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The Role of Pain Catastrophizing in The Pain and Functions of Young and Older Patients with Knee Osteoarthritis

Year 2025, Volume: 16 Issue: 2, 220 - 228, 18.08.2025
https://doi.org/10.22312/sdusbed.1536685

Abstract

symptoms, and methods of coping with pain in young and older adults with knee osteoarthritis (KOA).

Material and Methods: One hundred twenty-eight patients with KOA between the ages of 45-55 or 65-75 were included in our cross-sectional study. The sociodemographic data, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), Time Up and Go Test (TUG), pain intensity during activity and rest, pain catastrophizing levels, and pain coping scores of young and older participants with KOA were recorded.

Results: The mean age of young patients with KOA was 51.275.07 and older patients was 67.254.18 years. Older participants with KOA had longer pain durations, higher WOMAC scores, and longer TUG durations (p<0.005). There was a correlation between the pain catastrophizing scores of young patients with KOA and pain intensity during activity (r; 0.374), WOMAC scores (r; 0.617), and passive coping methods (r; 0.450) (p<0.001). A correlation was identified between the pain catastrophizing scores of older patients with KOA and pain intensity at rest (r; 0.427), pain intensity during activity (r; 0.530), pain duration (r; 0.312), WOMAC scores (r; 0.693), and active and passive coping methods (r; 0.429, r; 0.299, respectively) (p<0.001).

Conclusion: Older patients with KOA catastrophize painful stimuli more than young patients with KOA. This affects patients' pain intensity, methods of coping with pain, and KOA-related symptoms more. Accordingly, in the clinical follow-up of patients with KOA and determining rehabilitation approaches, it is necessary to consider that as age increases, patients are more affected by painful stimuli, and this affects patients' symptoms more.

