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The Mental Health Impact Of OA Knee Pain

21st February 2019

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Any injury to the knee can be particularly painful. This includes the mobility issues that often arise from osteoarthritis. As the knee is so important when standing or walking, damage to the joint can have a negative impact on your ability to accomplish day-to-day tasks. It is not, however, just the physical discomfort that can make life more difficult. As with any long-term injury, chronic pain in the knee can have a negative effect on mental health. For example, it can increase the likelihood of experiencing depression or anxiety.

Causes of knee pain

Damage to the knee can be caused by sporting injuries or a range of other conditions. One of the main causes is osteoarthritis. This is the most common type of arthritis and is known to particularly affect the hips and hands as well as the knees. Indeed, it can cause discomfort to any of the body’s joints.

Osteoarthritis occurs when the smooth cartilage at the ends of your bones breaks down and thins. This cartilage should protect your joints. Without it, ligaments and tendons are forced to do more work. The area can become swollen and red. Bony spurs called osteophytes can also develop. The normal wear and tear caused to joints by daily life will become more severe and pain and stiffness become common. Once the cartilage is fully worn away, one bone will rub directly on the other. This could force the bone out of position and permanently change the shape of the joint.

This type of arthritis is most common in those over the age of 40 and affects more women than men. It is also more likely if you have a family history of arthritis. Of the approximately 10 million people in the UK who suffer from arthritis, around 9 million experience osteoarthritis.

The other most common type of arthritis is rheumatoid arthritis. In this form, pain and swelling in the joints are caused by the body’s immune system attacking itself. It is possible to have both osteoarthritis and rheumatoid arthritis at the same time. Rheumatoid arthritis and other conditions such as gout can damage the joints to the extent that they are more susceptible to osteoarthritis.

Impact on mental health

When you are experiencing chronic pain, it impacts every aspect of your life. You may attempt to avoid situations where there is a risk of the pain increasing. This can lead to you avoiding activities that you normally enjoy. When you are unable to participate in your life as you want, it can damage your self-confidence and make you feel as though you have no control over your own routine. This can easily lead to depression. You may also feel frustration at this lack of control, which can place stress upon relationships and may even result in increased aggression.

Experiencing chronic pain can be an isolating experience. It can create a divide between you and friends and loved ones who may not understand your condition. This lack of emotional support can exacerbate feelings of anger or helplessness. Relationships with other people may change as you are no longer able to engage in activities in which you would previously have participated. Having to rely on other people to assist with daily tasks can further erode self-confidence. Many people are frightened to ask for help, but this is vital if you are to find ways to manage your condition and stay in control of your life.

Even receiving a diagnosis can cause more anxiety, as it can take time to understand exactly what that diagnosis means and how you can best manage your symptoms. Try to find communities of people who have similar experiences to help provide reassurance.

Other common symptoms of long-term pain, such as fatigue and other sleep problems, difficulty with memory and concentration and potential side effects from painkilling medication can all also contribute to a deterioration in your mental health. Fear, stress and depression can then cause you to avoid potentially helpful activities such as exercise that may help improve your mood.


There is no cure for arthritis but there are ways in which the condition can be managed. This should also help improve your mental state. For the mildest forms of osteoarthritis, this can include measures as simple as wearing different footwear and exercising more. Supports and other devices are available to help reduce any strain on your joints as you go about your day-to-day life.

Some more serious cases of arthritis require painkillers or even surgery. There are, however, other risks associated with medication. When used frequently, painkillers can become less effective. They may have side effects and some have potentially addictive properties. Side effects vary from person to person, but stronger painkillers tend to have more of them. Attempting to balance these side effects with potential benefits is an often difficult task that constantly needs to be reviewed.

Painkillers also fail to treat the cause of the pain. Whilst they may reduce painful symptoms, they will not stop your cartilage from wearing away further. Similarly, taking anti-depressants may help to manage any symptoms of depression, but will not stop the underlying pain of osteoarthritis from affecting your life. That can only be achieved by finding effective ways to manage your pain so you can continue to enjoy life on your own terms.

When exercising with osteoarthritis, it is best to avoid activities that may put more strain on the knees or other affected joints. This means less running (particularly on hard surfaces such as roads) or weight-training. Good activities to minimise the impact of arthritis include cycling and swimming. Instead of increasing the strain, these forms of exercise will instead help support your joints.

Avoiding exercise completely inevitably leads to your muscles becoming weaker. This, in turn, will increase the likelihood of strains, sprains and other injuries that can increase your pain further. Exercise can also help you feel more in control of your life and release positive hormones in the brain. Talk to your doctor or physical therapist about the best exercise for you, as every case of osteoarthritis is slightly different.

The more care you take with exercise, the more likely you will be to be able to avoid the risks of painkillers and surgery in future. Knee braces are another way in which you can reduce the risk of further harm whilst remaining healthy. Your knee can be stable and supported, allowing you to continue your activities without further damaging the cartilage. Modern technology means that the quality of knee braces available is constantly being improved. Today's knee braces are smaller, lighter and more comfortable than ever before. As different knee braces are available to support different injuries and conditions, ensure that yours is designed for your specific form of arthritis. Braces for other conditions will have little effect.

Another way of dealing with the mental and emotional impact of your pain is Cognitive Behavioural Therapy, or CBT. CBT teaches people to manage their thoughts and behaviours to better cope with everyday life. For example, if you avoid exercise because you are afraid of potential pain, it can help you find methods to relax and discourage negative thoughts. It may also help you set goals for the future. Finding ways to relax is important, otherwise your stress levels (which in turn have further negative impacts on your physical health) will continue to rise.

Every person will have different methods for coping with their osteoarthritis. What is important is that you make an informed decision based upon a proper understanding of the facts. This includes the potential benefits and side effects of different treatments, based on an appreciation of not just the physical but the mental symptoms than accompany osteoarthritis and its associated pain. You can then choose the system of pain management that is best suited to you.

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