gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Psychological factors are more strongly related to pain in CMC-1 osteoarthritis patients than radiographic features

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  • presenting/speaker Lisa Hoogendam - Erasmus MC, Rotterdam, Netherlands
  • Mark Van Der Oest - Erasmus MC, Rotterdam, Netherlands
  • Harm Slijper - Xpert Clinic, Eindhoven, Netherlands
  • Guus Vermeulen - Xpert Clinic, Eindhoven, Netherlands
  • Ruud Selles - Erasmus MC, Rotterdam, Netherlands
  • Jarry Porsius - Erasmus MC, Harvard Medical School, Rotterdam, Netherlands

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-847

doi: 10.3205/19ifssh0934, urn:nbn:de:0183-19ifssh09347

Published: February 6, 2020

© 2020 Hoogendam et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Conservative therapy for carpometacarpal (CMC-1) osteoarthritis is not effective for all patients. However, it is not possible to predict which patients will benefit. It is known that pain before treatment is associated with outcomes of therapy, but it is not clear which factors relate to pre-treatment pain. Therefore the aim of this study was to investigate which psychological factors are related to pain prior to conservative treatment in patients with CMC-1 osteoarthritis.

Methods: Patients were included at the start of conservative treatment for CMC-1 osteoarthritis. Pre-treatment pain was measured using the Michigan Hand Outcome questionnaire (MHQ). Psychological factors were defined as anxiety and depression, measured with the Patient Health Questionnaire-4 (PHQ), pain catastrophizing, measured with the Pain Catastrophizing Scale (PCS) and illness perception, measured with the Brief Illness Perception Questionnaire (B-IPQ). X-rays were scored on presence of osteophytes, subchondral sclerosis, subluxation, joint space narrowing, cysts and STT osteoarthritis.

Two linear regression models were fitted. Model 1 consisted of patient characteristics, such as age, gender and occupational intensity, and X-ray scores. In model 2 psychological factors were added to model 2.

Results and Conclusions: 255 patients were included in this study. 75% of the patients were female, mean age was 60 years and mean MHQ pain score was 47.1 (17.3). 7,8% of the patients reported elevated PHQ scores. The first regression model with patient characteristics and X-ray scores only accounted for 3% of the variance in MHQ-pain. After adding the psychological factors to our model, 42% of the variance could be explained.

Our results show that psychological factors are more strongly related to pain levels prior to treatment in patients with CMC-1 osteoarthritis than patient characteristics and X-ray scores. More research is needed to determine whether psychological factors will also affect treatment outcomes.