References

  • 1. Gregori, D., Giacovelli, G., Minto, C., Barbetta, B., Gualtieri, F., Azzolina, D. 2018. Association of pharmacological treatments with long-term pain control in patients with knee osteoarthritis: a systematic review and meta-analysis. JAMA, 320, 2564–2579.
  • 2. Campbell, C. M., Buenaver, L. F., Finan, P., Bounds, S. C., Redding, M., McCauley, L. 2015. Sleep, pain catastrophizing, and central sensitization in knee osteoarthritis patients with and without insomnia. Arthritis Care Res (Hoboken), 67, 1387–96.
  • 3. Lazaridou, A., Martel, M. O., Cornelius, M., Franceschelli, O., Campbell, C., Smith, M. 2019. The association between daily physical activity and pain among patients with knee osteoarthritis: the moderating role of pain catastrophizing. Pain Med., 20, 916–924.
  • 4. Lawford, B. J., Hinman, R. S., Kasza, J., Nelligan, R., Keefe, F., Rini, C. 2018. Moderators of effects of internet-delivered exercise and pain coping skills training for people with knee osteoarthritis: exploratory analysis of the IMPACT randomized controlled trial. J Med Internet Res., 20, e10021.
  • 5. Fingleton, C., Smart, K., Moloney, N., Fullen, B. M., Doody, C. 2015. Pain sensitization in people with knee osteoarthritis: a systematic review and meta-analysis. Osteoarthr Cartilage, 23, 1043–56.
  • 6. Hocaoğlu, A., Berk, H. Ö., Ketenci, A. 2019. Ağrıyla Başetme Envanteri’nin geçerlik ve güvenirlik çalışması. Agri, 31, 32–41.
  • 7. Aily, J. B., de Almeida, A. C., Ramírez, P. C., da Silva Alexandre, T., Mattiello, S. M. 2021. Lower education is an associated factor with the combination of pain catastrophizing and kinesiophobia in patients with knee osteoarthritis? Clin Rheumatol., 40, 2361–7.
  • 8. Zhaoyang, R., Martire, L. M., Darnall, B. D. 2020. Daily pain catastrophizing predicts less physical activity and more sedentary behavior in older adults with osteoarthritis. Pain, 161, 2603.
  • 9. Suzuki, Y., Iijima, H., Aoyama, T. 2020. Pain catastrophizing affects stair climbing ability in individuals with knee osteoarthritis. Clin Rheumatol., 39, 1257–64.
  • 10. Roos, E. M., Roos, H. P., Lohmander, L. S. 1991. WOMAC Osteoarthritis Index—additional dimensions for use in subjects with post-traumatic osteoarthritis of the knee. Osteoarthritis and Cartilage, 7, 216-221.
  • 11. Tüzün, E. H., Eker, L., Aytar, A., Daşkapan, A., Bayramoğlu, M. 2005. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthr Cartil., 13, 28–33.
  • 12. Bryant, R. A. 1993. Memory for pain and affect in chronic pain patients. Pain, 54, 347–51.
  • 13. Hawker, G. A., Mian, S., Kendzerska, T., French, M. 2011. Measures of adult pain: Visual analog scale for pain (VAS Pain), numeric rating scale for pain (NRS Pain), McGill Pain Questionnaire (MPQ), short‐form McGill Pain Questionnaire (SF‐MPQ), chronic pain grade scale (CPGS), short form‐36 bodily pain scale (SF). Arthritis Care Res (Hoboken)., 63, S240–52.
  • 14. Sullivan, M. J. L., Bishop, S. R., Pivik, J. 1995. The pain catastrophizing scale: development and validation. Psychol Assess., 7, 524.
  • 15. Osman, A., Barrios, F. X., Gutierrez, P. M., Kopper, B. A., Merrifield, T., Grittmann, L. 2000. The pain catastrophizing scale: further psychometric evaluation with adult samples. J Behav Med., 23, 351–65.
  • 16. Süren, M., Okan, I., Gökbakan, A. M., Kaya, Z., Erkorkmaz, Ü., Arici, S.,Kahveci, M. 2014. Factors associated with the pain catastrophizing scale and validation in a sample of the Turkish population. Turkish journal of medical sciences, 44;1, 104-108.
  • 17. Kraaimaat, F. W., Evers, A. W. M. 2003. Pain-coping strategies in chronic pain patients: psychometric characteristics of the pain-coping inventory (PCI). Int J Behav Med., 10, 343–363.
  • 18. Mehta, S. P., Morelli, N., Prevatte, C., White, D., Oliashirazi, A. 2019. Validation of physical performance tests in individuals with advanced knee osteoarthritis. HSS Journal®., 15, 261–268.
  • 19. Schober, P., Boer, C., Schwarte, L. A.2018. Correlation coefficients: appropriate use and interpretation. Anesthesia & analgesia, 126;5, 1763-1768.
  • 20. Tanaka, R., Hirohama, K., Ozawa, J. 2019. Can muscle weakness and disability influence the relationship between pain catastrophizing and pain worsening in patients with knee osteoarthritis? A cross-sectional study. Brazilian journal of physical therapy, 23;3, 266-272.
  • 21. Lim, J. Y. 2022. Aging with disability: what should we pay attention to? Annals of Geriatric Medicine and Research., 26, 61-62.
  • 22. Dekker, J., Tola, P., Aufdemkampe, G., Winckers, M. 1993. Negative affect, pain and disability in osteoarthritis patients: the mediating role of muscle weakness. Behav Res Ther., 31, 203–6.
  • 23. Rice, D., Nijs, J., Kosek, E., Wideman, T., Hasenbring, M. I., Koltyn, K., et al. 2019. Exercise-induced hypoalgesia in pain-free and chronic pain populations: state of the art and future directions. J Pain., 20, 1249–66.
  • 24. Roudsari, E. G., Nasab, S. M. H. M., Ghavidel-Parsa, B., Yazdi, F., Moghadam, N. K. 2022. Personality and pain intensity in rheumatoid arthritis patients: The mediating role of pain catastrophizing and cognitive emotion regulation strategies. Pers Individ Dif., 186, 111390.
  • 25. Wertli, M. M., Burgstaller, J. M., Weiser, S., Steurer, J., Kofmehl, R., Held, U. 2014. Influence of catastrophizing on treatment outcome in patients with nonspecific low back pain: a systematic review. Spine (Phila Pa 1976)., 39, 263–73.
  • 26. Hayashi, K., Kako, M., Suzuki, K., Hattori, K., Fukuyasu, S., Sato, K., et al. 2017. Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty. World J Orthop., 8, 336.
  • 27. Cano, A. 2004. Pain catastrophizing and social support in married individuals with chronic pain: the moderating role of pain duration. Pain., 110, 656–64.
  • 28. Ozan, G., Başar, S., Erdinç, E., Ataoglu, B., Turanli, S. 2022. The relationship of kinesiophobia and pain catastrophizing with pain, range of motion, muscle strength and function in osteoarthritis. Int J Disabil Sport Heal Sci., 4, 130–9.
  • 29. Goff, A. J., Silva, D. D. O., Merolli, M., Bell, E. C., Crossley, K. M., Barton, C. J. 2021. Patient education improves pain and function in people with knee osteoarthritis with better effects when combined with exercise therapy: a systematic review. J Physiother., 67, 177-189.
  • 30. Somers, T. J., Keefe, F. J., Pells, J. J., Dixon, K. E., Waters, S. J., Riordan, P. A., et al. 2009. Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability. J Pain Symptom Manage., 37, 863–72.

