A Mediation Appraisal of Catastrophizing, Pain-Related Outcomes, and Race in Adults With Knee Osteoarthritis

Overview

Journal J Pain

Specialties Neurology
Psychiatry

Date 2021 May 25

PMID 34033964

Citations 11

Authors

Dottington Fullwood

Rebecca N Gomez

Zhiguang Huo

Josue S Cardoso

Emily J Bartley

Staja Q Booker

Keesha L Powell-Roach

Alisa J Johnson

Kimberly T Sibille

Adriana S Addison

Burel R Goodin

Roland Staud

David T Redden

Roger B Fillingim

Ellen L Terry

Affiliations

Soon will be listed here.

Abstract

The current cross-sectional study investigates whether pain catastrophizing mediates the relationship between ethnicity/race and pain, disability and physical function in individuals with knee osteoarthritis. Furthermore, this study examined mediation at 2-year follow-up. Participants included 187 community-dwelling adults with unilateral or bilateral knee pain who screened positive for knee osteoarthritis. Participants completed several self-reported pain-related measures and pain catastrophizing subscale at baseline and 2-year follow-up. Non-Hispanic Black (NHB) adults reported greater pain, disability, and poorer functional performance compared to their non-Hispanic White (NHW) counterparts (Ps < .05). NHB adults also reported greater catastrophizing compared to NHW adults. Mediation analyses revealed that catastrophizing mediated the relationship between ethnicity/race and pain outcome measures. Specifically, NHB individuals reported significantly greater pain and disability, and exhibited lower levels of physical function, compared to NHW individuals, and these differences were mediated by higher levels of catastrophizing among NHB persons. Catastrophizing was a significant predictor of pain and disability 2-years later in both ethnic/race groups. These results suggest that pain catastrophizing is an important variable to consider in efforts to reduce ethnic/race group disparities in chronic pain. The findings are discussed in light of structural/systemic factors that may contribute to greater self-reports of pain catastrophizing among NHB individuals. PERSPECTIVE: The current study examines whether pain catastrophizing mediates the relationship between ethnicity/race and OA-related pain, disability, and functional impairment at baseline and during a 2-year follow-up period in non-Hispanic Black and non-Hispanic White adults with knee pain. These results point to the need for interventions that target pain catastrophizing.

Citing Articles

Disparities in Clinical and Experimental Pain Between Non-Hispanic White and Asian American Individuals With Knee Osteoarthritis and the Role of Pain Catastrophizing: Pilot Study in Florida.

Lee C, Kwoh C, Park J, Park L, Ahn H Asian Pac Isl Nurs J. 2025; 9:e64415.

PMID: 39999436 PMC: 11897668. DOI: 10.2196/64415.

John Henryism-racial stressors among older black men with low back pain.

Fullwood D, Fallon E, Means S, Stickley Z, Booker S, Ellie-Turenne M Geriatr Nurs. 2024; 59:196-202.

PMID: 39029256 PMC: 11456388. DOI: 10.1016/j.gerinurse.2024.06.038.

Pain catastrophizing in rheumatic diseases: prevalence, origin, and implications.

Wilk M, Zimba O, Haugeberg G, Korkosz M Rheumatol Int. 2024; 44(6):985-1002.

PMID: 38609656 PMC: 11108955. DOI: 10.1007/s00296-024-05583-8.

Investigating the association between knee osteoarthritis symptoms with pain catastrophizing domains between Hispanics and non-Hispanic Whites.

Nemati D, Quintero D, Best T, Kaushal N Rheumatol Int. 2023; 44(11):2539-2546.

PMID: 37597058 DOI: 10.1007/s00296-023-05396-1.

Race, Ethnicity, and Belief in a Just World: Implications for Chronic Pain Acceptance Among Individuals with Chronic Low Back Pain.

Crouch T, Sturgeon J, Guck A, Hagiwara N, Smith W, Trost Z J Pain. 2023; 24(12):2309-2318.

PMID: 37454884 PMC: 10789909. DOI: 10.1016/j.jpain.2023.07.014.

