A South Korean study of 660 men and women, all older than 65, found that being depressed can make symptoms of knee osteoarthritis feel worse.
Researchers used X-rays to measure how severe each subject’s osteoarthritis was. Naturally, those with the most damage reported the most pain. However, some of the subjects with mild to moderate arthritis also reported severe pain.
Now, setting aside limitations of X-ray measurements (and there are many, for conditions that involve soft tissues), what can we learn here?
An Arthritis Today article about this study quotes Jon T. Giles, an assistant professor of medicine at Columbia University:
“Painful sensations are relayed through the brain in a very complex way, and can be modulated up or down,” he says. With stress, poor sleep, anxiety and depression, which are known to influence pain levels, “stimuli feel more painful than they would in someone without the adverse psychosocial factors.”Now here are a few of my thoughts.
And if you have knee pain, you’ll be relieved to know that none equates to “Don’t worry, be happy.”
Because chronic knee pain stinks.
Of course there’s a good chance you’re depressed. If you’re anything like I was, you’re depressed because you have discomfort and pain most of the time. You’re depressed because merely climbing a set of stairs or carrying your toddler across the room causes a flare-up in your joints. You’re depressed because you know that almost everything you want to do in your life will involve your knees, and you’re doubtful that they’ll ever be normal again.
In short, you have a lot of very good reasons for feeling depressed.
Negativity levies a real tax on your body. That’s an inescapable truth. So even though you may be perfectly justified in your anger/bitterness/sadness, you have to realize you’re paying a price for it.
What to do? Here are a couple of ideas.
First, consider a de-stressing activity, such as meditation. I did it for a while, during my knee pain recovery (this was a period, by the way, when it wasn’t just my knees giving me problems). I found it useful.
Second, get into a long-term program that has one objective: healing your knees. This will restore something that is essential to getting better: hope.
This brings me to a closing rant.
In the Arthritis Today article, reactions to the study above included this suggestion: that care providers such as doctors screen patients for conditions such as depression and refer them for treatment (drugs, etc.) when needed.
I can imagine, upon hearing this, a gathering of doctors murmuring in approving tones, “Yes, yes, that sounds like an excellent idea.”
Here’s what irks me about that seemingly sensible suggestion. One major reason that knee pain patients suffer depression is because no one shows them a path to escaping knee pain. In this regard, doctors are the worst, from my experience.
In many cases, I suspect (again drawing from my experience), patients bounce around among doctors who just kind of shrug and say “You have knee pain, but I wouldn’t advise surgery just yet.” Further, patients are diagnosed with unhelpful, baffling terms such as “patellofemoral pain syndrome” that don’t tell them, in clear, specific terms, what’s wrong with their knees.
And then they’re found to be depressed. Well, no kidding.
Before doctors go about blithely prescribing pills for depression related to knee pain, they might want to ask themselves if they’ve done everything possible for their patients in terms of finding a good, long-term plan for eventually escaping that pain.