Association between widespread pain and psychosocial factors in people with knee osteoarthritis: a cross-sectional study of patients from primary care in Denmark

Abstract

ABSTRACT Introduction The relationship between psychosocial factors and bodily pain in people with knee osteoarthritis (KOA) is unclear. Purpose To examine whether widespread pain was associated with poorer self-efficacy, more anxiety, depression, and kinesiophobia in people with KOA. Methods This was a cross-sectional study based on data from Good Life with osteoArthritis in Denmark (GLA:D®). The association between widespread pain (multiple pain sites) and self-efficacy (Arthritis Self-Efficacy Scale), anxiety and depression (item from the EQ-5D-5 L), and kinesiophobia (yes/no) was examined using multiple linear tobit or logistic regression models. Results Among 19,323 participants, 10% had no widespread pain, 37% had 2 pain sites, 26% had 3–4 pain sites, and 27% had ≥5 pain sites. Widespread pain was associated with poorer self-efficacy (−0.9 to −8.3 points), and the association was stronger with increasing number of pain sites (p-value <.001). Significant increasing odds ratios (ORs) were observed for having anxiety or depression with 3–4 pain sites (OR 1.29, 95% CI 1.12; 1.49) and ≥5 pain sites (OR 1.80, 95% CI 1.56; 2.07). Having 2 and 3–4 pain sites were associated with lower odds of kinesiophobia compared to having no widespread pain. Conclusion Widespread pain was associated with lower self-efficacy and more anxiety and depression but also lower kinesiophobia in people with KOA.