Diz Osteoartriti Olan Genç Ve Yaşlı Hastaların Ağrı Ve Fonksiyonlarında Ağrıyı Felaketleştirmenin Rolü

Year 2025, Volume: 16 Issue: 2, 220 - 228, 18.08.2025
https://doi.org/10.22312/sdusbed.1536685

Abstract

Amaç: Araştırmamız, diz osteoartriti (DOA) olan genç ve yaşlı yetişkinlerde ağrı felaketleştirme düzeyinin, ağrı şiddeti, DOA ile ilişkili semptomlar ve ağrı ile başa çıkma yöntemleri üzerindeki etkisini karşılaştırmayı amaçlamaktadır.

Gereç ve Yöntemler: Çalışmamıza 45-55 yaş veya 65-75 yaş aralığında DOA'lı 128 hasta dahil edildi. Genç ve yaşlı katılımcıların sosyodemografik verileri, WOMAC (Western Ontario and McMaster Universities Osteoarthritis İndeks) ve Zamanlı Kalk ve Yürü testi (ZKYT), aktivite sırasında ve istirahatte ağrı şiddeti, ağrı felaketleştirme düzeyleri ve ağrı ile başa çıkma skorları kaydedildi.

Bulgular: KOA'lı genç hastaların ortalama yaşı 51,27±5,07 ve yaşlı hastaların ortalama yaşı 67,25±4,18 idi. KOA'lı yaşlı katılımcıların ağrı süresi daha uzun, WOMAC skorları daha yüksek ve ZKYT süreleri daha uzundu (p<0.005). KOA'lı genç hastaların ağrı felaketleştirme skorları ile aktivite sırasındaki ağrı şiddeti (r; 0,374), WOMAC skorları (r; 0,617) ve pasif başa çıkma yöntemleri (r; 0,450) arasında bir ilişki bulundu (p<0,001). KOA'lı yaşlı hastaların ağrı felaketleştirme skorları ile istirahatte ağrı şiddeti (r; 0,427), aktivite sırasındaki ağrı şiddeti (r; 0,530), ağrı süresi (r; 0,312), WOMAC skorları (r; 0,693) ve aktif ve pasif başa çıkma yöntemleri (sırasıyla r; 0,429, r; 0,299) arasında bir ilişki belirlendi (p<0,001).

Sonuç: KOA'lı yaşlı hastalar, KOA'lı genç hastalardan daha fazla ağrılı uyarıları felaketleştirmektedir. Bu durum, hastaların ağrı şiddetini, ağrı ile başa çıkma yöntemlerini ve KOA ile ilişkili semptomları daha fazla etkilemektedir. Buna bağlı olarak, KOA'lı hastaların klinik takibinde ve rehabilitasyon yaklaşımlarının belirlenmesinde, yaşın artmasıyla birlikte hastaların ağrılı uyarılardan daha fazla etkilendiği ve bu durumun hastaların semptomlarını daha fazla etkilediği göz önünde bulundurulmalıdır.

