The Role of Psychological Stress in the Development of Chronic Pain Syndrome in Patients with Osteoarthrosis

Alexander V. Karnitsky, PhD¹*, Dmitry Y. Sagin²

¹Omsk State Medical Academy, Omsk, Russian Federation

²Center of Rehabilitation Therapy "Rus",Omsk, Russian Federation

Corresponding author: Alexander V. Karnitsky, PhD, Department of Rehabilitation Medicine, Omsk State Medical Academy. 1, Leningradskaya sq., apt. 102, 644010, Omsk, Russian Federation. Tel: 7-905-9424103. Fax: 7-3812-65972. E-mail: karn1961@mail.ru

Abstract: 

Background: Osteoarthrosis has been identified as the commonest cause of chronic pain. Chronic pain syndrome significantly limits the functionality of patients with osteoarthrosis and reduces their quality of life. Besides the organic changes in the joints, a large part of the development of chronic pain is due to psychological factors. Psychological stress can manifest itself as neuropsychic tension and negative emotional experiences. Psychological stress is accepted today as an important factor leading to the development of chronic pain syndrome in patients with joint disorders. The purpose of this study is to identify and assess the severity of psychological stress in those patients with osteoarthrosiss and chronic pain syndrome in the Rehabilitation Department.

Methods: The study included 50 patients, ranging in age from 24 to 73 years (the average age being 58 years), suffering with osteoarthrosis, showing degeneration of the lower extremities (coxarthrosis, gonarthrosis). All the patients underwent x-rays of the affected joints. Joint mobility was assessed by the orthopedist. Assessment of the pain syndrome was conducted, both at the time of admission and at discharge, on the digital and visual analog scales. Right at the beginning of treatment psychological testing was performed using the PSM-25 questionnaire. (The scale of PSM-25 is designed to measure the nature of the stress experienced. It is a translation and adaptation of the Russian version of testing techniques performed by N.E.Vodopyanova).

Results: The presence of a statistically significant correlation between the psychological stress levels and the intensity of pain syndrome in patients with osteoarthrosiss in the Rehabilitation Department was observed.

Conclusions: Psychological stress is one of the important factors leading to the development of chronic pain syndrome in patients with osteoarthrosis.

Keywords: 
stress; psychological; pain; osteoarthrosis.
References: 
  1. Chichasova NV. The problem of pain in osteoarthrosis. The Doctor 2007; 2: 50-56.
  2. Smith MM, Ghosh P. Osteoarthritis: Current status and future directions. APLAR J Rheumatol 1998; 2: 27-53.
  3. Sturov NV. Pharmacotherapy of chronic pain syndrome non cancerous origin. Difficult Patient 2001; 5: 21-24.
  4. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of  pain in Europe: Prevalence, impact on daily life, and treatment.  European Journal of pain 2006; 10: 287-333.
  5. Kukushkina ML. Chronic pain syndrome. The Doctor 2010; 4: 20-23.
  6. Tunks ER, Weir R, Crook J. Epidemiologic Perspective on Chronic Pain Treatment. The Canadian Journal of Psychiatry 2008; 53: 235 – 242.
  7. Bair MJ, Robinson RL, Katon W, Krocnke K. Depression and pain co-morbidity. Arch Intern Med 2003; 163: 2433-2445.
  8. Bisschop MI, Kriegsman DMW, Beekman ATF, Deeg DJH. Chronic diseases and depression: the modifying role of psychosocial. Soc Sci Med 2004; 59: 721-733.
  9. Levenson JL. Psychiatric issues in rheumatology. Primary Psychiatry 2006; 13: 23-27.
  10. Nicassio PM. The problem of detecting and managing depression in the rheumatology clinic. Arthritis& Rheumatism 2008; 59: 155-158.
  11. Ozcetin A, Ataoglu S., Kocer E, YazycyII S, YildizIII O,  Ataoglull A et al. Effects of depression and anxiety on quality of life of patients with rheumatoid arthritis, knee osteoarthritis and fibromyalgia syndrome. West Indian Med J 2007; 56: 122-129.
  12. Parker J, Wright G. The implications of depression for pain and disability in rheumatoid arthritis. Arthritis  Care Res 1995; 8: 279-283.
  13. Sheehy C, Murphy E, Barry M. Depression in rheumatoid arthritis -underscoring the problem. Rheumatology 2006; 45: 1325-1327.
  14. Van Puymbroeck CM, Zautra AJ, Harakas PP. Chronic pain and depression: twin burden of adaptation. Depression and chronic illness. Cambridge: Cambridge University Press; 1999.
  15. Danilov A. Biopsychosociocultural model of pain. Physician 2009; 12: 5-8.
  16. Herrmann M, Scholmarich J, Straub R. Stress and rheumatic diseases. Rheum Dis Clin North Am 2000; 26: 737-763. 
  17. Lemure L, Tessier R, Fillion L. Mesure du Stress Psychologique MSP. The Aviora, Brosard-Québec, 1990.
  18. Vodopyanova NE. Psychodiagnostics of stress. St. Petersburg; 2009.

Download Article

Int J Biomed. 2011;1(2):84-86.© 2011 International Medical Research and Development Corporation. All rights reserved.