Newswise — Recent findings indicate that the presence of chronic knee pain resulting from osteoarthritis alone does not lead to cognitive impairment. It is now understood that additional elements, such as age, pain medication, and socio-economic factors, are likely to contribute to this phenomenon.
Individuals experiencing chronic pain often report challenges in cognitive functioning, including difficulties with attention, memory, and behavioral flexibility. These cognitive functions have been associated with specific regions of the brain, namely the hippocampus and prefrontal cortex. For instance, individuals may struggle to maintain focus during conversations, encounter difficulties when learning a new route, or face challenges in adapting their commute due to road closures or construction work.
A team of researchers from the University of Nottingham's School of Life Sciences, School of Psychology, and Pain Centre Versus Arthritis conducted a study using an experimental model of osteoarthritis-like knee pain. The purpose was to investigate whether knee pain alone, without other accompanying factors commonly found in patients with knee osteoarthritis, has a direct impact on cognitive impairment. The results of the study showed no evidence that osteoarthritis-like knee pain induces memory and behavioral flexibility impairments. This suggests that chronic pain resulting from knee osteoarthritis may affect cognitive functions to a lesser extent than other chronic pain conditions, which have demonstrated significant cognitive impairments in experimental models. The research findings have been published in The Journal of Pain.
Tobias Bast, one of the researchers involved in the study, explains the significance of the findings, stating, "Cognitive function plays a vital role in daily activities, and individuals with knee pain often report cognitive impairments. Understanding the impact of pain on cognitive function and identifying influencing factors are crucial in improving cognitive abilities and quality of life for individuals with knee osteoarthritis. Our new findings, combined with studies involving individuals with knee osteoarthritis, shed light on potentially modifiable factors such as pain medication and social engagement. These factors seem to be necessary for knee pain to have an adverse effect on cognition."
The recent findings obtained from the experimental model of knee osteoarthritis pain complement another recent study conducted in Nottingham, which demonstrated that individuals with knee osteoarthritis do experience pain-related cognitive impairment. Notably, in human subjects, it was discovered that pain interacts with various other factors, contributing to the decline in cognitive function. The study highlighted that social deprivation, in conjunction with chronic pain, impairs cognitive abilities such as memory and concentration. This impairment can pose challenges in carrying out daily activities like shopping or household chores for individuals suffering from painful osteoarthritis. Additionally, low educational attainment, partly due to its negative impact on cognitive function and increased anxiety, may make individuals with osteoarthritis more susceptible to difficulties in performing routine tasks.
Dr. Bast further explains the significance of the experimental model, stating, "The experimental model allows us to isolate the impact of chronic knee pain from other factors, which is not feasible in human studies. Interestingly, unlike the experimental model, individuals with knee osteoarthritis do exhibit pain-related cognitive impairment. However, our findings from the experimental model, where we can exclusively examine the influence of chronic knee pain apart from other factors, suggest that knee pain alone is not sufficient to cause cognitive impairment. This indicates that in humans, knee pain may impair cognitive functions by interacting with other factors commonly associated with knee osteoarthritis, such as advanced age, socio-economic factors, and pain medication. Some of these factors, including age and pain medication, can be directly investigated in the experimental model, providing us with an opportunity to explore how they interact with chronic pain to induce cognitive impairment."
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