References

  • 1. Gregori, D., Giacovelli, G., Minto, C., Barbetta, B., Gualtieri, F., Azzolina, D. 2018. Association of pharmacological treatments with long-term pain control in patients with knee osteoarthritis: a systematic review and meta-analysis. JAMA, 320, 2564–2579.
  • 2. Campbell, C. M., Buenaver, L. F., Finan, P., Bounds, S. C., Redding, M., McCauley, L. 2015. Sleep, pain catastrophizing, and central sensitization in knee osteoarthritis patients with and without insomnia. Arthritis Care Res (Hoboken), 67, 1387–96.
  • 3. Lazaridou, A., Martel, M. O., Cornelius, M., Franceschelli, O., Campbell, C., Smith, M. 2019. The association between daily physical activity and pain among patients with knee osteoarthritis: the moderating role of pain catastrophizing. Pain Med., 20, 916–924.
  • 4. Lawford, B. J., Hinman, R. S., Kasza, J., Nelligan, R., Keefe, F., Rini, C. 2018. Moderators of effects of internet-delivered exercise and pain coping skills training for people with knee osteoarthritis: exploratory analysis of the IMPACT randomized controlled trial. J Med Internet Res., 20, e10021.
  • 5. Fingleton, C., Smart, K., Moloney, N., Fullen, B. M., Doody, C. 2015. Pain sensitization in people with knee osteoarthritis: a systematic review and meta-analysis. Osteoarthr Cartilage, 23, 1043–56.
  • 6. Hocaoğlu, A., Berk, H. Ö., Ketenci, A. 2019. Ağrıyla Başetme Envanteri’nin geçerlik ve güvenirlik çalışması. Agri, 31, 32–41.
  • 7. Aily, J. B., de Almeida, A. C., Ramírez, P. C., da Silva Alexandre, T., Mattiello, S. M. 2021. Lower education is an associated factor with the combination of pain catastrophizing and kinesiophobia in patients with knee osteoarthritis? Clin Rheumatol., 40, 2361–7.
  • 8. Zhaoyang, R., Martire, L. M., Darnall, B. D. 2020. Daily pain catastrophizing predicts less physical activity and more sedentary behavior in older adults with osteoarthritis. Pain, 161, 2603.
  • 9. Suzuki, Y., Iijima, H., Aoyama, T. 2020. Pain catastrophizing affects stair climbing ability in individuals with knee osteoarthritis. Clin Rheumatol., 39, 1257–64.
  • 10. Roos, E. M., Roos, H. P., Lohmander, L. S. 1991. WOMAC Osteoarthritis Index—additional dimensions for use in subjects with post-traumatic osteoarthritis of the knee. Osteoarthritis and Cartilage, 7, 216-221.
  • 11. Tüzün, E. H., Eker, L., Aytar, A., Daşkapan, A., Bayramoğlu, M. 2005. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthr Cartil., 13, 28–33.
  • 12. Bryant, R. A. 1993. Memory for pain and affect in chronic pain patients. Pain, 54, 347–51.
  • 13. Hawker, G. A., Mian, S., Kendzerska, T., French, M. 2011. Measures of adult pain: Visual analog scale for pain (VAS Pain), numeric rating scale for pain (NRS Pain), McGill Pain Questionnaire (MPQ), short‐form McGill Pain Questionnaire (SF‐MPQ), chronic pain grade scale (CPGS), short form‐36 bodily pain scale (SF). Arthritis Care Res (Hoboken)., 63, S240–52.
  • 14. Sullivan, M. J. L., Bishop, S. R., Pivik, J. 1995. The pain catastrophizing scale: development and validation. Psychol Assess., 7, 524.
  • 15. Osman, A., Barrios, F. X., Gutierrez, P. M., Kopper, B. A., Merrifield, T., Grittmann, L. 2000. The pain catastrophizing scale: further psychometric evaluation with adult samples. J Behav Med., 23, 351–65.
  • 16. Süren, M., Okan, I., Gökbakan, A. M., Kaya, Z., Erkorkmaz, Ü., Arici, S.,Kahveci, M. 2014. Factors associated with the pain catastrophizing scale and validation in a sample of the Turkish population. Turkish journal of medical sciences, 44;1, 104-108.
