We found a strong level of evidence for a relationship between depression and knee pain , limited evidence for no relationship between anxiety and knee pain , and minimal evidence for no relationship between poor mental health and knee pain .
Conclusions Despite the heterogeneity of the included studies , these data show that depression plays a significant role in knee pain , and that a biopsychosocial approach to the management of this condition is integral to optimising outcomes for knee pain
Background While it is recognized that psychosocial factors are important in the development and progression of musculoskeletal pain and disability , no systematic review has specifically focused on examining the relationship between psychosocial factors and knee pain .
We aim ed to systematic ally review the evidence to determine whether psychosocial factors , specifically depression , anxiety and poor mental health , are risk factors for knee pain .
A double-blind, randomized, placebo-controlled study of the efficacy and safety of duloxetine for the treatment of chronic pain due to osteoarthritis of the knee.
OBJECTIVE To evaluate the efficacy and safety of duloxetine in the treatment of chronic pain due to osteoarthritis of the knee . METHODS This was a 13-week , r and omized , double-blind , placebo-controlled trial in patients meeting American College of Rheumatology clinical and radiographic criteria for osteoarthritis of the knee . At baseline , patients were required to have a ≥ 4 weekly mean of the 24-hour average pain ratings . Patients were r and omized to either duloxetine 60 mg once daily ( QD ) or placebo . At week 7 , the duloxetine dosage was increased , in a blinded fashion , to 120-mg QD in patients reporting < 30 % pain reduction . The primary efficacy measure was Brief Pain Inventory ( BPI ) 24-hour average pain . Secondary efficacy measures included Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) ; Clinical Global Impressions of Severity ( CGI-S ) . Safety and tolerability was also assessed . RESULTS Of the total ( n = 256 ) patients , 111 ( 86.7 % ) in placebo group and 93 ( 72.7 % ) in duloxetine group completed the study . Patients treated with duloxetine had significantly ( P ≤ 0.001 ) greater improvement at all time points on BPI average pain and had significantly greater improvement on BPI pain severity ratings ( P ≤ 0.05 ) , WOMAC total ( P = 0.044 ) and physical functioning scores ( P = 0.016 ) , and CGI-S ( P = 0.009 ) at the study endpoint . Frequency of treatment-emergent nausea , constipation , and hyperhidrosis were significantly higher in the duloxetine group ( P ≤ 0.05 ) . Significantly more duloxetine-treated patients discontinued the trial because of adverse events ( P = 0.002 ) . CONCLUSIONS Treatment with duloxetine 60 mg to 120 mg QD was associated with significant pain reduction and improved function in patients with pain due to osteoarthritis of the knee
We found a strong level of evidence for a relationship between depression and knee pain , limited evidence for no relationship between anxiety and knee pain , and minimal evidence for no relationship between poor mental health and knee pain .
Conclusions Despite the heterogeneity of the included studies , these data show that depression plays a significant role in knee pain , and that a biopsychosocial approach to the management of this condition is integral to optimising outcomes for knee pain
Background While it is recognized that psychosocial factors are important in the development and progression of musculoskeletal pain and disability , no systematic review has specifically focused on examining the relationship between psychosocial factors and knee pain .
We aim ed to systematic ally review the evidence to determine whether psychosocial factors , specifically depression , anxiety and poor mental health , are risk factors for knee pain .