Exploring the relationship between disease-related pain and cortisol levels in women with osteoarthritis

Carlesso, Lisa C.; Sturgeon, John A.; Zautra, Alex

doi:10.1016/j.joca.2016.06.018

Cited by 25 publications

(17 citation statements)

References 45 publications

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“…This finding may explain why weight loss may be directly associated with pain level 28 and that the strategic approach to decrease pain could allow individuals to do more exercise. A recent study showed that in women with OA, disease-related pain was positively associated with cortisol production, particularly with greater pain intensity 29 . Pain is a potential stressor and activator of the hypothalamic-pituitary-adrenal axis, which has been related to increased visceral obesity 30 .…”

Section: Discussionmentioning

confidence: 99%

Level of obesity is directly associated with the clinical and functional consequences of knee osteoarthritis

Raud

Gay

Guiguet‐Auclair³

et al. 2020

Sci Rep

147

101

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obesity is one of the most important risk factors of knee osteoarthritis (KoA), but its impact on clinical and functional consequences is less clear. the main objective of this cross-sectional study was to describe the relation between body mass index (BMi) and clinical expression of KoA. participants with BMi ≥ 25 kg/m 2 and KOA completed anonymous self-administered questionnaires. They were classified according to BMI in three groups: overweight (BMI 25-30 kg/m 2), stage I obesity (BMI 30-35 kg/m 2) and stage II/III obesity (BMI ≥ 35 kg/m 2). the groups were compared in terms of pain, physical disability, level of physical activity (PA) and fears and beliefs concerning KOA. Among the 391 individuals included, 57.0% were overweight, 28.4% had stage I obesity and 14.6% had stage II/III obesity. Mean pain score on a 10-point visual analog scale was 4.3 (SD 2.4), 5.0 (SD 2.6) and 5.2 (SD 2.3) with overweight, stage I and stage II/III obesity, respectively (p = 0.0367). The mean WOMAC function score (out of 100) was 36.2 (SD 20.1), 39.5 (SD 21.4) and 45.6 (SD 18.4), respectively (p = 0.0409). The Knee Osteoarthritis Fears and Beliefs Questionnaire total score (KOFBEQ), daily activity score and physician score significantly differed among BMI groups (p = 0.0204, p = 0.0389 and p = 0.0413, respectively), and the PA level significantly differed (p = 0.0219). We found a dose-response relation between BMI and the clinical consequences of KOA. Strategies to treat KOA should differ by obesity severity. High PA level was associated with low BMi and contributes to preventing the clinical consequences of KoA.

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Section: Discussionmentioning

confidence: 99%

Level of obesity is directly associated with the clinical and functional consequences of knee osteoarthritis

Raud

Gay

Guiguet‐Auclair³

et al. 2020

Sci Rep

147

101

View full text Add to dashboard Cite

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“…Pain has been associated with elevations in cortisol and increased cortisol exposure [3]. When examining the correlation between the change in pain level and the relative percentage change in cortisol no significant correlation was found ( Figure 4A).…”

Section: Reported Changes In Pain (Vas) Did Not Correlate With Changementioning

confidence: 96%

“…Pain, as a result of inflammation and degeneration, is a significant symptom of OA. In response to pain, the stress-axis is activated, resulting in increased circulating cortisol levels [3]. Over time, chronic pain associated stress can lead to cortisol dysfunction and widespread inflammation, thus exacerbating inflammationassociated joint degeneration [4].…”

Section: Introductionmentioning

confidence: 99%

Manual therapy is effective in reducing VAS pain scores in patients with osteoarthritis

Stoski¹,

Evans²

2019

Phys Ther Rehabil

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Osteoarthritis (OA) affects more than 30 million American adults over the age of 40. Current physical therapy treatment regimes to treat OA do not always include manual therapy and the efficacy of manual therapy remains controversial. Additionally, pain associated with OA can lead to increased stress and cortisol exposure. Our goal was to determine if manual therapy, in addition to prescriptive exercise and ultrasound, is more effective in reducing OA-associated pain and cortisol exposure as compared to prescriptive exercise and ultrasound alone. We hypothesized that the addition of manual therapy would promote an increased reduction in pain and cortisol. Participants were randomly assigned to either a control group (n=19) receiving ultrasound (US) and prescriptive exercise or to an experimental group (n=24) receiving manual therapy in addition to US and prescriptive exercise over a 6-week treatment period. Outcome measures included change in visual analogue scale (VAS) pain level and change in basal salivary cortisol levels. Participants who received the manual intervention experienced a significantly greater reduction in pain level and this was more evident among women, participants with low or normal BMI scores and participants with affected weight-bearing joints. No correlation between change in pain-level and change in basal cortisol was found. Limitations of this study include the small sample size, the length of the study follow up and extrinsic factors that are difficult to control for including stressors in the environment and timing of medication ingestion as it related to cortisol collection time. Overall our data support the efficacy of manual therapy in a physical therapy plan of care to promote the reduction of OA associated pain.

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“…Results from two studies suggest possible gender related differences in cortisol and pain associations, which has been reported in other non-OA related stress studies. 249 Carlesso et al 250 found that pain was positively associated with increased saliva cortisol levels throughout the day in female OA patients. In this study however, cortisol levels upon awakening were not measured and this would have provided a better indication whether the diurnal pattern of cortisol secretion was also disrupted in these OA patients.…”

Section: Endogenous Glucocorticoidsmentioning

confidence: 99%

Arthritis and the role of endogenous glucocorticoids

2020

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Rheumatoid arthritis and osteoarthritis, the most common forms of arthritis, are chronic, painful, and disabling conditions. Although both diseases differ in etiology, they manifest in progressive joint destruction characterized by pathological changes in the articular cartilage, bone, and synovium. While the potent anti-inflammatory properties of therapeutic (i.e., exogenous) glucocorticoids have been heavily researched and are widely used in clinical practice, the role of endogenous glucocorticoids in arthritis susceptibility and disease progression remains poorly understood. Current evidence from mouse models suggests that local endogenous glucocorticoid signaling is upregulated by the pro-inflammatory microenvironment in rheumatoid arthritis and by aging-related mechanisms in osteoarthritis. Furthermore, these models indicate that endogenous glucocorticoid signaling in macrophages, mast cells, and chondrocytes has anti-inflammatory effects, while signaling in fibroblast-like synoviocytes, myocytes, osteoblasts, and osteocytes has pro-inflammatory actions in rheumatoid arthritis. Conversely, in osteoarthritis, endogenous glucocorticoid signaling in both osteoblasts and chondrocytes has destructive actions. Together these studies provide insights into the role of endogenous glucocorticoids in the pathogenesis of both inflammatory and degenerative joint disease.

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Exploring the relationship between disease-related pain and cortisol levels in women with osteoarthritis

Cited by 25 publications

References 45 publications

Level of obesity is directly associated with the clinical and functional consequences of knee osteoarthritis

Level of obesity is directly associated with the clinical and functional consequences of knee osteoarthritis

Manual therapy is effective in reducing VAS pain scores in patients with osteoarthritis

Arthritis and the role of endogenous glucocorticoids

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