Osteoarthritis – Tackling Pain Linked Depression

Osteoarthritis can have a big impact on your life. We most often talk about the physical symptoms – pain, stiffness, loss of mobility and swelling – but the condition can also have a detrimental impact on your mental health. In this article we’ll look at the reasons why osteoarthritis is linked to pain, depression and fatigue and we’ll explore what to do to manage your mental as well as your physical wellbeing.

What is osteoarthritis?

Osteoarthritis is a chronic condition that affects the joints of the body. Any joint can be affected but it most often develops in the hips, knees, hands, neck and lower back. There are many different types of arthritis but osteoarthritis is the most common form of the disease. It occurs when the cartilage that lines the joints starts to wear away. In a healthy joint, the cartilage allows the bones to glide against each other smoothly when you move. When the joint becomes diseased and cartilage breaks down, however, the bones can start to rub against each other causing pain, stiffness and loss of movement in the joint. Osteoarthritis is a degenerative disease, which means it worsens as the condition develops. This is why the treatments offered for mild to moderate osteoarthritis differ from those available for people with more severe symptoms.

Why is osteoarthritis linked to depression, fatigue and low mood?

Alongside the physical pain of osteoarthritis, many people with the disease experience mental health impacts such as low mood, depression and fatigue. It can be hard living with chronic pain and, as well as being physically draining, it can have a negative effect on many different aspects of our life. We may find it harder to do the things we enjoy, for example, or we might struggle to continue in our career, particularly if it is physically demanding. Changes in our working life may have an impact on our finances; we might struggle to pay for everyday things or for luxuries like holidays. Our relationships might be affected and osteoarthritis can even impact our sense of identity as we are forced to give up activities that were once meaningful to us and come to terms with living with chronic pain.

People with the disease often speak about having a mix of different emotions, which can fluctuate on a daily or even hourly basis. It’s common to feel angry about the way osteoarthritis is affecting your life, for example. You might feel a sense of grief about what you’re having to give up or jealousy when you see other people doing the things you used to be able to do. Receiving a diagnosis of osteoarthritis can come as a shock. Sometimes people may deny that anything is wrong and try to carry on with life as normal. You might feel powerless and frustrated at the unwelcome changes in your body and lifestyle.

Research into pain-related distress

Arthritis UK conducted a research project called De-Stress which looks at what it means for people to live with the chronic pain caused by arthritis. It identified that pain-related distress is different from clinical depression, although the symptoms can be similar. Pain-related distress is a response to the everyday challenges of living with pain and, therefore, may not respond to anti-depressants. The De-stress project recognised that pain-related distress needs to be treated in a different way. The researchers identified the importance of self-kindness and engaging in enjoyable activities that can help to lift the mood and improve overall quality of life.

Improving quality of life with osteoarthritis

As orthopaedic consultants, we recommend that our arthritis patients take a multi-layered approach to improving their quality of life. This includes:

• Getting the right treatment: As described above, this varies from person to person, according to your symptoms, lifestyle and the severity of your condition. For mild to moderate osteoarthritis there are different non-surgical treatments available, including Arthrosamid injections which use intra-articular polyacrylamide hydrogel to treat stiffness, pain and loss of function in knee arthritis. For more severe osteoarthritis, you are likely to need surgery, such as conventional joint replacement or Mako robotic arm-assisted joint replacement. In England from 1 April 2022 to 31 March 2023, there were 74,000 hip replacement procedures. Over the same period, there were 85,000 knee replacements. 85.7% of hip replacement patients and 74.2% of knee replacement patients said they felt ‘much better’ after surgery.
• Making minor adjustments to your everyday life can help you stay healthy and well. For example, reducing trip hazards in your home can minimise your risk of falls and staying warm in cold weather can help relieve pain and stiffness in arthritic joints.
• Keeping active is important to help joints stay supple and flexible. Physical activity can help manage arthritis symptoms as well as helping you feel better mentally. Choose activities that you can do without further damaging your joints – for example, walking, yoga or swimming.
• Maintaining a healthy body weight can relieve pressure on damaged joints and reduce inflammation in your body. Every pound of excess weight puts four pounds of extra pressure on your joints. Also fat cells are linked to inflammation throughout your body so loosing excess weight can have multiple benefits.
• Being honest about how you’re feeling can help you feel less isolated. Telling people that you need to pace yourself and to rest when you feel tired means you can still enjoy socialising but without overstretching yourself or having to pretend.

For information and advice about managing osteoarthritis symptoms and the treatments that are available, contact us.

Talk to an orthopaedic consultant | Cambridge