Psychosocial factors are associated with altered pain processing in individuals with hip osteoarthritis: a cross-sectional study

Abstract

Objectives Alterations in central pain processing are hypothesized to underlie the discordance between pain and radiographic osteoarthritis severity, as well as the association between psychological trauma and pain sensitivity. This cross-sectional study explored whether psychosocial factors and traumatic experiences are associated with central pain processing in individuals with hip osteoarthritis.Method Independent variables included sociodemographic information, traumatic experiences, psychiatric disorders, symptoms of anxiety and depression, fear-avoidance, perceived injustice, general self-efficacy, perceived stress, social support, and pain-related variables. Thermal quantitative sensory testing was used to assess central pain processing through heat pain thresholds, temporal adaptation and summation, and conditioned pain modulation. Least absolute shrinkage and selection operator (LASSO) regression analyses were performed.Results One hundred thirty-three individuals with hip osteoarthritis were included. Sex differences were identified in measures of central pain processing. In combination with biological and pain-related factors, psychosocial factors explained between 11% and 21% of the variance in central pain processing. The selection of biopsychosocial variables and the direction of their effect differed between male and female participants. Inconsistent results were found with regard to the association between traumatic experiences and central pain processing.Conclusions Psychosocial factors contributed to the variance in quantitative sensory testing outcomes beyond the influence of biomedical variables. Different associations were found in male and female participants between psychosocial factors and central pain processing. Inconsistent results were found with regard to the association between traumatic experiences and altered central pain processing.