Psychotherapy for knee and hip osteoarthritis

Researchers in the United Kingdom are suggesting that people with chronic pain from knee and hip osteoarthritis may benefit from “Acceptance commitment therapy,” a form of psychotherapy.

“ACT for osteoarthritis is likely to be an acceptable treatment option for people with osteoarthritis. Acceptance commitment therapy is an effective treatment for many pain conditions and could be a useful intervention for people with osteoarthritis who have high levels of pain.”

The Acceptance commitment therapy intervention goals are success in reducing pain and sleep difficulties.1

The same group of researchers also examined the type of questionnaires that should be offered to patients with knee osteoarthritis to determine levels of hopelessness and depression. They believed patients should be asked about:

  • depression
  • anxiety
  • arthritis helplessness,
  • fatigue severity,
  • coping strategies
  • beliefs about pain control
  • illness perceptions
  • pain measures covering different aspects of osteoarthritis pain.2

At the University of Maryland, doctors examined depressive symptoms clearly associated with increases in pain and functional limitations in knee osteoarthritis patients. This research construct was to determine if depression severity accelerated problems of knee osteoarthritis and document it by radiographic and clinical assessments. They could not find evidence  that depressive symptoms have a detectable effect on changes in radiographic disease severity in knee osteoarthritis.3

While readings could not document osteoarthritis progression caused by depression, another study suggests that programmed exercise may be of great benefit physically and mentally.

Doctors in the United Kingdom write:

An exercise program was well received and has encouraged 80% of older adult participants to continue exercising after the program. The small but positive changes seen in comorbidities, benefit of the intervention, satisfaction and general health are promising. 4

1 Clarke SP, Poulis N, Moreton BJ, et al.  Evaluation of a group acceptance commitment therapy intervention for people with knee or hip osteoarthritis: a pilot randomized controlled trial. Disabil Rehabil. 2017 Apr;39(7):663-670. doi: 10.3109/09638288.2016.1160295. Epub 2016 Mar 25. [Pubmed]

2 Lincoln N, Moreton B, Turner K, Walsh D. The measurement of psychological constructs in people with osteoarthritis of the knee: a psychometric evaluation. Disabil Rehabil. 2017 Feb;39(4):372-384. doi: 10.3109/09638288.2016.1146356. Epub 2016 Mar 17. [Pubmed]

3. Rathbun AM, Yau MS, Shardell M, Stuart EA, Hochberg MC. Depressive symptoms and structural disease progression in knee osteoarthritis: data from the Osteoarthritis Initiative. Clin Rheumatol. 2017 Jan;36(1):155-163. doi: 10.1007/s10067-016-3495-3. Epub 2016 Dec 12. [Pubmed]

4 Patel S, Heine PJ, Ellard DR, Underwood M. Group exercise and self-management for older adults with osteoarthritis: a feasibility study. Prim Health Care Res Dev. 2016 May;17(3):252-64. doi: 10.1017/S1463423615000389. [Pubmed]