This was found to be particularly true in patients with radiographic findings of less severe – mild to moderate – knee osteoarthritis,
Dr. Kim’s research team studied data taken between 2005 and 2006 from 660 Korean men and women older than age of 65. They
measured the severity of participant’s OA damage with X-rays, questioned patients about their pain and interviewed them to diagnose
depressive disorders. Those with the most joint damage reported feeling the most pain, but more surprising was that patients with mild
to moderate knee OA who were experiencing depression also reported severe pain, even if X-rays didn’t show the significant damage
that typically indicates pain.
We believe that one simple and practical option for an orthopeadic clinic would be to establish a consultation system with relevant
psychiatrists who can identify and treat depression, if found, in patients who continue to complain of severe symptoms that are discordant
with the radiographic severity of knee osteoarthritis and who do not respond to treatment modalities
Because depression might amplify pain responses in OA and other musculoskeletal conditions, Dr. Giles says, clinicians should use
antidepressants and other treatments if necessary to alter mood, rather than just prescribing medications designed to block pain.
“Antidepressant medications have been found to have analgesic as well as antidepressant effects,” agrees Dr. Kim.
Dr. Giles says it’s also important for caregivers who treat musculoskeletal conditions to screen patients for potential psychological
aggravators of pain and refer them for treatment when needed.