The relationship between mental health and foot pain

NewsBot · Jan 29, 2014

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The relationship between mental health and foot pain.
Butterworth PA, Urquhart DM, Cicuttini FM, Menz HB, Strauss BJ, Proietto J, Dixon JB, Jones G, Wluka AE.
Arthritis Care Res (Hoboken). 2014 Jan 27.

Objectives Although mental health is related to the persistence of musculoskeletal pain, our understanding of the relationship between mental health and foot pain is limited. Subsequently, we conducted a three year longitudinal study to examine the relationship between mental health and foot pain in a community based population.

Methods Eighty-three community dwelling participants (mean body mass index 35.3 kg/m2 ± 9.0) who had foot pain at study inception in 2008, and for whom measures of mental health (Mental Component Summary of the Short Form-36) were available, were invited to take part in this follow-up study in 2011. Change in foot pain was determined by the difference between the Manchester Foot Pain and Disability Index score at baseline and follow up; therefore, a decrease in the score indicates improved foot pain and an increase indicates deterioration in foot pain. Linear regression was used to determine the factors affecting change in foot pain.

Results Of the 62 respondents (75% response rate, 49 females and 13 males), there were 27 (44%) whose foot pain deteriorated. A higher Mental Component Summary score of the Short Form-36 at baseline was associated with a slower progression of foot pain (beta coefficient -0.29, 95% confidence interval -0.42 to -0.01); adjusted for age, sex, body mass index and physical health.

Conclusion Mental health is associated with changes in foot pain. Clinicians dealing with this population should consider the contribution of mental health in their management and treatment of foot pain.
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Admin2 · Mar 22, 2014

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NewsBot · Mar 22, 2014

Psychological variables associated with foot function and foot pain in patients with plantar heel pain.
Cotchett MP, Whittaker G, Erbas B.
Clin Rheumatol. 2014 Mar 20.

It is widely accepted that psychological variables are associated with self-reported pain and self-reported physical function in patients with musculoskeletal pain. However, the relationship between psychological variables and foot pain and foot function has not been evaluated in people with plantar heel pain. Eighty-four participants with plantar heel pain completed the Depression, Anxiety and Stress Scale short version (DASS-21) and Foot Health Status Questionnaire. Using a hierarchical regression analysis, a baseline model with age, sex and BMI explained 10 % of the variability in foot function. The addition of depression and stress in separate models explained an additional 7.3 % and 8.1 % of foot function scores, respectively. In the respective models, depression was a significant predictor (β = -0.28; p = 0.009) as was stress (β = -0.29; p = 0.006). Females drove the effect between stress and foot function (β = -0.50; p = 0.001) and depression and foot function (β = -0.53; p < 0.001). In regression models for foot pain, depression, anxiety and stress did not contribute significantly to pain scores. When the data was stratified by sex, stress (β = -0.36; p = 0.024) and depression (β = -0.41; p = 0.013) were significantly associated with foot pain in females but not in males. For participants with plantar heel pain, stress and depression scores were significantly associated with foot function but not foot pain. When the data was stratified by sex, stress and depression were significant predictors of foot pain and function in females.
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NewsBot · Oct 3, 2018

The Effect of Depression on Pain Perception and Function in the Foot and Ankle Patient
Shannon Alejandro, MD, Matthew Geswell, MD, Louis Grandizio, DO, Jove Graham, PhD, Gerard Cush, MD
AOFAS Annual Meeting 2018 1

Introduction/Purpose: Foot and ankle (FA) pain can be found in up to 20% of the adult population.1 Etiologies are multifactorial
and include neurologic injury, trauma, deformity, tendinopathies and
psychological factors. The purpose of this investigation is to assess psychological factors contributing to FA pain in surgical and
nonsurgical patients. By identifying how psychological factors influence patient reported pain and disability, clinicians may be able
to develop interventions to decrease catastrophic thinking and improve psychological well-being prior to considering surgical
intervention
Methods: All patients seen in a FA clinic by a single fellowship trained orthopaedic surgeon from August 2016 to October 2016
were included. All patients completed 5 functional assessments prior to their visit (PHQ-2, VAS Pain Scale, FAAM, PSEQ, PCS).
We divided the patients into two groups based on their performance on the PHQ (PHQ < 3, or PHQ = 3), which measures
depression. Scores = 3 are indicative of clinical depression. Nonparametric Wilcoxon testing was used to determine whether
the distributions of the other scores (VAS Pain Scale, FAAM, PSEQ and PCS) were significantly different between these two
groups.
Results: Of the 225 patients included in our analysis, there were 175 (88%) had PHQ-2 depression scores of < 3 (Group 1) and
50 (22%) had scores = 3 (Group 2). Group 2 demonstrated a statistically significant increase in VAS Pain Scale and PCS. In
addition, patients in Group 2 showed statistically significant decreases in FAAM and PSEQ. Patients in Group 2 were statistically
more likely to be obese, use tobacco, and be unemployed.
Conclusion: In patients with common FA complaints, those with clinical depression, as assessed by the PHQ-2, demonstrated
increased pain scores, decreased ability to cope with pain, and lower functional outcome scores compared to patients without
depression. Tobacco use, obesity and employment status were found to independently affect pain, coping, and function of
patients. These data suggest that depression can significantly affect a patient’s ability to cope with pain and to achieve a higher
functional outcome. This data suggests patients with depression may have increased difficulty coping with their FA ailment leading
to the need for increased counseling regarding expected outcomes.
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