Research Spotlight: Mindfulness Moderates Knee Osteoarthritis Pain

By Dr. Augustine Lee

In short, what is the study about?

We analyzed how mindfulness was associated with pain, physical and psychological health among participants with symptomatic knee osteoarthritis.  For those who may not know, mindfulness is the ability or practice of maintaining a non-judgmental state of heightened awareness of one’s thoughts, emotions, or experiences on a moment-to-moment basis.

What would be the most important take-home messages from the study?

First, people who had higher levels of mindfulness tended to have better psychological health, including less stress, less depressive symptoms, and better quality of life and self-efficacy.

Second, when we analyzed the five individual facets of mindfulness, Acting-with-Awareness (the ability to attend to one’s current actions instead of behaving absent-mindedly), Non-judging (the ability to refrain from evaluating one’s sensations, thoughts, or emotions as negative or intolerable), and Describing (the ability to mentally label observed stimuli with words), were found most often associated with health outcomes in this patient population.

Third, although mindfulness did not appear to be associated with pain, the Acting-with-Awareness facet of mindfulness was found to moderate the relationship between pain and stress. In other words, most people can inherently understand that higher levels of pain tend to be associated with higher levels of stress. However, we found that among those with higher levels of mindfulness, the relationship between pain and stress was much weaker than it was among people with lower levels of mindfulness.  This is important because it suggests that mindfulness may alter the way one copes with their pain.

How are these findings important in practice?

The treatment of chronic pain disease is evolving toward a bio-psycho-social approach. Chronic pain is a very difficult symptom to manage and one way to help these patients involves helping them cope with their pain in healthier ways. Our findings suggest that by increasing mindfulness levels among patients with osteoarthritis, we may be able to reduce the psychological symptoms associated with this disease. Specifically, increased mindfulness may reduce the development of stress as a result of chronic pain.

What future studies would you recommend to further establish these results?

Randomized trials administering mindfulness-based interventions among patients with osteoarthritis can help clarify whether increased mindfulness facilitates better psychological health.

Link to the main paper: Lee, A. C., Harvey, W. F., Price, L. L., Morgan, L. P., & Wang, C. (2016). Mindfulness is associated with psychological health and moderates pain in knee osteoarthritis. Osteoarthritis and Cartilage. Advance online publication. DOI: 10.1016/j.joca.2016.06.017.

Further Reading

1. Ludwig D, Kabat-Zinn J. Mindfulness in medicine. JAMA 2008;300:1350e2.

2. Gotink RA, Chu P, Busschbach JJ, Benson H, Fricchione GL, Hunink MG. Standardized mindfulness-based interventions in healthcare: an overview of systematic reviews and meta-analyses of RCTs. PLoS One 2015;10:e0124344.

3. Goyal M, Haythornthwaite JA. Is it time to make mind-body approaches available for chronic low back pain? JAMA 2016;315:1236e7.

Dr. Augustine Lee

Dr. Augustine Lee

Augustine Lee, MD is a postdoctoral fellow at the Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, USA. His long-term career objective is to incorporate novel practices from Complementary Medicine into the field of Musculoskeletal Rehabilitation Medicine. In this post, he talks about the article he and his colleagues recently published in Osteoarthritis and Cartilage, the official journal of Osteoarthritis Research Society International (OARSI). Visit Augustine on LinkedIn or ResearchGate.

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Latest update: October 20, 2016
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