a língua Portuguesa. Rev Bras Reumatol. 2006;46(4):253-60.

Podsiadlo D, Richardson S. The Timed Up & Go: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8.

Ylinen J, Nykanen M, Kautianine H, Hakkinen A. Evaluation of repeatability of pressure algometry on the neck muscles for clinical use. Manual Ther. 2007;12(2):192-7.

Visscher C, Lobbezoo F, Naeije M. Comparison of algometry and palpation in the recognition of temporomandibular disorder pain complaints. J Orofac Pain,. 2004;18(3):214-9.

Imamura M, Imamura ST, Kaziyama HH, Targino RA, Hsing WT, de Souza LP. Impact of nervous system hyperalgesia on pain, disability, and quality of life in patients with knee osteoarthritis: a controlled analysis. Arthritis Rheum. 2008;59(10):1424-31.

Skou ST, Roos EM, Laursen MB, Rathleff MS, Arendt-Nielsen L, Simonsen O. A randomized controlled trial of total knee replacement. N Engl J Med. 2015;373(17):1597-606.

Glette M, Landmark T, Jensen MP, Woodhouse A, Butler S, Borchgrevink PC. Catastrophizing, solicitous responses from significant others, and function in individuals with neuropathic pain, osteoarthritis, or spinal pain in the general population. J Pain. 2018;19(9):983-95.

Campbell CM, Buenaver LF, Finan P, Bounds SC, Redding M, McCauley L. Sleep pain catastrophizing and central sensitization in knee osteoarthritis patients with and without insomnia. Arthritis Care Res. 2015;67(10):1387-96.

Iwaki R, Arimura T, Jensen MP, Nakamura T, Yamashiro K, Makino S. Global catastrophizing vs. catastrophizing subdomains: assessment and associations with patient functioning. Pain Med. 2012;13(5):677-87.

Sullivan MJL, Lynch ME, Clark AJ. Dimensions of catastrophic thinking associated with pain experience and disability in patients with neuropathic pain conditions. Pain. 2005;113(3):310-5.

Sánchez-Herán Á, Agudo-Carmona D, Ferrer-Peña R, López-de-Uralde-Villanueva I, Gil-Martínez A, Paris-Alemany A. Postural stability in osteoarthritis of the knee and hip: analysis of association with pain catastrophizing and fear-avoidance beliefs. PM&R. 2016;8(7):618-28.

Lazaridou A, Martel MO, Cornelius M, Franceschelli O, Campbell C, Smith M. The association between daily physical activity and pain among patients with knee osteoarthritis: the moderating role of pain catastrophizing. Pain Med. 2018;20(5):916-24.

Van Denburg AN, Shelby RA, Caldwell DS. Self-efficacy for pain communication moderates the relation between ambivalence over emotional expression and pain catastrophizing among patients with osteoarthritis. J Pain. 2018;19(9):1006-14.

Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17(1):52-64.

Sullivan MJ, Stanish W, Sullivan ME, Tripp D. Differential predictors of pain and disability in patients with whiplash injuries. Pain Res Manag. 2002;7(2):68-74.

Submitted date:
04/01/2020

Accepted date:
08/11/2020

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