Improve the Psychological Symptoms Knee Osteoarthritis with Mindfulness
By John M. de Castro, Ph.D.
“mindfulness has been shown to help with anxiety and depression and can also help some people with the pain and distress of arthritis, as well as back and neck pain. Mindfulness may also help people with rheumatoid arthritis as it improves pain and stiffness, which leads to improved feelings of well-being, ultimately improving function and quality of life in the long-term.” – Arthritis Action
Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. It is the leading cause of disability in the U.S., with about 43% of arthritis sufferers limited in mobility and about a third having limitations that affect their ability to perform their work. Knee osteoarthritis effects 5% of adults over 25 years of age and 12% of those over 65. It is painful and disabling. Its causes are varied including, hereditary, injury including sports injuries, repetitive stress injuries, infection, or from being overweight.
There are no cures for knee osteoarthritis. Treatments are primarily symptomatic, including weight loss, exercise, braces, pain relievers and anti-inflammatory drugs, corticosteroids, arthroscopic knee surgery, or even knee replacement. Gentle movements of the joints with exercise and physical therapy appear to be helpful in the treatment of knee osteoarthritis. Mindfulness practices have been shown to reduce the physical symptoms of knee osteoarthritis. So, it would seem reasonable to look further into the effectiveness of Mindfulness practices in treating knee osteoarthritis.
In today’s Research News article “Mindfulness is associated with psychological health and moderates pain in knee osteoarthritis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5183521/ ), Lee and colleagues reexamined the data collected from adult patients (mean age of 60 years) with knee osteoarthritis. They were measured for mindfulness, pain, physical function (walk test), quality of life, depression, perceived stress, and self-efficacy. The data were then subjected to multiple regression analysis.
They found that higher mindfulness was associated with higher mental and physical quality of life and self-efficacy and lower depressive symptoms and perceived stress, but was not associated with pain, physical function or mobility. This was true especially for the describing, acting-with-awareness, and non-judging mindfulness facets. It should be kept in mind that these results are correlational and causation cannot be determined. But they suggest that being mindful is associated with improvement of the individual’s ability to deal with the psychological effects of knee osteoarthritis.
It is well established that mindfulness lowers the psychological and physiological impact of stress, reduces depression, and increases the individual’s belief that they can control what is occurring to them (self-efficacy). So, the present results are not surprising, but demonstrate that these relationships are present in patients with knee osteoarthritis and are associated with an improved psychological response to their disorder.
So, improve the psychological symptoms knee osteoarthritis with mindfulness.
“Mindfulness-based therapies could be key to reducing chronic pain of arthritis and similar conditions.” – Arthritis Digest
CMCS – Center for Mindfulness and Contemplative Studies
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Lee, A. C., Harvey, W. F., Price, L. L., Morgan, L. P. K., Morgan, N. L., & Wang, C. (2017). Mindfulness is associated with psychological health and moderates pain in knee osteoarthritis. Osteoarthritis and Cartilage, 25(6), 824–831. http://doi.org/10.1016/j.joca.2016.06.017
Previous studies suggest that higher mindfulness is associated with less pain and depression. However, the role of mindfulness has never been studied in knee osteoarthritis (OA). We evaluate the relationships between mindfulness and pain, psychological symptoms, and quality of life in knee OA.
We performed a secondary analysis of baseline data from our randomized comparative trial in participants with knee OA. Mindfulness was assessed using the Five Facet Mindfulness Questionnaire. We measured pain, physical function, quality of life, depression, stress, and self-efficacy with commonly-used patient-reported measures. Simple and multivariable regression models were utilized to assess associations between mindfulness and health outcomes. We further tested whether mindfulness moderated the pain-psychological outcome associations.
Eighty patients were enrolled (60.3±10.3 years;76.3% female, body mass index:33.0±7.1kg/m2). Total mindfulness score was associated with mental (beta=1.31,95% CI: 0.68,1.95) and physical (beta=0.69,95% CI:0.06,1.31) component quality of life, self-efficacy (beta=0.22,95% CI:0.07,0.37), depression (beta=-1.15,95% CI:-1.77,-0.54), and stress (beta=-1.07,95% CI:-1.53,-0.60). Of the five facets, the Describing, Acting-with-Awareness, and Non-judging mindfulness facets had the most associations with psychological health. No significant association was found between mindfulness and pain or function (P=0.08-0.24). However, we found that mindfulness moderated the effect of pain on stress (P=0.02).
Mindfulness is associated with depression, stress, self-efficacy, and quality of life among knee OA patients. Mindfulness also moderates the influence of pain on stress, which suggests that mindfulness may alter the way one copes with pain. Future studies examining the benefits of mind-body therapy, designed to increase mindfulness, for patients with OA are warranted.