  • 17. Kraaimaat, F. W., Evers, A. W. M. 2003. Pain-coping strategies in chronic pain patients: psychometric characteristics of the pain-coping inventory (PCI). Int J Behav Med., 10, 343–363.
  • 18. Mehta, S. P., Morelli, N., Prevatte, C., White, D., Oliashirazi, A. 2019. Validation of physical performance tests in individuals with advanced knee osteoarthritis. HSS Journal®., 15, 261–268.
  • 19. Schober, P., Boer, C., Schwarte, L. A.2018. Correlation coefficients: appropriate use and interpretation. Anesthesia & analgesia, 126;5, 1763-1768.
  • 20. Tanaka, R., Hirohama, K., Ozawa, J. 2019. Can muscle weakness and disability influence the relationship between pain catastrophizing and pain worsening in patients with knee osteoarthritis? A cross-sectional study. Brazilian journal of physical therapy, 23;3, 266-272.
  • 21. Lim, J. Y. 2022. Aging with disability: what should we pay attention to? Annals of Geriatric Medicine and Research., 26, 61-62.
  • 22. Dekker, J., Tola, P., Aufdemkampe, G., Winckers, M. 1993. Negative affect, pain and disability in osteoarthritis patients: the mediating role of muscle weakness. Behav Res Ther., 31, 203–6.
  • 23. Rice, D., Nijs, J., Kosek, E., Wideman, T., Hasenbring, M. I., Koltyn, K., et al. 2019. Exercise-induced hypoalgesia in pain-free and chronic pain populations: state of the art and future directions. J Pain., 20, 1249–66.
  • 24. Roudsari, E. G., Nasab, S. M. H. M., Ghavidel-Parsa, B., Yazdi, F., Moghadam, N. K. 2022. Personality and pain intensity in rheumatoid arthritis patients: The mediating role of pain catastrophizing and cognitive emotion regulation strategies. Pers Individ Dif., 186, 111390.
  • 25. Wertli, M. M., Burgstaller, J. M., Weiser, S., Steurer, J., Kofmehl, R., Held, U. 2014. Influence of catastrophizing on treatment outcome in patients with nonspecific low back pain: a systematic review. Spine (Phila Pa 1976)., 39, 263–73.
  • 26. Hayashi, K., Kako, M., Suzuki, K., Hattori, K., Fukuyasu, S., Sato, K., et al. 2017. Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty. World J Orthop., 8, 336.
  • 27. Cano, A. 2004. Pain catastrophizing and social support in married individuals with chronic pain: the moderating role of pain duration. Pain., 110, 656–64.
  • 28. Ozan, G., Başar, S., Erdinç, E., Ataoglu, B., Turanli, S. 2022. The relationship of kinesiophobia and pain catastrophizing with pain, range of motion, muscle strength and function in osteoarthritis. Int J Disabil Sport Heal Sci., 4, 130–9.
  • 29. Goff, A. J., Silva, D. D. O., Merolli, M., Bell, E. C., Crossley, K. M., Barton, C. J. 2021. Patient education improves pain and function in people with knee osteoarthritis with better effects when combined with exercise therapy: a systematic review. J Physiother., 67, 177-189.
  • 30. Somers, T. J., Keefe, F. J., Pells, J. J., Dixon, K. E., Waters, S. J., Riordan, P. A., et al. 2009. Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability. J Pain Symptom Manage., 37, 863–72.
There are 30 citations in total.

Details

Primary Language English
Subjects Physiotherapy
Journal Section Araştırma Articlesi
Authors

Tuba İnce Parpucu 0000-0002-1942-6453

Merve Karapınar 0000-0003-2751-5744

Zeliha Başkurt 0000-0001-7488-9242

Ferdi Başkurt 0000-0002-8997-4172

Publication Date August 18, 2025
Submission Date August 21, 2024
Acceptance Date November 26, 2024
Published in Issue Year 2025 Volume: 16 Issue: 2

Cite

Vancouver İnce Parpucu T, Karapınar M, Başkurt Z, Başkurt F. The Role of Pain Catastrophizing in The Pain and Functions of Young and Older Patients with Knee Osteoarthritis. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2025;16(2):220-8.

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