Knee osteoarthritis pain 'amplified by poor sleep and negative attitudes'

Knee osteoarthritis patients are more likely to experience intense pain when they have poor sleep habits and a tendency towards negative attitudes, according to a new US study.

Led by Johns Hopkins University in Baltimore, the research project was the largest and most comprehensive examination of the relationship between sleep disturbance, catastrophising and central sensitisation in knee osteoarthritis, with a total 208 participants enrolled.

Central sensitisation is a type of hypersensitivity that causes an amplification of clinical pain, and can be an issue for knee osteoarthritis patients that affects their quality of life.

For this study, the patients were separated into four groups: osteoarthritis patients with insomnia, osteoarthritis patients with normal sleep habits, healthy controls with insomnia, and healthy controls without a pain syndrome and normal sleep.

According to results published in the medical journal Arthritis Care & Research, subjects with knee osteoarthritis and insomnia experienced the greatest degree of central sensitisation compared to the controls.

This was particularly the case in those with a tendency to catastrophise, or be consumed by thoughts of pain. Central sensitisation was also demonstrated to be significantly associated with increased clinical pain.

Lead author Dr Claudia Campbell, from the Department of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine, said: "Understanding the intricate relationship between sleep, central sensitisation and catastrophising has important clinical implications for treating those with chronic pain conditions such as knee osteoarthritis."

The Arthritis Research UK Pain Centre at the University of Nottingham is currently investigating the different pain pathways that drive the pain of osteoarthritis of the knee, with the intention of targeting different treatments for different subgroups of patients based on psychological profiles.

Researchers have identified that anxiety, stress and low mood are associated with changes in how the central nervous system processes pain signals - an important finding that could lead to new and better treatment targets in this group of patients.

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