References

Jordan J, Helmick C, Renner J, Luta G, Dragomir A, Woodard J . Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project. J Rheumatol. 2007; 34(1):172-80. View

Luong M, Cleveland R, Nyrop K, Callahan L . Social determinants and osteoarthritis outcomes. Aging health. 2012; 8(4):413-437. PMC: 3519433. DOI: 10.2217/ahe.12.43. View

Wallace I, Worthington S, Felson D, Jurmain R, Wren K, Maijanen H . Knee osteoarthritis has doubled in prevalence since the mid-20th century. Proc Natl Acad Sci U S A. 2017; 114(35):9332-9336. PMC: 5584421. DOI: 10.1073/pnas.1703856114. View

Campbell C, Buenaver L, Finan P, Bounds S, Redding M, McCauley L . Sleep, Pain Catastrophizing, and Central Sensitization in Knee Osteoarthritis Patients With and Without Insomnia. Arthritis Care Res (Hoboken). 2015; 67(10):1387-96. PMC: 4580506. DOI: 10.1002/acr.22609. View

Thirukumaran C, Cai X, Glance L, Kim Y, Ricciardi B, Fiscella K . Geographic Variation and Disparities in Total Joint Replacement Use for Medicare Beneficiaries: 2009 to 2017. J Bone Joint Surg Am. 2020; 102(24):2120-2128. PMC: 8190867. DOI: 10.2106/JBJS.20.00246. View

Friedman J, Kim D, Schneberk T, Bourgois P, Shin M, Celious A . Assessment of Racial/Ethnic and Income Disparities in the Prescription of Opioids and Other Controlled Medications in California. JAMA Intern Med. 2019; 179(4):469-476. PMC: 6450285. DOI: 10.1001/jamainternmed.2018.6721. View

Campbell L, Robinson K, Meghani S, Vallerand A, Schatman M, Sonty N . Challenges and opportunities in pain management disparities research: implications for clinical practice, advocacy, and policy. J Pain. 2012; 13(7):611-9. PMC: 3958966. DOI: 10.1016/j.jpain.2012.02.004. View

Meghani S, Polomano R, Tait R, Vallerand A, Anderson K, Gallagher R . Advancing a national agenda to eliminate disparities in pain care: directions for health policy, education, practice, and research. Pain Med. 2011; 13(1):5-28. DOI: 10.1111/j.1526-4637.2011.01289.x. View

Lape E, Selzer F, Collins J, Losina E, Katz J . Stability of Measures of Pain Catastrophizing and Widespread Pain Following Total Knee Replacement. Arthritis Care Res (Hoboken). 2019; 72(8):1096-1103. DOI: 10.1002/acr.24000. View

10.

Hunt M, Birmingham T, Skarakis-Doyle E, Vandervoort A . Towards a biopsychosocial framework of osteoarthritis of the knee. Disabil Rehabil. 2007; 30(1):54-61. DOI: 10.1080/09638280701189960. View

11.

Song J, Chang R, Dunlop D . Population impact of arthritis on disability in older adults. Arthritis Rheum. 2006; 55(2):248-55. PMC: 2757646. DOI: 10.1002/art.21842. View

12.

Edwards R, Cahalan C, Calahan C, Mensing G, Smith M, Haythornthwaite J . Pain, catastrophizing, and depression in the rheumatic diseases. Nat Rev Rheumatol. 2011; 7(4):216-24. DOI: 10.1038/nrrheum.2011.2. View

13.

Song J, Chang H, Tirodkar M, Chang R, Manheim L, Dunlop D . Racial/ethnic differences in activities of daily living disability in older adults with arthritis: a longitudinal study. Arthritis Rheum. 2007; 57(6):1058-66. PMC: 2740914. DOI: 10.1002/art.22906. View

14.

Staton L, Panda M, Chen I, Genao I, Kurz J, Pasanen M . When race matters: disagreement in pain perception between patients and their physicians in primary care. J Natl Med Assoc. 2007; 99(5):532-8. PMC: 2576060. View

15.

Dillon C, Rasch E, Gu Q, Hirsch R . Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. J Rheumatol. 2006; 33(11):2271-9. View

16.

Birch S, Stilling M, Mechlenburg I, Hansen T . The association between pain catastrophizing, physical function and pain in a cohort of patients undergoing knee arthroplasty. BMC Musculoskelet Disord. 2019; 20(1):421. PMC: 6739909. DOI: 10.1186/s12891-019-2787-6. View

17.

Hunter D, Bierma-Zeinstra S . Osteoarthritis. Lancet. 2019; 393(10182):1745-1759. DOI: 10.1016/S0140-6736(19)30417-9. View

18.

Hannan M, Felson D, Pincus T . Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J Rheumatol. 2000; 27(6):1513-7. View

19.

Edwards M, van der Pas S, Denkinger M, Parsons C, Jameson K, Schaap L . Relationships between physical performance and knee and hip osteoarthritis: findings from the European Project on Osteoarthritis (EPOSA). Age Ageing. 2014; 43(6):806-13. PMC: 4207630. DOI: 10.1093/ageing/afu068. View

20.

Meghani S . Corporatization of pain medicine: implications for widening pain care disparities. Pain Med. 2011; 12(4):634-44. DOI: 10.1111/j.1526-4637.2011.01074.x. View